Despite Hot Start in Insurance Enrollment, State Still Needs Big Numbers to Meet Targets

Oregon is outpacing other states, with nearly 43,000 signups on healthcare.gov, out of 2.3 million across the country. But to match last year, Oregon needs to double its enrollment by Dec. 15, while the nation must triple its own.

Midway through the open enrollment period for the individual health insurance market, Oregon is off to a hot start, but with only three weeks left till the normal window to sign up for 2018 closes on Dec. 15, the state may still fall short of 2017 enrollment.

A state-by-state enrollment breakdown from the Center for Medicare & Medicaid Services released Wednesday put Oregon at 42,834 signups through Saturday  -- one of the highest rates per capita in the country, and up from 32,406 in roughly the same period last year.

Oregon had almost twice as many enrollees as two slightly larger states -- Kentucky and Louisiana, while falling just short of Ohio, which has nearly three times as many people as the Beaver State. Oregon was behind Utah, a smaller state, possibly because Utah has not expanded Medicaid, prompting more low-income people to purchase marketplace plans in that state.

But despite the stellar start, Oregon would have to more than double the number of enrollments it gets in the rest of open enrollment  if it wants to match the 130,000 people who purchased healthcare on healthcare.gov last year.

Nationally, 2.3 million people have so far signed up in the 39 states that use healthcare.gov, compared to 9.2 million during the total open enrollment for 2017 plans. That means enrollment will have to triple in the remaining time period to maintain 2017 enrollment levels.

Chiqui Flowers, administrator of the Oregon Health Insurance Marketplace, told lawmakers last week that she anticipates that exchange enrollment will be just 75 percent of 2017 enrollment, falling below 100,000.

“It’s a shorter open enrollment period,” Flowers testified. “That is just our very conservative estimate.”

If that’s conservative, it still means that the rest of open enrollment will need to be in the ballpark of 55,000 enrollees to meet the target.

Shea Brown, an insurance agent at RJS Associates in Philomath, said the pace of enrollments have not greatly exceeded last year’s open enrollment, though she is working 10-hour days, six days a week, trying to sign up as many people as she can in the rushed open enrollment.

“It’s been a lot more difficult to figure out how to help people in the shorter time frame,” she said, noting that open enrollment is competing with the holiday season for attention.

Some observers have suggested moving the open enrollment period to the spring, when tax refunds leave household pocketbooks the fullest. With both the Christmas shopping season and heating bills rising this time of year, personal budgets are the leanest -- and the contracted open enrollment period during the holidays only exacerbates this, tacitly discouraging enrollment.

The Obama administration had planned to shorten the enrollment period starting with 2019 plans, but the Trump administration moved that up by a year. It has also released a series of YouTube videos discouraging people to avoid the exchange.

Brown’s focus is on rural communities, which have much fewer options this year. Much of her area has only Providence Health Plan -- and only three choices from them: bronze, silver or gold. In Benton County, Kaiser Permanente sells plans in Corvallis and Philomath, but those plans are oddly not sold in rural communities like Monroe, where people would likely travel to Eugene or Corvallis for care anyway.

Matthew Woodbridge, an insurance broker in Salem, differed from Brown in his observations, noting he was signing up 21 consumers a day as opposed to about 12 people a day last year. “Open enrollment is busy,” he said.

Woodbridge has a focus on immigrant communities. When Cover Oregon launched four years ago, he was one of only six Spanish-speaking brokers working with the state health insurance exchange.

His work with Latin American communities taught him to navigate the bureaucracy of families with mixed immigration status, a skill set he can now offer to Vietnamese and Middle Eastern immigrants, as well as the Pacific Islander community, despite not speaking their native languages.

Woodbridge said most of his clients have health plans that are about the same price as last year, but those with Kaiser Permanente plans are seeing their rates fall compared to last year because of the arcane formula used to set subsidy levels and the last-minute 7.1 percent increase of silver plans to make up for the loss of cost-sharing subsidies for insurers.

He said about 75 percent of his consumers have been able to get a bronze plan for $15 a month or less. The disclaimer on these plans is that they are nearly catastrophic, geared toward consumers who only anticipate a couple of office visits throughout the year. For other users, silver plans, which can be about $120 with subsidies, are generally still the better option.

Most of his clients are return customers who could sign up on healthcare.gov but choose to work with an agent. Since he’s paid a commission by insurance carriers as well as through grants from the state, this service is free to consumers: “It’s easy to make a mistake on the exchange,” Woodbridge said. “It can be a lot quicker and cleaner with an agent.”

Reach Chris Gray at chris@thelundreport.org

Correction: The article gave the wrong last name for the Salem broker, Matthew Woodbridge.

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