State health insurance exchange officials released their 2014 annual report late Thursday and made a case to legislators they had a successful first full year of operations and that 2015 enrollment problems are manageable.
The exchange has increased Coloradans choices and access to health insurance and its affordability, Connect for Health Colorado officials said.
“We can do better,” interim chief executive Gary Drews said. “We’re still very much a start-up organization — basically a train heading down the track at a couple hundred miles an hour and still laying the track ahead of it.”
Appearing before a joint legislative committee on health and insurance issues late Thursday, Jan. 15, Drews said the exchange could be self-sustaining after remaining monies from $177.7 million in federal grants were used up in 2015.
Yet, he conceded, the board and managers clearly need to engage in strategic planning on how to achieve this.
Part of the 2015 strategic plan is to assess carriers a charge of $1.25 per policy per month in 2015. The exchange has statutory authority to charge up to $1.80, but the board chose not to last year or to charge the full amount this year.
Another revenue stream from operations is the 1.4 percent administrative fee charged carriers on premiums. It is currently among the lowest in the country, Drews said, and less than half that charged by the federal exchange, which is $3.50.
Drews reminded legislators he’s only been acting CEO for four months. The exchange board had interviewed eight candidates for the position by Thursday, and scheduled two more for Friday.
“We hope to be able to make an offer before the end of the month,” board chairman Sharon O’Hara said.
According to the annual report, the exchange signed up about 150,000 individual Coloradans and 335 small businesses in 2014. However, as of Dec. 31, there were 123,138 active policies. Some people had churned out of the system before year’s end.
About 58 percent of exchange enrollees received a tax credit — an average $262 a month. Their average premium for their selected plans would have cost $400 a month without it. People who purchased through the exchange without tax credits chose plans that cost, on average, of $287 a month.
In total, marketplace tax credits for Coloradans amounted to $191 million.
Sen. Kevin Lundberg, R-Berthoud, chair of the Health and Human Services Committee, accused the exchange of “padding” its number in quoting the 150,000 figure rather than 123,138. Drews said the number is the one required by federal reports, and it speaks to overall volume and revenues gained from completed enrollments.
Lundberg also wondered if the claim was valid that Colorado’s uninsured rate in Colorado fell from 17 percent to 11 percent last year. What about, he asked, the 300,000 people whose insurance policies were canceled by carriers because they were non-compliant with the Affordable Care Act. Drews said it wasn’t known how many opted for other plans and what portion stayed uninsured, but the 11 percent net figure came from a statewide Gallup Poll, not from the exchange.
Drews talked about, but downplayed, the technical problems with the 2015 enrollment site that have frustrated consumers. They also necessitated an emergency infusion of $322,000 beyond what was budgeted to resolve about 1,900 outstanding problem tickets and provide workarounds for known technical glitches through February.
Rep. Jon Keyser, R-Morrison, said costly short-term fixes couldn’t continue. “I don’t think that’s sustainable,” Keyser said. “I worry about people getting frustrated to the point they just give up.”
Lundberg said he’s heard from constituents “in tears” because they were so stymied by the enrollment process.
“For some folks there were a few technical glitches,” Drews said. “We did work through immense technology changes this year. “We obviously have some work to do to improve our technical systems.”
The exchange reported at one point there were 4,800 problem tickets representing an unknown number of individuals. Some people had generated multiple tickets.
Rancher and Rep. J. Paul Brown, R-Ignacio, said he and his wife tried to sign up after they lost their old insurance plan but, because of a number of hoops and hurdles they found objectionable, they gave up.
“I’m still a little upset about it,” Brown said. “We don’t have insurance to this day.
Rep. Jonathan Singer, D-Longmont, said he’d heard quite a few concerns from constituents, but they seemed to be tapering off. “I think we’re going on the right path,” Singer said.
Several would-be enrollees have emailed or called The Denver Post each day since mid-November to say that trying to sign up for insurance on the exchange has been one of the most exasperating, time-sucking experiences they’ve ever had as a consumer.
Drews said complicated family dynamics make eligibility and financial screening and determinations very problematic. Sen. Irene Aguilar, D-Denver, said advance premium tax credits had never been done before and “that’s why it such a nightmare.”
On an “encouraging” note, Democratic Rep. Beth McCann of Denver said, the exchange signed up many young, and presumably healthier, Coloradans. About 38 percent of the newly covered is aged 0-34. Just over 35 percent is 54 years or younger. And 27 percent is 55 and older.
Lundberg said the exchange should prepare for the possibility that Obamacare as we know it may not exist in a few years.
Date: January 20, 2015