Unoriginal thoughts on December enrollment

Just a couple of quick thoughts on December enrollment figures as HHS has released their detailed data dump. The New York Times has some nice graphics and breakdowns:

  • Pace is about 70% of projection
  • People are buying decent to good coverage. 1% Catastrophic, 20% Bronze, 60% Silver
  • Lots of subsidies, so the right audience is getting online
  • As good or better age mix compared to Massachusetts at similar points

This is part of an e-mail I got from a cousin who makes in the high teens to low twenties right now:

I did get through the process, but the premiums were much higher than I anticipated, so i decided to hold off and get enrolled for the March deadline. My catastrophe policy can carry me through a few more months while I finish paying off the new transmission I had to buy in July (ouch!). Without those payments, though, I should be able to swing the insurance premiums.

Higher than anticipated for her zip code, age and silver cost sharing assistance plan was $84 per month after subsidy. Her catastrophic plan is $54 a month for a $10,000 deductible.

The Massachusetts experience was that the reasonably young, healthy and flat broke waited until they absolutely had to until they committed.  My cousin fits into all of those categories.

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36 replies
  1. 1
    Kropadope says:

    This is excellent news for Chris Christie!!!! (My mostly unoriginal thought)

  2. 2
    jl says:

    Thanks for the update and good news.

  3. 3
    satby says:

    It’s been great for me, though I will stretch a bit to pay even the subsidized silver plan price while unemployed. But compared to COBRA I save $500, and I never miss a chance to tell people that .

  4. 4
    Tommy says:

    It took me a god awful amount of effort to enroll. Like hitting refresh a few thousand times (well harder to enroll), But I got my plan through Obamacare (I prefer the Affordable Care Act). I work for myself and healthcare is always an issue. My LARGEST single fee. I at times have skimped on it. No more. That shouldn’t be the case. I now have a plan that is amazing. ;Like $100/month less. Those yahoos on TV that say this sucks, well they don’t know what they talk about!

  5. 5
    Kropadope says:

    @jl: Most indeed. The age mix was one of my biggest concerns but, if it’s true that the age mix looks good compared to MA’s experience, that’s definitely encouraging. We’ve loved our Obamacare here since before we even heard of Obama.

  6. 6
    aimai says:

    84 dollars a month seems incredibly low for a silver plan. Is this not a good deal? If 84 dollars a month for real health care coverage seems too expensive for your cousin shouldn’t she be on medicaid? Is it that the subsidies are not high enough in her area, or that her income is, in fact, really low and her debts are high (and don’t offset her income)?

  7. 7
    Mike E says:

    Yay! Happy insurance cards in the mail day to me! I will be celebrating tomorrow by getting my free flu shot.

  8. 8
    PsiFighter37 says:

    @Kropadope: You got it wrong. The good news is non-transferrable; it always belongs to John McCain.

  9. 9
    Belafon says:

    If I read that correctly, she needs an extra $30/month to cover silver?

  10. 10
    Kropadope says:

    @PsiFighter37: I thought 2014 required a new media darling Republican with an undeserved reputation for moderation.

  11. 11
    Mike E says:

    @aimai: I chose a decent “unrestricted” silver plan and will pay $55 more than that, and will be doing it gladly. I heard a blurb about our state’s enrollment so far: only 1% of the total has opted for the catastrophic minimum; more women in the pool than men.

  12. 12
    Ronnie Pudding says:

    @aimai:

    On the contrary, $84/month is way expensive. If we let the magic of the marketplace do its job, insurance would be more like $15 a month.

    No, seriously, about 20 years ago when I was working a temp job I was paying $105/month for NYS Cobra.

  13. 13
    Tommy says:

    There is a story I tell. I am blessed with amazing health. At the same time I have had like the best health care plans you can imagine. Never really used them. Paid in, never used them.

    More than ten years ago I got sick. Really sick. One in a million sick. I got cut from ear to ear and spent a week in the ICU with a tube down my throat.

    Funny thing, I was unemployed at the time, had just lost my job in the dot.com thing. My insurance refused to pay.

    $67,000 later they refused to pay. Long, long story my parents could step in and pay otherwise I would have been that stat of a person bankrupted by illness. It always amazes me. That from cradle until now I’ve had health care. But the only time I really needed it, it wasn’t there for me.

  14. 14
    Tommy says:

    @Mike E: Over the holidays I am the only liberal in the room. Brother married into, well a hornets nest. Before I could get my coat off his wife’s father was all over me. Obamacare this. Obamacare that. As wingnuts go we have a pretty good relationship.

