Obamacare's enrollment failure hits the working class
JED GRAHAM 4 hrs ago
No one is getting a worse deal than the people of Mississippi. Despite the fact that the state ranked near the bottom last year with enrollment of just 38% of those eligible for subsidies, the number of people signing up for subsidized exchange plans in 2016 was virtually flat from a year ago (97,943 vs 97,606 in 2015).
Centene Wins, Mississippi Loses
IBD predicted last fall that Mississippi would be "ground zero for ObamaCare's individual mandate" because stagnant state sign-ups looked like a sure bet with after-subsidy premiums set to jump on the order of 60%, far more than in any of the 36 other states using HealthCare.gov last year.
For 30-year-olds in Yazoo City earning about $25,000 (214% of the poverty level), the after-subsidy cost of the cheapest bronze plan spiked by about $550 to just under $1,500, or 6% of pay. Because this plan from Ambetter, a unit of Centene (CNC), covers little before the $6,800 deductible is met, it may make the $695 mandate tax look like the best among bad options for someone who isn't expecting big medical bills.
It's becoming clear that millions of working-class Americans face a choice between paying a penalty they surely can’t afford and buying a policy — if they can foot the bill — that may still wreck their finances if they land in the hospital.
While this reality is pretty pervasive, it's especially harsh in some areas, Mississippi and Washington state among them, partly due to competitive pricing decisions made by Centene. While the cheapest bronze-plan premium (before subsidies) rose about $250 in Mississippi for a $25,000-earner, the subsidy fell $300, yielding the $550 increase. That came about because the subsidies are tied to the cost of the second-cheapest silver plan, and Centene cornered the market on low-cost plans in a number of states this year by attaching bronze-like deductibles ($5,500 and $6,500) to silver plans.
Centene took the same tack in Washington state, with a similar result. This year, Washington's exchange signed up 140,000 people for subsidized plans. At first blush, the 10.5% growth over last year's 126,650 total looks good, but it's deceptive because last year, unlike this year, the state only counted paid enrollment. Once nonpayers are scrubbed from the total, the number of subsidized customers in 2016 may end up being equal to, perhaps even lower than, last year's.
Centene, along with other Medicaid managed care players like Molina Health (MOH), moved into the individual market with the launch of ObamaCare and has been credited with navigating the market more adeptly than bigger players such as UnitedHealth (UNH).
The Department of Health and Human Services also revealed that the exchanges ended 2015 with just under 8.8 million paid enrollees nationwide, down 25% from the 11.7 million sign-ups to start the year.
