|By John Webster, The Spokesman-Review, Spokane, Wash.|
|McClatchy-Tribune Information Services|
Friday, the state's Health Benefit Exchange released a 12-page statistical report, containing demographic details about those who have enrolled so far.
The report changes the subject, from the initial furor about technical glitches, to the human and economic questions that will determine how successful reform might be in the longer run.
The heavy traffic speaks to the level of consumer interest. Paying customers gravitated strongly to "silver" plans with a higher level of coverage. As expected, initial signups were weighted to older people who tend to have more health issues, but officials pronounced themselves pleased with the level of signups, so far, from the hard-to-persuade "young invincibles" between 18 and 34.
During its first month of operation,
Of the new
Completed signups from those who will purchase an insurance policy have been few -- a surprise to no one, since payments for a policy effective
--21,671 completed their application to buy a health insurance plan, but have not yet submitted their payment.
--72,136 are partway though the application process, but have not made final decisions about which plan to buy.
--1,516 paid for a new insurance plan and either did not qualify for a tax credit to reduce their premium, or did not seek financial help.
--4,835 paid for a new plan and did qualify for a tax credit. The credits are available up to 400 percent of federal poverty level (annual income of
--The paid-up customers divided this way, by age: 18-25, 5 percent; 26-34, 18 percent; 35-44, 19 percent; 45-54, 20 percent; 55-64, 37 percent.
--64 percent of the completed purchases were for a Silver plan covering 70 percent of average medical needs. Gold plans, covering 80 percent, attracted only 16 percent of buyers. Bronze plans, covering 60 percent, attracted 21 percent.
--57 percent of the enrollments, for both
Similarly, among paying customers, the largest numbers by far are at lower income levels, between 150 and 200 percent of poverty. This also is the level at which federal subsidy levels are the highest.
The Silver insurance plans appear to be hitting a sweet spot with consumers, Marchand said, because they reduce the out-of-pocket costs from co-pays and deductibles. This is due to federal cost-sharing subsidies, which are available in Silver plans but not for the cheaper Bronze plans. The cost-sharing subsidies, a seldom-mentioned feature of the Affordable Care Act, are in addition to the tax credits which reduce consumers' premiums. Both are calculated automatically as consumers browse the site, based on a consumer's income.
What's with the number of women? "The car industry came to this realization some decades ago," Marchand said. "A lot of times women are the leaders for financial decisions in the household. Women view the importance of having their health taken care of more so than men. But it's not so easy getting a man to go to the doctor short of blindfolding him, gagging him and getting him in the trunk."
It's still early, said Marchand, to know from
By December or January, he said, after consumers have had more time to study and make their choices, the picture will become more clear.
What about technological glitches, the cause for so much controversy at the national level?
Developers continue listening closely to feedback, he said -- from users who call the help line, insurance brokers and insurance companies whose products are being sold on the site. The most recent enhancements, he said, have been to error messages that give users more descriptive, immediate feedback when they make mistakes while filling out the website's forms. The goal is to fix problems early, he said, before the traffic really takes off later in the year.
At the toll-free call-in center for the
Traffic, Marchand said, continues to rise. He predicts many consumers will not make purchasing decisions until December when the payment deadline arrives, and others may even wait into the new year, since the enrollment window for 2014 remains open until March.
According to insurance brokers consulted by The Spokesman-Review, it's wise for consumers to take their time; health insurance policies deserve careful scrutiny, brokers say, so that consumers wind up with plans that include the hospitals and doctors they need. If a particular hospital or doctor is not among a plan's "preferred providers," the consumer will be asked to shoulder a bigger percentage of the provider's fees.
(c)2013 The Spokesman-Review (Spokane, Wash.)
Visit The Spokesman-Review (Spokane, Wash.) at www.spokesman.com
Distributed by MCT Information Services