By Daniel Weintraub
California’s new online insurance marketplace signed up 31,000 customers in the first month it was open for business and another 18,000 in the first two weeks of November, officials said Wednesday.
That’s less than 1 percent of the number of people without insurance in the state, but California, through Nov. 2, still accounted for more than a third of those who signed up for insurance nationwide under the Affordable Care Act, President Obama’s signature program to overhaul the health insurance industry.
Peter Lee, executive director of CoveredCa.com, said 75 percent of those who enrolled in California in October did so despite not being eligible for tax credits offered by the federal government to help make coverage more affordable.
That number, along with the fact that those who enrolled were, on average, older than the general population, suggests that the consumers who jumped at the chance for coverage were most likely those with pre-existing health conditions who were shut out of the private health insurance system. The Affordable Care Act requires all insurers to take anyone who applies, and prohibits them from charging higher premiums to people who have been sick.
“Those are individuals who have been waiting a lifetime to get coverage,” Lee said. “They weren’t waiting to get a subsidy. They were waiting for the insurance rules to change so they would not be turned away from the door by insurance companies who wanted to basically exclude anyone who had any health history.”
Lee said he expects the composition of the exchange’s customer base to change in the months ahead.
“Next month is going to be very different,” he said.
That’s crucial, because if the customer demographics don’t change, the insurance pool in its first year in operation will likely be tilted toward older, sicker people whose care will be expensive. To make it pencil out financially, the system also needs to enroll plenty of younger, healthier people who, as a group, will use less care, allowing their premiums to help balance the books.
The state hopes to sign up at least half a million people eligible for the subsidies by March 31.
Lee said that Covered California’s enrollment numbers have already been climbing in November, with about 2,000 people per day completing the process by choosing a health plan. Numbers are not available yet on how many of those people have actually paid an insurance company for their coverage, which would begin on Jan. 1. Lee also could not say how many of his agency’s new customers were already insured, or how many had policies that were cancelled because of federal and state rules that were part of the Affordable Care Act.
Lee said another 72,000 people who contacted the exchange in October were found to be eligible for the state Medi-Cal plan, which provides essentially free care to those whose incomes are at or near the federal poverty level. The Affordable Care Act also changed the rules for Medi-Cal, opening it to people with higher incomes and to people who don’t have children living at home.
Consumers have until Dec. 15 to enroll for plans that would begin coverage Jan. 1 and until Dec. 26 to pay for those plans. The open enrollment period for the first year ends March 31. People who do not have coverage by that date could face financial penalties when they pay their taxes in 2015.