A final-week surge boosted statewide enrollment under the health care law, also known as “Obamacare,” to 184,532 Louisiana residents — 81 percent higher than last year.
It was unclear Wednesday how much that will reduce the number of uninsured. A year ago, close to 102,000 Louisiana residents bought coverage under the Affordable Care Act. But the state’s uninsured population, estimated at about 800,000 people, dropped by just 1.5 percent, according to a 2014 report from the Louisiana Hospital Association and Wallet Hub, a financial products comparison website. That’s because most of those who bought policies through the federal marketplace already had coverage; they were just switching to “Obamacare.”
Nationally in 2014, the health insurance law lowered the number of uninsured Americans ages 18 to 64 by about 5 percent, said Kevin Counihan, chief executive officer of the federal health insurance marketplace. The data for 2015 is not yet available, but Counihan expects the uninsured rate will continue to shrink.
Counihan said it will take five years to firmly establish the Affordable Care Act enrollment process.
“It takes time to implement something that’s complicated and has a lot of moving parts,” he said.
The New Orleans metro area accounted for more than a third of the state’s enrollment, at 62,872 people newly enrolled or automatically re-enrolled in a plan. In the Baton Rouge area, that number was 37,154, according to the U.S. Department of Health and Human Services.
Officials estimate that about 87 percent of the people who enrolled this year will actually buy coverage through HealthCare.gov, the federal government’s online insurance marketplace. In Louisiana, that would work out to 160,543 consumers.
During the last weekend of enrollment that ended Sunday, the marketplace saw the highest number of phone calls and highest number of accounts established, Counihan said. That kind of activity shows people want and need the health insurance made possible by the ACA, he said.
In Louisiana, final-week enrollment jumped by 17 percent, the second-fastest growth in the country, HHS said. Only Nevada increased enrollment by a larger percentage, at 21 percent.
Brian Burton, program director for the Southwest Louisiana Area Health Education Center, the state’s largest navigator group set up to help guide enrollees, said the Louisiana numbers grew thanks to several factors, including:
- Improvements to Health Care.gov. The simplified website made it easier to navigate. The site worked 99 percent of the time, unlike last year, when the website didn’t function during the first six weeks of the first enrollment period and was plagued by technical issues.
- The experience gained last year helped navigators coordinate with other enrollment groups and form coalitions at state and regional levels.
- A big push by hospitals throughout the state to enroll their patients. Baton Rouge General Medical Center, for example, stationed health insurance agents in the lobbies and emergency rooms of both campuses. Ochsner Health System also provided enrollment help at each of its facilities.
- Higher penalties for those who don’t have insurance. The penalty for forgoing coverage in 2014 was $95, or 1 percent of income. For 2015, the penalty is $325 for an individual, or 2 percent of income.
“But I think the biggest thing we saw was that peer-to-peer network, learning from someone else who also had coverage,” Burton said.
People saw that “Obamacare” provided real insurance and that it worked, he said.
One of the biggest misconceptions about the Affordable Care Act is that it is government-run health care, Burton said.
The Affordable Care Act connects people to private insurance companies in their communities. The law also provides financial assistance to people who couldn’t otherwise afford coverage.
About 89 percent of the Louisiana consumers who had signed up as of Jan. 30 qualified for an average tax credit of $322 per month through the marketplace, according to HHS. The financial assistance means that 84 percent of Louisiana enrollees had monthly premiums of $100 or less.
Critics have said many of the “Obamacare” plans include deductibles so large that policyholders will never meet them, short of a disaster. The Affordable Care Act also has drawn fire because expanding coverage to poorer people forces others to pay more for coverage, and over concerns that the legislation will lead to huge increases in premiums over the next few years.
Blue Cross and Blue Shield of Louisiana, Humana Health Benefit Plan of Louisiana, Louisiana Health Cooperative, UnitedHealth and Vantage Health Plan offered coverage in Louisiana through the federal marketplace for 2015.
Vantage spokesman Billy Justice said there was a lot more pricing competition this time around.
Vantage lost some previous customers because of pricing issues but picked up others, he said. Overall, the company expects its “Obamacare” enrollment to increase a little over the roughly 8,000 people who bought plans in 2014.
The word is starting to get out, and Vantage is hoping the third enrollment period will be better than this one, Justice said.
Blue Cross said it is too early to determine enrollment because customers are still making their first premium payments.
Roughly 11.4 million Americans enrolled in private health insurance plans through the online federal and state insurance marketplaces, according to HHS.
“The numbers are showing the marketplaces are really working to effectively enroll people,” said Sara Collins, vice president for health care coverage and access at the Commonwealth Fund. “Enrollment awareness of coverage options is rising so that it has been a very successful year in terms of enrolling people who are eligible.”
In the next few years, as more and more people get help and choose plans, Collins said, the enrollment numbers will continue to climb.
Follow Ted Griggs on Twitter, @tedgriggsbr.