Health-Law Insurance Sign-Ups Decline

The number of consumers signing up for Affordable Care Act plans through the federal HealthCare.gov insurance marketplace declined compared with last year’s open-enrollment period, affected by challenges including a shorter sign-up window and some steep premium increases.

But the 4% falloff, to around 8.8 million sign-ups from about 9.2 million, was narrower than some insurers and analysts had projected. In addition, some state exchanges, including in California, Washington, New York and Minnesota, said sign-ups for ACA plans so far were up compared with a year ago.

The enrollment period for 2018 ACA plans ended Dec. 15 for HealthCare.gov, which is used by 39 states, but a number of insurance marketplaces operated by states are continuing to let consumers choose coverage, so a final tally on 2018 enrollment won’t be available for several weeks.

Several major ACA insurers, including Centene Corp., Health Care Service Corp. and Medica, said their own sign-ups appeared on track to meet internal projections. “We’re almost exactly on our expectations,” said Steve Ringel, president of the Ohio market for CareSource, which sells ACA plans in four states. “It’s playing out exactly as we had hoped.”

Of the 8.8 million consumers who were signed up for plans on HealthCare.gov during the federal exchange’s enrollment period, which started Nov. 1, about 2.4 million were new consumers, while 6.4 million were returning enrollees, including people automatically re-enrolled in plans.

Last year, at the close of the open enrollment period, which then lasted until the end of January, around 3 million new consumers chose plans through HealthCare.gov, 4.6 million returning enrollees signed up, and 1.6 million people were automatically re-enrolled.

Rick Notter, an executive at Blue Cross Blue Shield of Michigan, said increased premiums pushed away consumers who don’t get federal subsidies to help pay for coverage, because they bear the full brunt of the rates. “That is by far the main driver, what we’re hearing on the phone from people,” Mr. Notter said. “They’re upset.
But on the other side, many people with lower incomes, who are eligible for federal premium subsidies, found a growing array of plans for which they will pay little or nothing in premiums. That is because rates in many places went up the most on middle-tier “silver” plans, and premium subsidy amounts are linked to those plans. Some insurers and agents heavily promoted this “zero-dollar” insurance.

The subsidies are tied to the silver plans?! When O-care started I looked into the bronze plan. No subsidy, which I wouldn’t qualify as I had a 401k. My family lives into their nineties so my $400k dollars wouldn’t last in any case. My plan would cost $8k per year. I would need to pay $10k out of pocket before any benefits kicked in. Even then, drugs were not part of the plan. I wouldn’t have even applied for subsidies as I don’t believe in them AND, at the time they were automatically granted but if you were found later not to qualify they would be billed to you.

The whole scheme was stupid beyond belief. I chose not to pay. I recently had an operation. At a hospital it would have cost over $30,000. I had it done out patient, paid cash and it cost just over $5000.

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