If HealthCare.gov was a rock band this would be the time a manager might call it quits. “You’re not selling out arenas anymore my friends – our pre-sales have dropped double digits in Arizona,” you might hear whispered backstage. “The label doesn’t believe in you anymore.”
As we enter into the final two weeks of enrollment, only about 41,000 Arizonans have turned to HealthCare.gov to select 2019 health insurance coverage – a drop of 26 percent from the same time last year.
That’s bad news for the state and the stability of the individual market, but no surprise. Even as the ACA gained national popularity and Arizona’s uninsured rate fell from 15 to 10 percent in 2017, the GOP’s contempt for the law sounded like a broken record. The Trump Administration cut advertising dollars by 85 percent and slashed navigator funding for outreach.
In 2013, four Arizona organizations received more than $2 million in navigator grants. From 2014 through 2016 annual navigator funding in the state averaged $1.7 million. This year, CMS wrote a check for $300,000 to one grant recipient to cover outreach for the entire state.
Until this year, premium increases and limited competition left Arizona HealthCare.gov customers singing the blues. In 2017, premiums soared and choice fell to just two insurers: Blue Cross Blue Shield of Arizona and Health Net.
During this year’s open enrollment, HealthCare.gov features three new players in Arizona, Oscar Health, Bright Health and Cigna, a lineup designed to woo the lifeblood of the insurance industry, the young and healthy. Shoppers can choose from 18 plans on average, last year they had five. Even better news, the $311 average premium for the most popular silver plan fell 10 percent and most (85%) of Arizonans who purchase health insurance on HealthCare.gov are eligible for a subsidy this year.
While insurers grew more optimistic and the individual market stabilized, Arizona’s GOP front man Gov. Doug Ducey gave a thumbs down to the ACA when the state joined Texas v. Azar. It places Arizona in US District Court arguing the law is unconstitutional and should be repealed in its entirety. Arizona’s support of the Texas suit is in harmony with the loss of the individual mandate and Washington’s rhetoric against the ACA, which a recent Georgetown Report concluded created an “unwelcome mat” effect for those seeking coverage.
HealthCare.gov enrollment next year may not look much better. Last week, the Centers for Medicare & Medicaid Services (CMS) showcased Section 1332 waiver concepts to states that included redirecting subsidies to non-ACA plans and risk stabilization strategies including state-run reinsurance programs or high-risk pools.
We’ve heard this tune before, cheerful until you read the lyrics. For example, the federal Pre-Existing Condition Insurance Plans, which operated from 2010 to 2014, didn’t offer subsidies and on average beneficiaries paid 35 percent of their medical expenses. In its final year, the program’s net losses totaled more than $2 billion.
So far the 1332 waivers aren’t getting much airtime from local legislators – but they should.
The number of people in Arizona who purchase 2019 coverage on HealthCare.gov could fill State Farm Stadium in Glendale. In May, The Rolling Stones will play their hearts out for the crowd of more than 60,000. There will be no backstage whispers about scrapping the tour.
Politicians should work as hard.
During the OEP HealthCare.gov sold 166,000 plans in Arizona –
Effectuated enrollment in the first six months of 2018 dropped Arizona enrollment to 145,475.
By Paula Blankenship, Managing Editor
The Hertel Report