Last week, Covered California’s Executive Director, Peter Lee, provided
Congress with his perspective on the results of California’s first open
enrollment period under the new Affordable Care Act. Having received in excess
of $1 billion in federal grants to fund the launch of Covered California, Mr.
Lee informed two Congressional panels that more than 3 million Californians
obtained health insurance plans or enrolled in Medi-Cal through the Exchange by
the end of the open enrollment period on March 31. While detailed
enrollment statistics are not yet public, Mr. Lee shared his appreciation of
agent-driven enrollments no less than five times throughout his testimony.
During his testimony, Mr. Lee stated, “The health plans report
that over 85 percent of consumers paid their premium for coverage starting in
January. If that trend continues, Covered California will have over 1 million
customers who will have effectuated their coverage, and we will surpass the
“enhanced enrollment scenario”.” Mr. Lee concluded that Covered
California accounts for about one-fifth of national enrollments in the
Affordable Care Act’s insurance exchanges.
CAHU Looks at the Numbers and Fnds that Questions Remain
Health insurance providers reported 85 percent of non-subsidized
customers who enrolled through Covered California’s Exchange had paid their
premium, not the aggregate number of subsidized and non-subsidized
health plan enrollments as Mr. Lee cited in his testimony. Dylan Roby, who directs
UCLA's Health Economics and Evaluation Research Program, estimates that only 10
percent of Covered California’s 1.2 million enrolls are nonsubsidized
paying customers (Medi-Cal claimed nearly 2 million of Covered California’s
enrollments). Of the 3
million aggregate enrollments through Covered California during open
enrollment, approximately 100,000 non-subsidized customers have paid
their premiums to date. While these numbers are estimates, the number Covered
California’s non-subsidized paying customers is an important economic
analytic that may bear relevance to the business sustainability of the
Exchange.
Although an additional 1.75 million non-subsidized customers
enrolled in insurance policies off the exchange, very little has been mentioned
about this group in the media - perhaps because Covered California does
not derive financial benefits from off-exchange enrollments. The off- exchange,
non-subsidized customer statistics also may be relevant to future revenue
generation discussions as Covered California weans itself from federal funding
in 2015.
Concerns have emerged about the unexpectedly low enrollment
numbers among African-American and Latino populations and compelled State
Senator Norma Torres to introduce SB 1052. CAHU supports SB 1052, which will
require the California Health Benefit Exchange to produce an independent annual
report on performance, marketing and enrollment activities. Until recently,
Covered California was exempted from complying with the Brown Act, which
requires government agencies to keep the public informed of their actions.
CAHU believes that it is in the best interest of our members to
ensure an evaluation of all aspects of the recent open enrollment period,
complete with verifiable data disclosure. Full transparency is needed if we are
to realize a successful open enrollment period later this year.
Until Next Week,
Sam