    I heard him out and had to say, “dude that is Medicare” not “Obamacare.”

    I then asked him, how much do you pay. He said not a penny. His family has a lot of health care issues. Ton. And they don’t pay a penny. Everything covered. I told him (not sure he got it) he was blessed and maybe other folks would like the same.

  15. 15
    Ruckus says:

    Eight yrs ago I applied for individual insurance. 56 yrs old, for a crap policy that of course had exclusions for every problem I’d ever had, was quoted just over $1000/month. About a month ago I looked at Covered CA and saw that a upper end policy for my current age and of course without pre existing conditions was $634 without subsidies, $200 with, and that wasn’t the cheapest, just average. Even with the minimal copays and deductible my max out of pocket would be far less than just my yearly min of 8 yrs ago. I’d say that was a huge improvement. And I had my choice of providers, 3 to 4 in every cost segment.

  16. 16
    doug r says:

    Just for reference, here in Canuckistan my Provincial Health Insurance for a family of 3 is about $120 (Canadian) a month. The Obamacare numbers are very comparable.

  17. 17
    Mike in NC says:

    The number of Letters to the Editor published by our local wingnut paper that are submitted by elderly morons who watch FOX News and declare the ACA to be the work of Satan have dropped off dramatically.

    Now they’re actually publishing letters from people who had pre-existing conditions and are now able to afford health insurance after years of going without.

  18. 18
    Mike E says:

    @Tommy: It’s tough sledding when generally genial people lose it and fly off the handle.

    I was waiting for my car window to get replaced and the teevee at the shop had the president on live…a switch flipped and people suddenly grew a 2nd head and commenced to banging them together:
    “Did he pass a law to Kill Everyone?”
    “When he says ‘we’ you know who he’s talking about.”
    “I’m in healthcare, and people are really gonna suffer.”

    It was like watching some 60’s era 16mm school film about venereal disease, but live.

  19. 19
    Comrade Mary says:

    @doug r: Are you out west? In Ontario, I pay no overt health premiums (I pay myself as a small business owner, my taxes are dinged appropriately), but my personal taxes include some amount for coverage, plus a surcharge if my income is over a certain amount.

    I wish it was a little more transparent so I was able to compare my costs better. Back in the 70s/early 80s, OHIP was $90 every three months for a single person, with a full exemption of these fees if your income was under a certain figure.

  20. 20
    doug r says:

    @Comrade Mary: We live in BC. With real estate so redonculous out here, I’m thinking of buying in the US and commuting to Canada. Nobody seems to know what I would pay or how-except the one thing for sure is BC Medical would drop me.

  21. 21
    El Caganer says:

    What’s her deductible now? ‘Cause if it’s with the bronze plan, she’s pretty much fucked if she get’s into an accident.

  22. 22
    jl says:

    If RM happens by here, or if anyone knows, I am curious about HI and MA. I assume those states have small numbers to worry about because of HIs long standing near universal care, and MAs Romneycare? Most of the people in those states are not affected by the ACA, right?

  23. 23
    I'mNotSureWhoIWantToBeYet says:

    Something that Dean Baker has been beating the drum about for a while now is that it’s not the age of the enrollees that matters most, it’s their state of health.

    E.g. Today:

    The NYT had yet another silly front page piece warning that Obamacare is about to go under, this time because not enough young people are signing up. If it keeps doing this people will mistake it for a Jeff Bezos publication.

    The point, which was shown in this Kaiser Family Foundation analysis, is that the age skewing really doesn’t matter much for the success of the program. The fee structure of Obamacare is designed to somewhat favor older enrollees, but the gap is not very large. The Kaiser study found that even large skewing toward older enrollees would only raise the cost by 2.0 percent.

    The real issue is the risk of a skewing by health condition. If healthy older people sign up it actually benefits the plan far more than if the “young invincibles” sign up since the older people will pay three times as much for their insurance and basically get nothing back from the program. (My readers only seem to know sick people in the age group 55-64. In the real world, many are quite healthy. I couldn’t find a quick reference for costs of the 55-64 cohort, but the cheapest quintile of Medicare beneficiaries cost on average just $331 per person on average. Presumably the cost for the bottom quintile of the 55-64 group would be even less.)

    […]

    See the original for embedded links.

    Cheers,
    Scott.

