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Smart Benefits: Low Exchange Enrollment Means More Taxpayer Costs

Monday, January 06, 2014

 

The federal and state healthcare exchanges did everything possible to boost enrollment in the final days of open enrollment: they extended application deadlines, expanded customer service hours, and worked to overcome the web marketplace tech bugs. Despite it all, final enrollment for January 1 still lagged.

Federal Figures Fall Short

Obama administration officials reported 2.1 million enrolled nationally in federal and state exchanges. While the administration is celebrating this number, it falls short of the 3.3 million target for January and way behind the 7 million enrollee target by March 31st.

Low MA Membership Blamed on Technology

In Massachusetts, as of December 30th, only 497 had successfully enrolled in new subsidized health plans through Massachusetts' Health Connector. State officials placed another 22,000 people on temporary plans, paid for by the state, while the Connector works to process applications. The Massachusetts Health Connector blames the low enrollment on its information technology vendor, CGI, who developed the state's new website.

RI Enrollees Elude Targets

In Rhode Island, HealthSource RI reported 9,803 individuals enrolled in exchange plans as of the end of December (this figure does not include another 5,280 Medicaid enrollees as of November 30th). While HealthSource RI touts a jump in enrollment since early December, the total is still only about 16% of original population targets of 44,406 uninsured and 15,000 insured individuals set by the Rhode Island Health Benefits Exchange before it was renamed HealthSource RI. And the majority of HealthSources RI's enrollees are between the ages of 55-64, which will likely drive costs higher, particularly when coupled with low enrollment figures.

The Cost of Low Enrollment?

Now that enrollment figures support lower than predicted demand, what will the cost to the taxpayer be?

According to the Center for Consumer Information and Insurance Oversight, the federal government gave 99.1 million directly to Rhode Island's government to launch HealthSource RI. So far, it’s cost the U.S. taxpayer $10,109 per enrollee to set up the site - and that's just for Rhode Island.

In Rhode Island, HealthSource is asking for $26 million in the next budget, effective July 1, 2014, to keep the state exchange running. Based on 9,803 enrollees, it's going to cost the state’s taxpayers $2,652 per enrollee to maintain it.

With these numbers, now may be the time for the exchanges to take stock and examine their core purpose. If it's to help create more affordable coverage, perhaps the bureaucracy and infrastructure of too many exchanges is not the most cost effective way to help those in need.

 

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.

 

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Comments:

Here we go. The thing is just implemented, finally, and the government is already telling us that we will be paying a lot more because the government was unable to sell the program properly. Was this not one of the things that was predicted by the opponents, only to be dismissed by the leftist ideologues who run Obamacare? This thing is a complete flustercluck, and it should have been repealed. At the very least, the one year delay seems like a good move.

Comment #1 by Michael Trenn on 2014 01 06

Medicaid costs will push the RI budget to the brink in 2015 when RI will have to pay its normal share on the new enrollments.

This quote from Christine Ferguson, executive director of Health Source RI should have people shaking in the wallets as should the thoughts of Patrick Quinn who is already talking about a tax. Who are these people to decide that a tax be imposed for this. Where was this during discussion of the ACA?

“They’re affecting our ability to be sustainable,” Ferguson said.

Another advisory board member, Patrick Quinn of the Service Employees International Union, which represents nurses and other health-care workers, suggested Rhode Island could impose a tax on soda, or assess a fee on not-for-profit health-care providers that pay “outrageous” salaries to their executives.

“Let’s think big,” Quinn said, arguing that such taxes would help finance an agency ostensibly created to help drive down health-care costs and improve the health of all Rhode Islanders.

Comment #2 by Jim D on 2014 01 07

So the most up-to-date numbers (released, apparently, today) for individual enrollment on HealthSource RI is actually 11,305. And HealthSource RI is "far ahead of the internal projections for 2014 enrollment," according to this article:

http://blogs.wpri.com/2014/01/06/healthsource-ri-enrollment-quadrupled-to-11305-in-december/

Since the publication of this commentary missed the new update by a matter of hours, I'm sure GoLocal's editors plan on adding the updated number to this column. But in the meantime I figured I'd at least stick it in the comments section. JSYK.

Comment #3 by Mark Gray on 2014 01 07

Mark the targets were about 60,000. What is also not being released is the age patterns which will have a huge effect on costs.

That is all aside from the fact that the plans flat out stink.

Comment #4 by Jim D on 2014 01 07




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