We are now nearly halfway into 2014, the first year of new coverage through the health insurance marketplaces. A total of 8 million people selected new private health insurance plans during the marketplaces’ first open enrollment period. A late surge of enrollees in March overcame the initial lagging numbers resulting from the technical problems with www.healthcare.gov and state marketplace websites last fall, resulting in a final number of enrollees that exceeded projections. Approximately 50% of these new enrollees are younger than 45 with 28% between age 18 to 34, leading some health experts to believe that the risk pools have enough young (and presumably healthy) people in them to balance risks and keep premium costs from rising excessively in 2015. The vast majority of enrollees (85%) received financial assistance that reduced their premium or out-of-pocket costs. The Congressional Budget Office (CBO) has also estimated that an additional 5 million people enrolled in new ACA-compliant plans directly from insurers outside of the Marketplace. Detailed data on the number and demographics of marketplace enrollees in each state can be found here. An additional 4.8 million people were found eligible for Medicaid and the Children’s Health Insurance Program (CHIP).
This means that many consumers have new health insurance plans. Some studies have found that marketplace plans have more restrictive provider networks than other private plans, and many marketplace plans have relatively high deductibles, meaning that consumers could be on the hook for spending thousands of dollars before their coverage kicks in. Many of the new Medicaid enrollees are likely to be enrolled in managed care, which also have relatively narrower networks than traditional Medicaid. This all adds up to many millions of people having new health insurance coverage, but it is less clear whether this will translate into meaningful access to services.
IMF has continued to monitor ACA implementation and advocate for myeloma patients as the new plans have kicked in. With our coalition partners in the Patients’ Equal Access Coalition (PEAC) and State Patients’ Equal Access Coalition (SPEAC), IMF has submitted several letters to federal and state officials to advocate for increased transparency and strengthened protections for cancer patients. We are now working to set up meetings with state-based marketplaces to continue our advocacy. We will be holding a webinar on November to update the community about any changes and what to expect when open enrollment begins again November 15.