Close to 1.1M Have Selected Plans in ACA's HealthCare.gov, HHS Reports

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By Sara Hansard

Nov. 18 — Close to 1.1 million people had selected health plans for 2016 in the federal HealthCare.gov Affordable Care Act marketplace used in 38 states from Nov. 1 through Nov. 14, the HHS reported Nov. 18.

About 34 percent of those selecting plans were new consumers, the Department of Health and Human Services said in a fact sheet. Close to 2.1 million people had submitted applications for coverage.

HHS Secretary Sylvia Mathews Burwell has predicted that between 11 million and 14.1 million people will select marketplace plans in the open enrollment period from Nov. 1 through Jan. 31, and about 10 million of those people will have paid premiums and have coverage at the end of 2016—an increase of about 1 million from 2015 (219 HCDR, 11/13/15). Between 2.8 million and 3.9 million currently uninsured people are likely to gain coverage out of the 10.5 million uninsured people who qualify for coverage, Burwell said in October.

The HHS's weekly “snapshot” only looks at new plan selections and active renewals, and starting at the end of December, it will include enrollees who took no action and were automatically renewed, the department said. The snapshot doesn't include the number of consumers who paid premiums.

The HHS said that comparisons between this year's open enrollment and last year's are difficult for a variety of reasons, including the fact that the Thanksgiving holiday fell during the second week of last year's open enrollment period. In addition, Hawaii is using HealthCare.gov this year because its state-based marketplace website didn't work.

Consider Deductibles

There has been increasing concern that deductibles and other out-of-pocket expenses for marketplace plans are unaffordable for many enrollees. In a blog posting Nov. 17 titled Five Facts about Deductibles, HHS Health Insurance Marketplace Chief Executive Officer Kevin Counihan advised people to consider deductibles and factors other than premiums, such as whether their doctors are in a plan's network, when choosing plans. Primary care and generic drugs are services most likely to be covered without a deductible, Counihan said.

While people with income between 100 percent and 400 percent of the federal poverty level are eligible for premium subsidies, only people with income between 100 percent and 250 percent are eligible for cost-sharing subsidies under the ACA.

In 2015, 80 percent of consumers who weren't eligible for cost-sharing reductions who enrolled in silver-tier plans, the most popular type of plan sold in the marketplaces, selected plans with a primary care visit covered without having to meet a deductible, 82 percent had plans that covered generic drugs without a deductible and 59 percent had plans with mental health services covered without a deductible, Counihan said. All marketplace plans cover recommended preventive services without a deductible, he said.

Pilot Rx Drug Lookup Started

HealthCare.gov this year has a search tool allowing shoppers to get an estimate of out-of-pocket costs for plans. On Nov. 16 Centers for Medicare & Medicaid Services spokeswoman Lori Lodes said in an e-mail that HealthCare.gov started a pilot prescription drug lookup feature on HealthCare.gov. A pilot doctor lookup feature was added Nov. 3, but the HHS removed the ability to search by medical facilities for a brief period of time because facilities may have multiple identifier codes, which meant some consumers may have incorrectly thought a facility wasn't covered in a network, Lodes said.

Meanwhile, the Kaiser Family Foundation Nov. 18 released an analysis tracking premiums of the 2015 lowest-cost silver plans in states that used HealthCare.gov in both 2015 and 2016. A single 40-year-old adult enrolled in the lowest-cost silver plan in 2015 would see an average premium increase of 15 percent if he or she automatically re-enrolled in 2016 before any tax credit, the analysis found. In 73 percent of the counties analyzed, that person's plan would no longer be the lowest-cost option in 2016, Kaiser said.

Among those who switch to a different low-cost plan, the average premium saving would be $322 over the course of the year, Kaiser found. As the lowest-cost silver plan is the most popular type of plan on the marketplace, this suggests that a substantial share of enrollees could save money on their monthly premium by shopping and switching to a different plan in 2016.

To contact the reporter on this story: Sara Hansard in Washington at shansard@bna.com

To contact the editor responsible for this story: Janey Cohen at jcohen@bna.com