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Signups on Md. exchange increase as open enrollment nears midpoint

So far, Kaiser Permanente making market gains against CareFirst

10-12-2016 BALTIMORE, MD- Dr. Samyra Sealy, Internal Medicine, examines Baltimore resident Greta Houston, at Mercy Medical Center. (The Daily Record/ Maximilian Franz).

10-12-2016 BALTIMORE, MD- Dr. Samyra Sealy, Internal Medicine, examines Baltimore resident Greta Houston, at Mercy Medical Center. (The Daily Record/ Maximilian Franz).

Despite significant turmoil this year, the 2018 open enrollment period of Maryland’s health exchange has seen an increase in signups from last year’s open enrollment period, just days before the period’s midpoint.

As of Friday, more than 130,500 people have been enrolled for the 2018 plan year, up 3 percent from last year. That number includes new signups, previous enrollees who changed their plan and previous enrollees who were auto-renewed for 2018.

“By many measures, people seem to be getting the word and seem to be taking action,” said Andy Ratner, chief marketing officer for the exchange, at Monday’s meeting of the board of the Maryland Health Benefit Exchange.

Of the two insurers on the exchange, CareFirst BlueCross BlueShield raised its premiums more significantly than Kaiser Permanente. CareFirst premiums increased an average of 58.2 percent across its silver level HMO plans from 2017 and increased 76 percent across its silver level PPO plans. Kaiser’s silver level plans increased 43.4 percent.

The price differences could be having an effect on the market. This year, CareFirst controls about 75 percent of the individual market in Maryland. Under 2018 enrollments so far, that share has fallen to around 50 percent.

The exchange will need to sign up around 37,000 more in order to match enrollment from last year’s open period. Last year, around 95 percent of enrollments happened in the first 45 days of the period, with the final 5 percent coming over the last 45 days.

That is significant as this year’s open enrollment period has been shortened to 45 days.

To counter the earlier deadline, Dec. 15, the health exchange kept its marketing budget from last year even this year, spending the same amount in 45 days as it did on 90 days. That marketing has included increased outreach to minorities, young people and rural residents.

Advertisements for the exchange have aired during Dancing with the Stars and and a Ravens game.

Ratner expects one group that will come in late will be younger adults.

“We know from past experience that the younger adults tend to come in at the end,” he said.

That growth could not have been easily predicted before the enrollment period began Nov. 1.

This year, Maryland’s insurance regulator approved substantial premium increases for insurers offering plans on the exchange. That came as the number of insurers dwindled to two after four submitted rate requests.

Last month, President Donald Trump threw the exchange into greater turmoil by stopping subsidy payments to insurance companies. As a result insurance carriers requested and received even higher premiums.

But because of how those increases were structured, targeting only silver level plans on the exchange, they may be allowing consumers to purchase better plans than they may otherwise have been able to at similar prices.

Targeting silver plans increased the value of the advanced premium tax credits consumers with income below 400 percent of the federal poverty line receive when purchasing insurance. Higher tax credits brought the more expensive gold plans into a more affordable range and made many bronze plans virtually free to purchase.

According to a report at Monday’s board meeting, one navigator referred to an increase in the preference for gold plans by remarking, “It’s raining gold out here.”


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