Nation sees increase in Obamacare enrollment, while Kynect numbers drop, but members of failed co-op can still enroll

By Melissa Patrick
Kentucky Health News

While the nation saw an increase of 4 million people sign up for private health insurance during the 2015-16 open enrollment period that ended Jan. 31, Kentucky saw a decline of 12,247. But the gap could decrease as people who were members of the failed Kentucky Health Cooperative get more time to sign up.

In Kentucky, 93,687 people signed up for private health insurance on Kynect, the state’s online health insurance marketplace, during the enrollment period, Jill MidKiff, spokeswoman for the Cabinet for Health and Family Services, said in an e-mail.

During the 2014-15 enrollment, she said a total of 105,877 Kentuckians signed up for private health insurance plans through Kynect: 102,830 of them during the regular 2015 open enrollment period and an additional 3,047 during a special, later period.

“There are many reasons this number may vary from last year,” Midkiff said. “Some who enrolled last year may now have a job that offers health insurance benefits so they no longer need to buy an individual plan. Others may have lost their jobs and their income has now dropped low enough for them to qualify for Medicaid. Others may now have reached age 65 and have transitioned to Medicare. Some others may have purchased a private insurance plan outside of the exchange.”

She also said another factor that likely affected enrollment is that about half of those with Kynect plan had to find new coverage for 2016 because the Kentucky Health Cooperative went out of business.

“Of the 102,830 individuals who enrolled in a private insurance plan through Kynect in 2015, 51,000 were in the KYHC,” Midkiff said. “Of those, 36,003 have now enrolled in another plan through Kynect this year. Of that number, 33,626 have enrolled in another private insurance plan and 2,377 now meet income eligibility requirements for Medicaid.”

That leaves 15,000 co-op members unaccounted for. Those who lost their co-op insurance still have until Feb. 29 to sign up for coverage under a provision of the Patient Protection and Affordable Care Act that allows up to 60 days from the loss of coverage to enroll through a special enrollment period, Midkiff said.

Nationwide, federal health officials reported Feb. 4 that nearly 13 million people signed up for health insurance for 2016 on the state and federal exchanges, an increase of 4 million new people on the federal exchanges alone, Jayne O’Donnell reports for USA Today. Health officials also noted that of the 9.6 million consumers who got coverage through the federal exchange for 2016, about 42 percent of them were new to it.

Department of Health and Human Services Secretary Sylvia Burwell said on a news-media call that many of the newly insured were 18 to 34, which includes more new, young enrollees than last year, O’Donnell reports.

Andrew Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, told O’Donnell that the agency’s marketing that emphasized the penalties increased enrollment, coupled with “deadline-consumers, suggests a greater number of healthy new enrollees.”

The penalty for not having health insurance this year is 2.5 percent of your income, or $695 per adult and $347 per child, with a maximum of $2,085 per family, whichever is higher.

The success of health reform depends on young, healthy people to enroll and pool the risk with older, sicker policyholders whose healthcare cost will likely exceed their premiums. This has been a challenge for participating insurance companies, along with funding restrictions that Republicans added to the 2015 omnibus spending bill that decreased funds to the “risk corridor” program that helps insurance companies deal with losses from such policyholders.

Health economist John Goodman, who opposes the ACA, told O’Donnell that this “social experiment” was an “overall failure” because “for every person insured in the exchanges there are almost three others who have elected to remain uninsured.” Goodman also said that the ACA enrollees tend to be those who get the highest subsidies or are the sickest and suggested that people find ways to “game the system” by signing up for health care, but drop it after they get treatment. Others, he noted, will drop their coverage by September, “if last year is a guide.”

Critics complained last year that the ACA enrollment numbers didn’t reflect plans that were cancelled until much later, but this year CMS enrollment numbers will reflect people whose plans are canceled in real-time, O’Donnell reports.

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