Short Takes On News & Events

Obama Announces 6 Million Have Signed Up For Insurance

More than 6 million people have signed up for health insurance through the health law’s state and federal online marketplaces, or exchanges, since Oct. 1, the administration announced Thursday.

President Barack Obama, who is traveling in Europe, announced the number in a conference call with groups that are helping consumers sign up for coverage.

In a blog post, Centers for Medicare & Medicaid Administrator Marilyn Tavenner said  the health law’s web site, healthcare.gov, and 800 number, had near record traffic Wednesday, with 1.5 million visitors and more than 430,000 phone calls.

“With 4 days left for consumers to sign up for coverage, we are working hard to ensure that our systems can handle the unprecedented demand as people enroll before the March 31 deadline,” Tavenner wrote.

The Congressional Budget Office originally estimated that 7 million people would sign up for the exchanges by the end of the enrollment period. After computer problems botched the Oct. 1 rollout, the CBO revised that estimate down to 6 million. Federal officials have said they do not yet know how many people who have enrolled have paid their first month’s premium. Insurance industry officials have reported that about 70 to 80 percent of enrollees have paid.

Reaching 6 million has both practical and political significance. The more enrollees there are, the more likely the risk pool will be balanced between sick and healthy individuals. That calculus will be based on enrollments at the state and local levels where premiums are set, say experts. Republicans have expressed skepticism that the law would provide affordable coverage for millions of Americans and called for its repeal.

March 27th, 2014, 4:00 PM by Mary Agnes Carey

Short Takes On News & Events

What’s Working, What Isn’t As Healthcare.gov Deadline Is Extended

KHN’s Mary Agnes Carey was on PBS NewsHour Wednesday to talk about the Obama administration’s plan to allow extra time for Americans to sign up for health insurance coverage under the health law.

March 27th, 2014, 9:00 AM by KHN Editors

Short Takes On News & Events

Consumers Get $10B In Subsidies For Health Coverage, Study Finds

Americans have already qualified for about $10 billion in tax credits to help them purchase private health insurance this year through the Affordable Care Act, according to a study from the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)

That’s an average of $2,890 for each of the 3.5 million people who qualified for a subsidy as of March 1 — about 83 percent of those who enrolled in an exchange plan.

But four of five Americans who could qualify for a subsidy hadn’t applied for coverage by that date. And sign-up rates varied greatly by state.  More than half of the subsidy money allotted so far will go to consumers in California, Florida, North Carolina, Texas and New York.

“States that are lagging in enrollment are leaving billions of dollars on the table that their residents qualify for,” said Larry Levitt, one of the study authors.  In Hawaii, South Dakota, Iowa, New Mexico, North Dakota, Washington, D.C., and Oklahoma, for example, 10 percent or fewer of those eligible for tax credits signed up.

If all states had been able to enroll people at the rates of the five most successful states (Washington, Connecticut, California, Rhode Island and Vermont), where an average of 39 percent of those eligible signed up, another 3.1 million people would have qualified for an additional $8.6 billion in premium subsidies.

That money could provide a valuable infusion of cash that “not only has a benefit to individuals, but also to state economies as well,” Levitt said.

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March 27th, 2014, 4:57 AM by Jenny Gold

Short Takes On News & Events

Half Of Uninsured Not Planning On Getting Coverage, Poll Finds

With less than a week left for customers to apply for insurance through the health care marketplaces, a poll released Wednesday finds that half of the people still without health coverage intend to remain uninsured.

Five million people have signed up for insurance since the marketplaces created by the federal health law opened  in October. The official deadline to sign up without facing a financial penalty is March 31, although federal officials told news organizations Tuesday that consumers who begin the process before then and have had trouble with the technology will an extension of several weeks to finish the process. The Congressional Budget Office estimates by the year’s end, 6 million people will have obtained insurance on the marketplaces.

The Kaiser Family Foundation’s latest poll, conducted in mid-March, found that 50 percent of adults under age 65 who still lack coverage plan to remain without insurance, while 40 percent aim to sign up by the deadline at month’s end. (KHN is an editorially independent program of the foundation.) The other 10 percent said they did not know what they would do or refused to talk about it.

Of the uninsured, two out of three said they have not tried to get coverage yet. The rest said they attempted to get it through an online marketplace such as healthcare.gov, the state-federal Medicaid program, their employer or a private insurance company.

