August 24, 2019
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Decoding Maine’s Obamacare enrollment numbers

Troy R. Bennett | BDN
Troy R. Bennett | BDN
Sara Cameron (left) helps a couple sign up for health insurance on Feb. 13 at the Portland Public Library.

New Obamacare enrollment numbers released Tuesday shed more light on Mainers who signed up for coverage in 2015.

We already knew that about 75,000 Maine residents enrolled in a plan during the second signup season under the Affordable Care Act. (That “open enrollment” period officially ended on Feb. 15.) Tuesday’s U.S. Department of Health and Human Services report captured some last-minute stragglers, putting Maine’s enrollment tally at 74,805 as of Feb. 22.

That’s far more Mainers than in 2014, when about 40,000 residents enrolled.

This time around, the state signed up about 60 percent of the 124,000 Maine residents eligible to buy a private plan on the federal health insurance marketplace, ranking Maine among the top-enrolling states in the nation.

Here are some other highlights:

Half of Maine enrollees met for the first time.

The report showed that 47 percent of Maine residents who signed up through the marketplace this time were new customers. In other words, they were people who didn’t already have coverage through as of November 2014. They may have lacked insurance or had coverage some other way, such as through work.

Mainers shopped around.

Health advocates really wanted consumers who signed up through in 2014 to come back and sniff around for a better deal in 2015. People who relied on the site to automatically renew their old plan — without updating their information or checking out other options — were at risk for big premium hikes because of the way the ACA’s subsidies are calculated.

It looks like Mainers got the message. Here, about a third of the remaining consumers who re-enrolled in a plan took the time to update their information. Of those people, 7,550 switched to a different plan than they had in 2014.

The switchers represented 19 percent of all Maine enrollees — a much higher proportion of engaged shoppers than in other insurance programs, according to the Department of Health and Human Services. For example, only about 7.5 percent of people with health coverage through work switch plans for reasons other than changing jobs.

People tend to stick with the health plan they already have. If you’ve ever waded through your plan’s benefits explanation, you know why. Shopping for health insurance isn’t exactly a thrill. But shoppers aren’t like the majority of people in Maine.

Most of us get coverage through work or government programs such as Medicaid and Medicare. shoppers buy their own plans, without the help of an HR department. The new data shows they’re more willing to shop around for the best deal.

Average premiums dipped.

In 2015, the average monthly premium for a shopper in Maine was $425. Consumers paid far less than that after applying tax credits provided under the law. In Maine, nearly 90 percent of enrollees qualified for the financial leg up. With the tax credits, Maine enrollees forked over just $93 per month on average.

In 2014, the subsidies slashed Mainers’ average premiums from $443 to $99 per month.

Premiums don’t tell the whole story.

Not all Maine enrollees wanted bargain basement plans — 71 percent of those who qualified for a tax credit could have purchased a plan that cost $50 or less per month, but only 40 percent did. Premiums play a big role in shoppers’ decisions, but consumers also want benefits that cover their doctors and prescription drugs.

Some Mainers who could have enrolled didn’t.

The report states that 88,598 Maine residents who visited were eligible to enroll in a plan. About 75,000 actually signed up. That means nearly 14,000 residents chose not to, for reasons the report doesn’t provide.

Younger Mainers signed up, but so did older residents.

In 2015, 24,652 “young people” (under age 35) signed up for a plan in Maine, according to the Department of Health and Human Services. That’s 33 percent of all Maine enrollees, a little more than the proportion last year but just under the national average of 36 percent in 2015.

The report shows that 53 percent of Maine enrollees in 2015 were between 45 to 64 years old.

The ACA’s overhaul of the insurance market for those who buy their own coverage relies on young, healthy Americans signing up to help share the risk with older, sicker consumers and keep costs from skyrocketing.

While Tuesday’s report reflects consumers who signed up for a plan through, we don’t know how many of them paid their first premium. That’s the standard most insurers use to classify customers as “enrolled.”

Also, these figures will change. Consumers can drop or pick up plans outside of open enrollment under certain circumstances, such as getting married or changing jobs.

Plus, people facing tax penalties for skipping health insurance last year now have an extra opportunity to avoid getting fined next tax season. Last month, the Department of Health and Human Services announced a special sign-up period for those who lacked coverage in 2014 and didn’t realize the ACA requires all Americans to have health insurance or pay a penalty. Now, eligible consumers can sign up from March 15 to April 30.

Correction: A previous version of this story incorrectly stated that switchers represented 22 percent of all Maine enrollees. Switchers actually represent 19 percent of Maine enrollees.

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