Health Overhaul Signups

The Healthcare.gov website is where people sign up for health insurance coverage on the federal exchange under the Affordable Care Act, known as Obamacare. Rates in Louisiana for 2019 are dropping an average 6.4 percent.

The early report is that enrollment in the individual health plans through the U.S. Affordable Care Act marketplace is down from last year, but that may not mean much until final numbers are in.

The reason? The relatively limited role of ACA policies, aka Obamacare, in the overall health care marketplace.

The majority of Louisiana residents, like those in other states, are covered by workplace-sponsored health plans, although those were upgraded in terms of coverage by the then-controversial 2010 law.

Another big chunk of Louisiana families in lower-income groups, approaching 500,000 people, are covered by the state-federal partnership called Medicaid. That program was expanded by the ACA. Louisiana opted into Medicaid expansion later than other states but eventually did so in mid-2016 by order of Gov. John Bel Edwards.

That puts into perspective the limited scope of the Obamacare marketplace for individual policies. At the midpoint of the open enrollment period, 18,425 policies were issued through the marketplace.

The figures released Wednesday by the Centers for Medicare and Medicaid Services show Louisiana was running short of the 25,502 people who had signed up through three weeks in 2017, though the reporting period is a day shorter this year.

Open enrollment ends Dec. 15, although others — people losing their jobs, or otherwise qualifying to sign up later in the year — can get individual policies through the marketplace later.

Brian Burton directs the Southwest Louisiana Area Health Education Center, a federally contracted group that helps guide Louisiana residents through the process. He sees enrollment as steady, but with open enrollment that began during Thanksgiving, there are reasons why fewer new policies have been signed up.

Also, the process for those with existing plans who don’t make a change kicks in toward the end of the sign-up period, which provides a large influx in the numbers.

Premiums for Obamacare marketplace policies, offered by Blue Cross and Blue Shield of Louisiana and Vantage Health Plan, are a bit lower this year, but we would suggest that the slower pace of sign-ups might have something to do with an improving overall state economy.

We’ll see once the numbers all shake out, but with America’s almost unique system of workplace-sponsored insurance, folks who might have opted for the marketplace policies may now have access to health care plans at work.

Overall, it’s a plus that folks have options through a marketplace for individual policies, even without subsidies. The economy is shifting all the time, and jobs might not last as long as they have in the past. But people still need insurance, and the marketplace helps keep families covered.

That’s a plus, even if the marketplace is a relatively small segment of Louisiana’s overall insurance market.