ACA's state-run insurance exchanges fare better than the law's federal marketplace
09 February, 2018, 05:20
States that run their own marketplaces overcame some of those challenges, according to NASHP, through efforts such as conducting targeted outreach to key populations and improving their enrollment operations. He highlighted that almost 390,000 new consumers signed up for coverage, an increase of 5% over the prior year.
Although fewer people signed up for coverage through the state's insurance marketplace, more than 50,000 new consumers selected a plan during the final three days of open enrollment. But it remained essentially flat in the 12 state-based marketplaces and in the five states that have their own exchanges, but outsource the enrollment process to healthcare.gov.
Arizona, Louisiana and West Virginia, for example, all saw enrollment falling by more than 15 percent, which may also not bode well for 2019. Elected officials in Minnesota developed their own reinsurance system to help control premiums this year.
"Put simply, marketing matters", Lee said.
Obamacare advocates had feared that sign-ups would plummet after the Trump administration cut the open enrollment period in half, slashed advertising by 90% and reduced support for enrollment assistance.
Those states saw enrollment numbers that were pretty much the same as last year's.
"Obamacare is finished. It's dead".
Created under former President Barack Obama's health law, Covered California, the state's insurance marketplace sells health plans to people who do not get coverage from an employer, Medicare or Medicaid.
Korbulic credited the state's Republican governor, Brian Sandoval, with helping to stabilize a shaky market even as insurers stopped selling plans in the state and threatened to leave consumers in some rural areas with no choice of plans. In all, enrollment dropped by 3.7 percent nationwide, less than 7 to 13 percent decline predicted by S&P Global Ratings.
They have been buffeted for much of the past year by uncertainty over their future, with insurers in some areas raising rates steeply or exiting markets altogether.
Peter Lee, executive director of the Covered California exchange, said one reason why its numbers fell 2.3% is because it encouraged residents who don't qualify for premium subsidies to buy coverage off the exchange, where rates were cheaper for some plans.
The law offers subsidies to Americans making between 100 percent and 400 percent of the federal poverty line, or between $12,060 and $48,240 a year. But because subsidies rise alongside premiums, lower income consumers were insulated from the price hikes.
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