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March 26th, 2014, 4:55 AM by Jordan Rau

Health Care In The States

Insurance Agents Key To California Success Enrolling Asian-Americans

While Latino enrollment has lagged in California’s insurance marketplace, Asians have signed up in numbers outstripping their representation in the pool of eligible people.  According to new Covered California data, the overwhelming majority of Chinese, Korean and Vietnamese enrollees are buying plans through certified insurance agents, as opposed to community groups or the Covered California website.

A Covered California brochure in Chinese.

There is no charge to consumers who work with agents, whose commissions are paid by insurance companies.

Since January, Asians have been enrolling in strong numbers. People of Asian descent make up about 14 percent of California’s eligible pool, according to estimates compiled by the UCLA Center for Health Policy Research and the UC Berkeley Labor Center. Asians reached that target straight out of the gate, making up 13.5 percent of all enrollees by January. They have surged from there. In the most recent data from Covered California, which comprised enrollment from Oct. 1 to Feb. 28, Asians made up 22.9 percent of all enrollees.

Licensed insurance brokers can sell customers plans on the Covered California marketplace, but they must first be specially certified to do so. Covered California says 40 percent of its total Covered California enrollments are coming via these certified insurance agents. But within certain Asian sub-populations, the percentage is much higher, Covered California says:

  • 57 percent of Chinese enrollments are through certified insurance agents (CIAs)
  • 65 percent of Vietnamese enrollments are through CIAs
  • 70 percent of Korean enrollments are through CIAs

These numbers “suggest that the Asian agents are a driving force in helping Covered CA exceed our enrollment goal in Asian communities,” Wendy McAnelly, a public information officer for Covered California, said in an email.

This information was not a big surprise to Simon Chew. He runs Ehealth-Plans, an insurance business with four offices in San Francisco. All his agents are trilingual — in English, Mandarin and Cantonese. Chew estimates he’s signed up 2,000 people since the Covered California marketplace opened last October, and half of them were uninsured. He sees a difference between how Caucasians shop and how his clients — overwhelmingly Chinese Americans and Chinese immigrants — shop. While what he calls the “mainstream market” is comfortable purchasing insurance online, those of Chinese descent want to do business face-to-face, with someone of a similar background.

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March 25th, 2014, 5:00 AM by Lisa Aliferis, KQED

Short Takes On News & Events

AHIP President Calls For New Level Of Insurance Under Health Law

A new tier of coverage should be added to the health law’s online marketplaces, or exchanges, that would be less comprehensive than what plans are now required to offer, the head of the health insurance industry’s trade group said Sunday.

“I would create a lower tier, so that people could gradually get into the program, so they could be part of the risk pool, so we don’t hold the healthier people outside,” Karen Ignagni, president and CEO of American’s Health Insurance Plans, said in an interview on C-SPAN’s Newsmakers.  “What I would do is give people more choices.”

Plans on and off the health law’s exchanges are required to cover a package of essential health benefits, including hospitalization, maternity and newborn care, pediatric care and prescription drugs.  Ignagni said that some people who had not purchased that coverage before don’t want to do so now and want other choices.  Requiring such comprehensive coverage may be “a bridge too far” for some people, she said.

The health law features four tiers of coverage – platinum, gold, silver and bronze – plus a catastrophic option open to people under 30, people who qualify for hardship exemptions and some people in the individual market whose plans were cancelled because they did not comply with the health law.

In the interview, Ignagni also said while the health law’s website, healthcare.gov, is working far better now for consumers than at its technologically troubled Oct. 1 launch, “much work remains” on the “back end” functions that insurers depend on to get information about enrollees and payment information.

“The whole finance package is left to be built. How do the plans receive their premium subsidies [from the federal government] for the individuals who are eligible for them and ultimately how do we reconcile with the exchange in terms of the people they think we have and the people we really have,” she said.

March 24th, 2014, 5:00 AM by Mary Agnes Carey

Short Takes On News & Events

Cholesterol Guidelines Could Mean Statins For Half Of Adults Over 40

This story was produced in collaboration with

When sweeping new advice on preventing heart attacks and strokes came out last November, it wasn’t clear how many more Americans should be taking daily statin pills to lower their risk.

