News Feature | January 24, 2014

Mixed Results On Health Exchange Enrollment

Source: Health IT Outcomes
Christine Kern

By Christine Kern, contributing writer

HTO Insurance Definition

Numbers fall far short of projections for sustainability of Healthcare Exchanges despite December’s increase

The Department of Health & Human Services issued its enrollment report for Healthcare Exchanges, finding nearly 2.2 million Americans have signed up for insurance through them as of December 28. This represents 1 percent of the total U.S. adult population and approximately 5 percent of the uninsured population. Of these, 54 percent were female and almost 80 percent qualified for federal subsidies to reduce their health insurance premiums.

The report revealed that in December alone there were nearly 1.8 million enrollees in state and federal marketplaces, and that December enrollment in the federal Marketplace was seven-fold greater than the combined total for October and November – and eight-fold greater for young adults ages 18 to 34.

Ipsos offers an early assessment of what is happening with the Health Exchange Enrollments, writing the Reuters/lpsos daily polls have aggregated further data that suggests although the initial wave of enrollments tended toward sicker and older individuals, there has been a growing trend in January to younger and healthier enrollees. The data reveals that “the earliest adopters – the individuals who fought through the worst of the Healthcare.gov snafus – were disproportionately suffering from major health issues. This makes sense because you would have to be very concerned with your health to deal with the challenges of the first month of the federal exchange website.”  And, the data suggests, since the start of 2014, “The exchanges are actually recruiting more healthy people than sick people.”

Despite these factors, according to the American Action Forum, total enrollment remains at only 65 percent of the HHS goal for January 1, and enrollment numbers in the HIX varies state to state. As of the end of 2013, only 10 states had met the necessary numbers to absorb their operating costs. And the 10 worst performing states all failed to enroll more than 40 percent of their goal numbers by end of year.

Added to these unimpressive numbers are the many glitches plaguing the federal healthcare website.  These glitches are also being reflected in some of the state exchange sites as well, as FOX NEWS reports.  The former head of the Congressional Budget Office Doug Holtz-Eakin flatly stated, "The back end's not working. There's no way to effectively match policies and people.” The problem is that there was not enough time for end-to-end system testing in the state exchanges to guard against such lapses. And it means that many are falling through the cracks.

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