Obamacare Repeal Talk Dampening Enrollment

Jan. 27--The leader of Connecticut's Obamacare exchange said he expects overall participation to fall in 2017, because people believe the Affordable Care Act has already been repealed.

Unlike previous years, there hasn't been a last-minute rush in the final weeks of open enrollment, he said. Open enrollment ends Tuesday.

"The last two weeks, we've begun to see a falloff, which is not consistent with what we've seen in the previous years," said Access Health CEO Jim Wadleigh.

He said last year's open enrollment hit about 115,000, and he thinks this year will be between 110,000 and 112,000. He had hoped it would climb slightly.

Wadleigh said he is planning a last-minute effort -- including TV appearances -- to remind people that Obamacare still exists, and there is still a penalty for not having health insurance.

Last year, Anthem had the most market share in Connecticut Obamacare plans, but that shifted dramatically this year. ConnectiCare sold 73,237 of the nearly 108,000 plans so far. Wadleigh said that's because ConnectiCare's silver-level plan was priced lower than Anthem's.

Wadleigh and the board that runs the public exchange in Connecticut voted Thursday to require companies to pay commissions to brokers next year. Because the individual plans were causing financial losses, both Anthem and ConnectiCare decided not to pay brokers to help consumers pick plans for 2017.

As a result, Access Health hired 21 brokers, at wages of $51 to $61 an hour, despite the agency's revenue dropping as more companies self-insure. The quasi-public agency is funded through an assessment on health insurance policies.

While that board vote will make it more costly for insurers to operate in Connecticut's Obamacare exchange next year, another vote aimed to save them money. Customers signing up between open enrollment periods will not get benefits until they prove they had a qualifying event.

About 500 people a month sign up for Obamacare plans between open enrollment periods. People are allowed to sign up when they lose a job, lose coverage they used to have through a spouse, move to the state without a job that offers insurance (as long as they had insurance before), or start making too much money to receive Medicaid. They can also add children to a plan between open enrollment, after a birth or adoption.

Insurance carriers complain that people who buy a plan between open enrollment periods have far higher claims, and they believe people are dropping their insurance after they get elective surgeries and after-care.

For a few months last year, Access Health started asking people to provide proof of their qualifying events, such as a job loss. They found the carriers' complaints to be fair -- Wadleigh said it wasn't unusual for that job loss to have been a year and a half ago. If the customers broke a rule in that way, they were kicked off insurance once the documents were received, but they still had the benefits for a month.

Wadleigh said carriers have said that premiums in Obamacare would be 6 to 10 percent lower if cheaters were barred from entering the system between open enrollment periods. He said the board will be watching carefully as rate requests come in for 2018, because the agency doesn't want to keep people from getting care if there's no benefit to other customers.

About 24 percent of Connecticut's Obamacare customers pay their own premiums without any government help. More than half of the Obamacare customers have such low incomes that they get premium subsidies and limits on what they spend out of pocket on co-pays.

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