A new analysis provides an answer: a whole lot. Nearly 13 million more, to be precise.

If the guidelines were followed to the letter, about half of all Americans over 40 would be on cholesterol-lowering statins — more than double the current level.

Even more striking, the new recommendations would make prescription of the drugs almost universal among older men. “What was personally most surprising to me, is that it turns out the difference between the old and new guidelines is very small in younger adults — 40 to 59,” says Duke University biostatistician Michael Pencina, lead author of the study.

“The vast majority of those affected by the new guidelines are between 60 and 75,” he says. “So much so that 87 percent of men 60 to 75 and 54 percent of women [in that age range] should be on statins.”

The great majority of Americans newly recommended for statin treatment have no known heart disease, Pencina and his colleagues say.

The analysis was published online Wednesday by the New England Journal of Medicine.

Statin drugs are pretty cheap these days. Most are generics. Common doses of atorvastatin, the generic form of Lipitor, can be had for 50 cents a day. Older statins cost even less. Still, the number of potential patients is so huge that the recommended expansion in treatment has major cost implications.

If all those newly recommended for treatment got the drugs, the expansion would cost from $2 billion to $6.6 billion a year more than the price tag under the old guidelines, which is $7.8 billion to $22.4 billion depending on cost assumptions for a year’s worth of the drugs .

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March 20th, 2014, 11:38 AM by Richard Knox

Short Takes On News & Events

Mass. To Drop Contractor Behind Flawed Health Insurance Website

Massachusetts is negotiating an end to its contract with CGI, the Canadian vendor that built the state’s flawed health insurance website while scrambling to fix it.

Photo by naslrogues via Flickr

The site was supposed to be up last October, offering one-stop health insurance shopping for anyone in Massachusetts. But six months later, only a few functions work but have glitches, and a few are not usable at all.

Sarah Iselin, a special assistant to Gov. Deval Patrick hired to oversee the fixing of the website, has been working with a team of outside contractors from the health technology company Optum to determine if the CGI project can be fixed.

“That assessment made clear that based on past performance and our current needs, parting ways with CGI is the right course for the commonwealth moving forward,” Iselin said Monday.

In a statement, CGI said it will “work with the Commonwealth to ensure a smooth transition to the next phase of exchange deployment, allowing for the best use of system capabilities already in place.”

Iselin and her team told the Health Connector board they are reviewing two possible remedies: hiring a new vendor to build on working parts of the current site or buying website elements from other insurance exchange sites. (The Massachusetts Health Connector, which started years ago, is the state’s equivalent of an exchange.)

Iselin cautions that buying elements will be difficult because Massachusetts has many unique insurance rules, including 263 different factors that determine who is eligible for what type of coverage.

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March 18th, 2014, 3:53 PM by Martha Bebinger, WBUR

Short Takes On News & Events

What You Need To Know As Health Care Deadline Looms

KHN’s Mary Agnes Carey was on NPR’s Tell Me More program Tuesday talking about the upcoming deadline for many Americans to buy health insurance or face a fine. Listen below:

March 18th, 2014, 1:05 PM by KHN Editors

Health Care In The States

Local Control Key To Colorado Exchange’s (Moderate) Success

Colorado capitol by Jesse Varner via Flickr

Being an early adopter can be rewarding. Remember how amazing it was to have the first iPhone? But then, sometimes early adopters pay a price, like that early version of the Apple map tool that led to some wrong turns.

Colorado is one of 14 states going through their own version of this with the health law. The first shot at signing up millions for health insurance wraps up at the end of the month, and the vast majority of states are using the federal marketplace, healthcare.gov.

Those states which built exchanges of their own took tremendous financial risks setting up the marketplaces, working out everything from insurance plan offerings to advertising strategies.

Some states, like Connecticut and California, are reaping the rewards, leading the country in signing up people for insurance. Others, like Minnesota, Maryland and Oregon, have spent lots of money only to see technology fumble, contractor turnover, and director resignations.

Then there are some states in the middle. The people who built Colorado’s health insurance exchange were sure that they were ahead of the game from day one. Months before the Affordable Care Act even passed, a big bipartisan health reform study group here had already concluded the state should create an exchange.

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March 18th, 2014, 5:50 AM by Eric Whitney