February 11, 2014 – February 17, 2014

Top Successes

  • January marketplace enrollment: Enrollment continued its strong growth in January with a 53 percent increase in overall marketplace enrollment. Both the proportion of young adults and consumers receiving financial assistance increased slightly in January. Young adults made up 27 percent of enrollments in January, compared with 24 percent in October through December, and 83 percent of consumers received financial assistance in January, compared with 79 percent in October through December.  
  • State-based marketplace (SBM) improvements:
    • California: Covered California is adding hundreds of new staff, including more bilingual representatives, to increase its call center capacity. They are also working on improving aspects of the website, including the chat function and Spanish-language pages.
    • Massachusetts: The Health Connector added 300 contract staff to process a backlog of paper applications and is instituting workarounds to ensure consumers enrolled in sunsetting Connector plans stay covered.
    • Nevada: Nevada Health Link has added staff to work on improving their website and call center. Wait times for the call center have gone down from over an hour to less than 30 minutes.
    • Oregon: The Cover Oregon website is reportedly opening for enrollment with assisters and agents this week, and aiming to be available to the general public in March.

Marketplace Enrollment Update

  • New enrollment report: Last week the U.S. Department of Health and Human Services (HHS) released updated enrollment numbers for the period from October 1, 2013 through February 1, 2014 for both SBMs and federally facilitated marketplaces (FFMs). This month’s report includes more detailed breakdowns of FFM demographics and plan selection than previous reports.
  • Toplines:
    • 1.1 million Americans selected marketplace plans in January. This brings the cumulative total to 3.3 million (1.9 million in FFMs and 1.4 million in SBMs).
    • 1.6 million Americans were determined or assessed eligible for Medicaid or the Children’s Health Insurance Program (CHIP) through the marketplaces in January. This brings the cumulative total to 3.2 million. (Note: This does not include individuals who applied for Medicaid/CHIP directly through their state Medicaid agency.)
  • More young adults enrolling in marketplace plans: Enrollment among young adults (ages 18-34) grew by 65 percent between December and January, the biggest increase among any age group. Young adults now comprise 25 percent of marketplace plan purchasers.
  • More marketplace enrollees getting financial help: More consumers received financial assistance in purchasing marketplace plans in January (83 percent) than in the first three months of enrollment (79 percent). This brings the cumulative percentage of enrollees receiving financial help up to 82 percent for all four months. Also notable is the fact that 72 percent of FFM consumers who are getting financial assistance chose silver plans, which indicates that many are taking advantage of the cost-sharing reductions that are only available through these plans.

Consumer Experiences in the Field

  • Consumer issues: Enroll America’s field staff report that the most frequent issues consumers had this past week were confusion over provider networks and issues applying via HealthCare.gov (likely due to the Social Security Administration’s system maintenance, which caused a temporary outage in HealthCare.gov’s online verification system).

Challenges

  • Payment procedures: Insurers report a wide variation in the proportion of enrollees who have paid their first premium, from 70 percent among Aetna enrollees to 84 percent of Independence Blue Cross enrollees and 95 percent among Blue Cross Blue Shield Minnesota enrollees. The few SBMs that collect these data also show variation, from 67 percent in Nevada to 90 percent in Vermont. These differences are likely caused in part by variable payment policies from insurer to insurer. Adopting consumer-friendly payment systems—like easy to understand directions, flexible payment methods, and extra time to pay the first premium— will help ensure as many consumers as possible are able to pay their first premium moving forward.
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