Ohio ACA insurance enrollment strong despite uncertainty

Ohio residents turned out in larger numbers this year to enroll in the Affordable Care Act health insurance marketplaces despite premium price hikes and uncertainty about the future of the health law.

A little more than 109,000 Ohioans enrolled in plans on the exchange as of Dec. 9, which is up 12 percent from the year before.

Final enrollment numbers are not available, so it’s not clear how close total enrollment was to last year’s roughly 230,000 initial sign ups.

However, a surge of last-minute enrollees were expected before the Dec. 15 deadline, which was shorter than last year’s enrollment period of Nov. 1 to Jan. 31.

Dayton-based CareSource, which sold Affordable Care Act plans in four states, reported about 250,000 people enrolled this season in its plans, compared to about 130,000 last year, when it was also selling plans in fewer counties and had less competition after other insurers stopped selling individual plans.

Steve Ringel, Ohio market president for the non-profit insurer, said the number of sign-ups met CareSource’s expectations and projected targets.

RELATED: High Medicaid, Medicare use in Dayton increases health care costsPrior to sign-ups, President Donald Trump's administration ended government payments to help lower the cost of health insurance sold on the marketplaces, adding about 11 percent more to the average premium cost in Ohio cost in 2018.

Ringel says the media attention given the ACA this year, even though much of it was negative, may have helped enrollment.

‘The biggest thing is it kept it to the forefront of people’s mind, and no matter what the news says you’re going to find out what the truth is for yourself,” he said.

Higher premiums

The average premium is up 34 percent overall for next year, continuing a steady increase over the last couple of years. The weighted average premium for an individual marketplace plan will be $5,798.83 in 2018, a 119 percent increase from 2013.

Local insurers   
Four insurers will have Affordable Care Act plans for sale next year in the area.   
InsurerAvg. rate change %Minimum rate change %Maximum rate change %
Buckeye Community Health Plan49.625.3139
Medical Health Insuring Corp.29.48.4132.2

Not everyone pays the sticker price, however. The actual price went down for some consumers because of tax credits that lowered the final cost.

The increased signups occurred even as the federal government cut how much it was spending on advertising and "navigators" who help people sign people up for insurance.

The Ohio Association of Foodbanks, which had been the biggest receiver of navigator funding in Ohio, dropped its navigator program after its funding was cut 71 percent, down from $1.7 million to about $486,000.

“The obvious and most interesting dynamic was the lack of formal media campaigns from the federal government,” Ringel said.

RELATED: Dayton’s CareSource expanding amid uncertain times for Obamacare

Zach Reat, an analyst with Health Policy Institute of Ohio, said while changes to the marketplace can have a big impact on those buying individual insurance, a relatively small number of Ohioans actually get their coverage through the marketplace.

About 5 percent of Ohioans had individual health insurance and about half of those residents bought their individual plans on the exchanges last enrollment season.

“There’s been so much attention placed on the individual market, and specifically the marketplace, but there has not been that much attention that there is a relatively small part of the population,” Reat said.

Network deals help CareSource expand

RELATED: Local ACA marketplace plans spike in cost next year

ACA marketplace enrollment 
Enrollees by county during 2016 open enrollment. 
CountyTotal enrollees
Butler County7,806
Champaign County587
Clark County2,074
Darke County1,005
Greene County3,015
Montgomery County10,486
Miami County2,162
Preble County764
Warren County5,359
Source: Centers for Medicare and Medicaid Services

Most of the plans sold by CareSource were mid-level plans, or silver plans, with moderate premiums and costs. For the 2018 benefit year, 75 percent of CareSource Marketplace consumers bought silver plans, about the same as last year.

As CareSource expanded its territory, the insurer had to reach in-network deals so people with CareSource policies could access doctors and hospitals where they live.

The insurer struck a recent deal with Kettering Health Network for in-network coverage to continue next year. Without the agreement, both major hospital systems in the Dayton area would have been out-of-network for those with ACA plans through CareSource.

Locally, in Miami County, CareSource is the only insurer selling ACA marketplace plans and remains out-of network with Premier Health, the only hospital system in the county. CareSource also just worked out deals with Holzer Health System in southeast Ohio, with a series of providers around Indiana, and with the Baptist Health, the largest non-profit health system in Kentucky.

RELATED: CareSource business is booming

Ringel said CareSource put a “tremendous amount of effort” into expanding places where its plans would provide coverage at area health facilities.

Edie Kreider, a Beavercreek resident, said while shopping for a plan for her husband Bob, who won’t qualify for Medicare for a few years, she was frustrated by the lack of options for insurance and the lack of doctors where those plans would be in-network.

Kreider said they ended up selecting CareSource, but had a last minute scare when she wasn’t sure if Kettering Health would take the plan.

“I was very disappointed this year. I just never thought it would come to this. I’m just so spoiled having insurance through my husband’s work all those years,” she said.

About the Author