Later this week the Obama administration will release figures on how many people have successfully enrolled in the private insurance exchanges. The Wall Street Journal reports the number could be as small as 50,000, just 10 percent of the administration’s targeted number of 500,000.
“Technology problems and design flaws have blocked many users from completing insurance applications or even creating accounts to use on the site, which serves consumers in 36 states (including West Virginia) where the federal government oversees the new health-insurance exchanges,” the Journal reports.
We’ll find out when the numbers are released Friday how many West Virginians have enrolled. I doubt it will be many, certainly nowhere near what was expected, even though an estimated 14 percent of the state’s population has no insurance (according to the Kaiser Family Foundation).
Like everywhere else, West Virginians have had trouble with the healthcare.gov website. Those with serious health problems or pre-existing conditions are, and will be, the most persistent in trying to sign up.
That’s good for them, since many have been stuck in a terrifying health care netherworld where they desperately need coverage, but they can’t get it.
However, health insurers need young, healthy people in the pool to balance the risk. No doubt Highmark Blue Cross Blue Shield of West Virginia, the only insurance company in the state’s exchange, should be bracing for the possibility that the exchange will turn into a high-risk pool.
The same goes for all the insurance companies in the exchanges. The ACA contains a provision to subsidize the insurance companies if actual costs to care for the sick turn out to be three percent or higher than the estimated cost.
Still, insurance companies are nervous about a possible “death spiral,” if the exchanges have too many sick people and not enough healthy policy holders, and the fear is the ongoing problems with the website discourage those healthy people from signing up.
Meanwhile, much of the coverage about the President’s broken promise (“If you like your private health insurance plan, you can keep it. Period.”) has focused on the individual market. The replacement of current individual plans with new insurance policies that meet the requirements of the Affordable Care Act will impact as many as 11 million people.
However, there is a much larger group of Americans who are also going to see their insurance change because of Obamacare.
A McClatchy Newspaper analysis of employer-based insurance “finds that the number of people who have plans changing, or have already changed, could be between 34 million to 52 million.”
The public perception is that existing employer-based plans would be grandfathered in. However, McClatchy’s Kevin G. Hall and Anita Kumar point out in their story that the law says if those plans changed after the law was passed—adjusted a co-pay or deductible, for example—the grandfathered status would be lost.
The health delivery system in this country needs repair, which is why we got Obamacare. Many Americans, frustrated with system, were willing to take a chance on reform, especially if they believed their coverage would not change.
The early going on Obamacare shows, however, that millions are going to see a change, whether they like it not, and new health exchanges are in danger of collapsing under their own weight.