  24. 24
    🎉 Martin says:

    @El Caganer: She makes $20K a year. She’s in a bad way no matter what happens. If she’s in an accident she almost certainly loses her job. If she’s barely making the payments and she loses her job, and can’t make the payments, her credit goes to shit, and then she can’t get a job.

    Honestly, anyone on that end of the income scale would almost be better off throwing caution to the wind putting their money into hard assets, and just declaring bankruptcy on a regular basis. The constant unwillingness of light to appear at the end of any tunnel will break any person.

  25. 25
    Mike E says:

    @jl: Dunno about HI but I saw somewhere (TRMS mebbe) that MA already has a 98% coverage and most add-ons are gonna be thru Medicaid. Thank you, Gov Romney!

  26. 26
    Another Holocene Human says:

    @jl: Kinda misleading–they’re all affected because ACA includes some pretty sweeping insurance reform which supercedes state laws. I don’t think even the 20-25 states with strong insurance regulation had the kind of preventative care requirements that PPACA rolled out.

    Plus, MA had to move a bunch of people from one plan (basically the you’re broke but it’s not medicaid plan) to Medicaid and stuff like that.

    It looks like VT might do MA in on uninsured #s next year. Although MA might have more ACA-ineligibles as well.

  27. 27
    balconesfault says:

    Next time you hear that the younguns are having to buy insurance they’ll never need to keep programs affordable for their elders, note that at the very least they are being insured against a serious condition barring them from being insurable for the rest of their lives.

    Oh … and X-game sports.

  28. 28
    Another Holocene Human says:

    @I’mNotSureWhoIWantToBeYet: Great link. The comment below it makes me want to cry. $1400 for a family plan with two 50+ adults, that sucks. Hope they get a subsidy. This is what unions were fighting for. Management gets that s*** paid for as a perq.

  29. 29
    pseudonymous in nc says:

    @jl: If you extrapolate, then it’s about 350,000 total eligible in MA, which fits with the uninsured rate of around 5%. The data suggests a fairly common demographic theme.

  30. 30
    ruemara says:

    @🎉 Martin: Yes, pretty much.

  31. 31
    Tommy says:

    @I’mNotSureWhoIWantToBeYet: We’re working here in Illinos.

    I used to have the best health plans known to man. I worked at great places and that was just part of the job.

    Then I started to work for myself and found getting health care wasn’t so easy.You’d think the far right would love me, but health care, not so much. What Obama did is staggering.

  32. 32
    mai naem says:

    I worked with a 62 yr old woman about nine years ago who got laid off and her COBRA was running out and she couldn’t find a job with health benefits. She had severe rheumatoid arthritis for which she got an IV treatment every 2-3 months costing around $5K. She applied for CIGNA and it would have cost $1200/mo with a super high deductible for medical and some kind of deductible with a low max payout for her meds. Thank god for her, she found a job just in time.

  33. 33
    Matt McIrvin says:

    @jl: My understanding is that Massachusetts and Hawaii are both having some real problems getting newly eligible people signed up; the Hawaii exchange is pretty messed up.

    But in Massachusetts, at least, the outrage doesn’t seem to be getting much traction inside the state, probably because there are relatively few uninsured here in the first place. There are some “Obamacare destroys Massachusetts website, serves them right” stories floating around but they seem to be mostly a right-wing-political-media thing.

  34. 34
    taylormattd says:

    $84 per month is too expensive, so your cousin is paying $54 a month for absolute garbage.

    Ok then.

    I get the feeling none of these people ever once looked into what a bronze-type plan would have cost before the ACA.

  35. 35
    Avi says:

    The people I talk to around here who don’t have insurance complain that health care is too expensive even though they qualify for premium subsidies and partial cost-sharing subsidies. They don’t want to pay anything. Hell, our lawn guy bitches that the Medicare Part B premium is taken out of his Social Security check (and goes to a Medicare Advantage plan that has a zero copay for PCP visits and most drugs—even in the donut hole).

    Meanwhile, I went from a Gold-equivalent plan last year to a Platinum plan this year, and it looks like my out-of-pocket costs will drop by a little more than half, as anticipated. Even better, my premium dropped by roughly the same fraction.

  36. 36
    Richard Mayhew says:

    @taylormattd: My cousin definately did not look into Bronze or Silver level coverage pre-PPACA as she knew that it was unaffordable on her budget at the time.

    She never has enough money, even when things go right much less when an unaticipated but statistically likely event happens (transmission falling out)

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