Insurers do not seem to sweat a possible adverse selection of the new registration period open to the ACA: experts


Insurance groups are praising President Joe Biden’s decision to create a special three-month enrollment period despite concerns about the potential for adverse selection.

This support means insurers likely think they could get a pool of new listings large enough to mitigate any changes in the risk pool, several experts have said. Biden signed an executive order on Thursday that creates a special registration period from February 15 to May 15.

“The global pandemic has just intensified the value of health insurance for everyone, making it much clearer at any time that you could get sick,” said Michael Kolber, partner at the law firm Manatt Health, in an interview with Fierce Healthcare.

America’s Health Insurance Plans, the leading insurance lobby group, welcomed the call for a special enrollment period – which is double the normal period for 2021 which ended on December 15 – which is “accompanied by solid consumer awareness and education,” according to a statement.

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Insurers praised the Trump administration for shortening the open registration period when it came to power in 2017. The administration has claimed that the halving of the period was aimed at combating adverse selection.

Insurers know they tend to have smaller populations from special enrollment periods, which is when people can enroll if a certain life event occurs such as divorce or a job loss.

But insurers could get more registrations in the new period thanks to increased advertising and greater awareness of health insurance due to job losses due to the pandemic, said Joel Ario, Managing Director of Manatt, during the interview.

The Centers for Medicare & Medicaid Services aims to spend $ 50 million on awareness and education, including targeted advertising and other tactics to build awareness, according to an agency fact sheet.

Current scholarship registrants can also switch to any plan available in their region “without restriction at the same level of coverage as their current plan,” the agency added.

It is not yet known how many people will sign up during the new coverage period.

A Kaiser Family Foundation analysis released Wednesday predicted that nearly 9 million Americans could get free or subsidized insurance through exchanges. Dan Mendelson, founder of consulting firm Avalere Health, also estimates registrations to run into the millions.

“It could be very substantial,” he told Fierce Healthcare in an interview. “There is real power in aggressive marketing, especially when the states and the federal government are completely aligned. “

So far, registrations on HealthCare.gov, which are used by residents of 36 states to choose an Affordable Care Act plan, were 8.2 million people at the end of open registration on December 15. This figure is lower than the 8.3 million who signed up. in 2019, but that doesn’t include listings from New Jersey or Pennsylvania, which have created their own state scholarships, Ario said.

“We haven’t seen the final numbers in the states, but some of them have growth rates similar to 7% or 8%,” he added.

RELATED: CMS Finalizes Some Regulations Governing ACA Exchanges for 2022

Several state-based exchanges have also said they will reopen registrations to coincide with the HealthCare.gov period.

Mendelson said he was not surprised by the length of the special period.

“This gives the administration time to aggressively promote these plans and re-energize the trade hedging market,” he said.

The new period is likely a harbinger of things to come for Biden, who has made expanding health coverage a key pillar of his campaign. The exchange is one place where Biden has more control over affecting Medicare and Medicaid coverage, Mendelson said.

Other policies, like lowering the age of Medicare eligibility to 60, will require congressional approval, which could be risky because Democrats have a slim majority, Mendelson said.


Martin E. Berry

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