High Medicaid enrollments and more people buying insurance in the private market resulted in fewer than expected in the exchange insurance market.
Thanks to a two-month special enrollment period that extended a Feb. 15 deadline, the state’s Washington Healthplanfinder insurance exchange has managed to sign up 16,000 additional residents, bringing the total to 170,101 in the second year of operation.
The special enrollment — which ran from Feb. 17 through April 17 — was open to consumers who either had technical difficulties in their attempts to enroll by Feb. 15 or who were not aware of the tax penalties for failing to have insurance.
While the numbers slightly exceeded the 164,000 recorded at the close of first enrollment last year, they still fell short of expectations. Washington Health Benefit Exchange, which runs Healthplanfinder, had set a goal of 213,000, a number the exchange staff had said was needed for the exchange to be self-sustaining, as required under the law.
The exchange receives a portion from premiums of plans sold through the exchange.
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Michael Marchand, the exchange’s communications director, said there were two primary reasons for the lower than expected enrollment.
First, more people than expected have qualified for Medicaid. Over the past year and a half, Medicaid has added about half a million people to its rolls in the state, boosted by expanded Medicaid coverage under the Affordable Care Act.
Second, Marchand said, more consumers than expected have opted to remain in the private insurance markets even though they might qualify for a small tax credit by purchasing insurance in the exchange. “The tax credit in some cases isn’t enough to move the needle for them,” he said.
Because of the fewer than expected enrollments, the premium assessment that goes to the exchange may rise. Marchand said the current assessment, $4.19 per premium payment each month, may increase in a worst-case scenario to just more than $13.
Marchand added, however, that the exchange has also been revising its operating budget in an effort to require lower increases in assessments.
“It’s a difficult budget environment, and not just for us but for every agency and organization,” he said.
Richard Onizuka, CEO for the Washington Health Benefit Exchange, noted in a release that since opening for business 18 months ago, nearly 2 million Washingtonians — almost 30 percent of the state’s population — have used Healthplanfinder to enroll in coverage.
“We fully expect to see increased numbers in both the individual and Washington Healthplanfinder Business marketplace as we continue to improve the system in order to best meet people’s needs,” Onizuka said.
While the April 17 deadline effectively closed general purchases of plans through the exchange, some residents still can apply for and purchase coverage if they have experienced one of several qualifying “life events,” including getting married, having or adopting a baby, moving to a new coverage area or losing other health-care coverage.