ACA enrollment ahead of projections

Business has been brisk for downtown Dayton-based CareSource and more than a dozen other insurers selling health plans this year through Ohio’s health insurance marketplace.

CareSource officials said enrollment in the company’s Just4Me health plans is already well ahead of 2015 projections with about two weeks left to go before the three-month open enrollment period ends Feb. 15.

“CareSource’s second year in the marketplace has been better than the first,” said Scott Streator, vice president, enterprise strategy and planning for CareSource.“We’ve already doubled our enrollment from last year with over 70,000 (members) to date.”

The enrollment figure includes new markets in Indiana and Kentucky, where CareSource has expanded its marketplace business after a successful run in Ohio. Founded as a nonprofit Medicaid managed care provider, CareSource began selling commercial health insurance for the first time last year under the auspices of the Affordable Care Act.

“We’ve already enrolled almost twice our projection (in Indiana). We’re closing in on 20,000,” Streator said. “In Kentucky, we launched in a smaller geography than we did in Indiana or Ohio, but our enrollment is right on target there with several thousand.”

CareSource sells its Just4Me health plans in 23 counties in Kentucky, and 16 in Indiana. But Ohio remains CareSource’s first and largest market, where the company has about 50,000 Just4Me members in 43 counties.

CareSource now controls about a quarter of the state’s marketplace, where enrollment stood at 196,073 through mid-January, including new and re-enrolled members, according to the latest enrollment report from the U.S. Department of Health and Human Services (HHS).

CareSource is competing for business with 15 other marketplace insurers, including Dayton-based hospital system, Premier Health, which joined the health insurance marketplace for the first time this year. Premier declined to release enrollment data until after the Feb. 15 deadline.

Marketplace insurers are likely to see a late wave of new customers as the final deadline to sign up for marketplace coverage approaches, according to local enrollment assistors and ACA counselors.

“People tend to procrastinate, but we know deadlines motivate people, and we know there will be a late surge in sign-ups as the deadline approaches,” said Stacia Dawson, outreach and enrollment specialist at Community Health Centers of Greater Dayton.

Nearly half of the 8 million Americans — including 154,668 Ohioans — who signed up for marketplace health insurance last year did so in the final seven weeks of the inaugural six-month enrollment period, according to HHS figures.

A similar surge this year could push nationwide enrollment well above revised government forecasts, although still short of original projections.

Nationwide, more than 7.1 million consumers selected or were automatically re-enrolled in federal marketplaces in 37 states, including Ohio, and 2.4 million were enrolled in the 13 states and the District of Columbia using their own marketplace platforms.

Last November, HHS predicted between 9 million and 9.9 million individuals would enroll this year in marketplace plans, which are available to most adults who don’t have work-based insurance and don’t qualify for Medicaid or Medicare.

HHS’ forecast is about 3 million shy of the Congressional Budget Office’s original projection for 2015.

Still, marketplace numbers are growing in Ohio. And combined with expanded Medicaid coverage — which has added more than 450,000 Ohioans to the state’s Medicaid rolls — the marketplace has had a profound impact on reducing the number of medically uninsured in the state.

In the nine-county Miami Valley region, nearly 25,000 residents have signed up for marketplace coverage, according to HHS figures.

“Obviously, it’s a positive for the community, given that more people now have access to medical care,” said Janine Howard, interim director of disease prevention for Public Health – Dayton & Montgomery County. “Now it’s important that we continue to help people find medical care and not just use their insurance when they go to the ER.”

Despite its success, the ACA continues to face stiff challenges from conservative lawmakers, including House Republicans, who have voted more than 50 times to repeal the law.

The votes are seen as largely symbolic because Pres. Barack Obama has vowed to veto any effort to repeal his signature health care law. But that didn’t stopped the House on Tuesday from voting once again for repeal.

Perhaps the biggest threat to the law is the King v. Burwell challenge the Supreme Court has agreed to take on. The case threatens to end government subsidies in state’s like Ohio with federally run health insurance marketplaces.

More than 80 percent of marketplace enrollees in Ohio and the rest of the nation have received financial assistance from the federal government in the form of tax credit subsidies to help cover their premiums and out of pocket costs.

“Because of government subsidies thousands of uninsured Americans, many of which live right here in the Miami Valley, have been able to get health care coverage, which was once unaffordable,” CareSource’s Streator said. “We believe the Supreme Court will rule in favor of continuing subsidies.”