Enrollment Issues – CT Example

In CT, as in many States around the Country, a Health Insurance Exchange Board, caught up in bureaucratic politics of trying to manage an Exchange, allowed their complacency to hurt many people,  10,000’s if not 100,000’s.  For example,during 2015 and 2016, the cancellation rate for those signing up for a health plan during Open Enrollment on the Exchange was well over 50% within 90 days of applying, over 30% for 2017, with no explanation from the Exchange Management Team and no questioning from the Exchange’s Board.  The dis-enrollment issue was not unique to CT; however, the CT numbers seem extreme by any standards, as there should never be a 50%+ dis-enrollment within 90 days for over 2 years with no changes to the enrollment and verification process.   Today, dis-enrollment numbers remain high nationally, pointing to ongoing issues with the difficulty of administering a multi-tiered Subsidy Tax Credit program based on an income floor, instead of an income ceiling; and the lack of ability to verify future income eligibility for a Subsidy.

From an insured perspective, in CT, as an example, there were fewer people insured at the end of 2017 than were insured prior to health reform being implemented, even after accounting for Medicaid expansion.  The Small Group market, under 50 Employees, lost over 50% (over 160,000 of almost 300,000) of the people enrolled in the Small Employer plans by 2017.  At the same time, the Individual Plan enrollment stayed basically the same, with Medicaid being the only program that had an increase in the number of people being insured.

Previously submitted HHS/CMS Public Comments were more detailed and are available here: HHS Public Comment Reducing Regulatory Burdens of PPACA 12 Jun 17 and here: HHS Public Comment of PPACA Regulations 17 Feb 17.  It was a disheartening situation that so many people were left behind or outright ignored in CT.  The complete opposite of of the intent of health care reform!

 

Enrollment Issues and Workarounds (CT Example)

The links below are to documents previously released between early June 2016 and end of July 2016 that were specific to navigating many of the Enrollment Issues in CT, which were and still are common around the Country.  The former company involved, that has since been dissolved, was Health Educated, Inc.

Documents