Sign-ups for health insurance up, there are still questions

Source: The Montana Standard, ButteJan.迷你倉 19--HELENA -- Supporters of the Affordable Care Act, also called Obamacare, got some good news last week, as the feds reported a surge in sign-ups for new health-insurance policies via the law's online marketplaces in December, after the system had badly stumbled its first two months.In Montana, the news was better than average, as the state now has the second-highest rate of sign-ups in the nation, measured against its population. About 13,100 Montanans chose health plans through the marketplace by Dec. 28, or 1.3 percent of our population.Only one other state -- Vermont -- had a higher percentage of its population signed up, at 2.4 percent.But if you drill down on the numbers and other aspects of this experiment called Obamacare, you'll still find plenty of unanswered questions.Will the high percentage of older people signing up for policies drive up costs in this market in the near future? Are these policies really affordable? And, perhaps most importantly, are we really reducing the numbers of the uninsured?The short answer is, we don't know. That's not a judgment of the ACA, up or down. It just means it will be a while before get a true, accurate picture of how this very complex, ambitious law is working to achieve its goal of extending affordable health coverage to most Americans.We'll take a closer look at the questions and some possible answers, but first, a bit more on the numbers:In Montana, 13,135 people signed up for a plan through the marketplace through Dec. 28, and the numbers continue to increase.Nationwide, the number of sign-ups rose to 2.15 million, seven times what it had been through November, when the website .healthcare.gov was barely working.These sign-ups are individuals who generally don't have access to group health policies at their job -- the self-employed, the unemployed or many people in lower-paying or part-time jobs, which often don't offer health insurance.If they buy health coverage through the marketplace, they could get a subsidy to help pay their premiums, if they earn between 100 percent and 400 percent of the federal poverty level, or $11,500 to $46,000 for a single person.In Montana, 83 percent of the people signing up for plans were eligible for a subsidy. The nationwide average is 79 percent.Also in Montana, the percentage of people signing up for policies who are between the ages of 55-64 was relatively high, at 38 percent. Montana also has a fairly high amount -- 26 percent -- of its enrollees buying the lowest-cost Bronze plan, which has higher deductibles and co-pays. The national averages are 33 percent and 20 percent, respectively.Although Montana has a high amount of older folks buying policies, insurers and regulators say that's unlikely to drive up pr迷你倉將軍澳miums for the overall pool any time soon.Jerry Dworak, president and CEO of the Montana Health Co-op, one of three companies selling polices on Montana's marketplace, said they must submit rates for 2015 by the end of April. Claims data from current policies will be pretty thin at that point, so insurers will look at their average age of customers and apply some sort of inflationary factor, he said.And so far, the average age of sign-ups in Montana isn't that bad, Dworak said. The Co-op's average customer is 44 for those buying on the marketplace -- close to the state's median age -- and will probably continue downward, as younger people tend to sign up later, he said. Enrollment goes through March 31."Based on (those ages), I feel we probably dodged a bullet," he said. "If we had nothing but 56-year-olds, I'd be really panicking right now."But are these policies affordable? An analysis last week by USA Today concluded that many buying Bronze or even the more generous Silver plans still face out-of-pocket expenses in the thousands of dollars -- after they pay their premiums.Insurers and regulators in Montana say it all depends, on what you buy, your income, and how much medical care you end up needing.No kidding. But some Bronze, or even Silver, plans in Montana have deductibles ranging from $3,000 to $6,000 -- a hefty amount for someone with a moderate income. The best deals are special Silver plans for those earning less than 250 percent of the poverty level, offering much lower deductibles.Finally, we come to the real question: Is this push making a dent in the uninsured?Before the Oct. 1 launch of the Obamacare online marketplace, the estimate of Montanans without health insurance stood at 195,000.So, we have 13,000 who've chosen policies. And how many of those perhaps already had health coverage, and just bought a new policy through the marketplace? Certainly some. But we have no idea how many.Also, we have 40,000 to 50,000 uninsured Montanans earning below 100 percent of the poverty level. They can't get a subsidy, they can't afford a policy without one, and won't be covered by Medicaid, since the Montana Legislature rejected its expansion here. So, by any measure, we have a long way to go before declaring any sort of success on health coverage for most Montanans."We're off to a good start, given all that has transpired," said John Doran, a spokesman for Blue Cross and Blue Shield of Montana, which is selling polices on the marketplace. "But 13,000 and change isn't close to 195,000. But I will say this: Interest and activity (on health coverage) has never been higher."Copyright: ___ (c)2014 The Montana Standard (Butte, Mont.) Visit The Montana Standard (Butte, Mont.) at .mtstandard.com Distributed by MCT Information Services倉