Maine health advocates gearing up for a second round of health insurance signups under the Affordable Care Act are analyzing new federal figures that shed light on their initial success.
The U.S. Department of Health and Human Services released new data this week detailing health insurance enrollment under the law by ZIP code. Statewide, 44,000 people signed up for plans through Healthcare.gov, the federal insurance marketplace launched under the health reform law.
The new data show how many plans were purchased between Oct. 1, 2013, the first day of open enrollment for plans taking effect in 2014, and April 19, 2014, the final enrollment day after federal officials approved an extension for individuals who had already started the process.
Unsurprisingly, more health plans were purchased in Maine’s populous ZIP codes in the Portland area, Bangor, Brunswick and Lewiston, the data show. But due to privacy concerns, the figures omit data for ZIP codes where residents purchased fewer than 50 plans, leading to underestimates for many of Maine’s rural areas, said Emily Brostek of Consumers for Affordable Health Care.
The data account for 39,600 Healthcare.gov plans purchased in Maine, about 90 percent of the 44,000 U.S. HHS reported in May.
The Augusta advocacy group, as part of a statewide network of consumer “navigators” and assisters, is now preparing its outreach push for the second ACA enrollment period, which kicks off Nov. 15 and ends Feb. 15, 2015.
“It’s really great planning for people like us who are trying to decide, as we go toward the next open enrollment, where are the places that might need more help or might need more resources?” Brostek said.
Some rural towns could benefit from more resources to help residents enroll, she said. While more than 1,000 health plans were purchased in Bangor, Brostek said Penobscot County overall fell short of enrollment hopes. Piscataquis County could similarly benefit from more targeted outreach, which the local community action plan will provide this fall, she said.
Health advocates particularly want to drive enrollment in rural areas, where higher shares of residents tend to lack insurance.
Wendy Wolf, president of the Maine Health Access Foundation, which organized a statewide enrollment initiative called Enroll 207, said the new data will help to target pockets of low enrollment. The ZIP code-level information will allow outreach staffers to examine their efforts and increase their presence down to individual neighborhoods, she said.
Varying factors could account for weak enrollment in certain areas, including low populations. In ZIP codes where the average age is higher, more people might be eligible for Medicare instead of a Healthcare.gov plan, Wolf noted.
In poor neighborhoods, many residents might fall into the “coverage gap,” Brostek said, a health reform law no-man’s land encompassing nearly 5.2 million Americans who live in many states, including Maine, that don’t plan to expand Medicaid to cover more low-income residents. Adults who fall into the gap earn too much to qualify for existing Medicaid programs but too little to qualify for federal financial help to buy private health insurance in the new marketplaces set up under the law.
About 25,000 people fall into the coverage gap in Maine, according to the Kaiser Family Foundation.