Washington exchange's first March enrollment numbers and exemptions from the mandate

By: Emily Makings
12:00 am
March 13, 2014

The first March enrollment numbers have been released by the Washington Health Benefit Exchange.Through March 6, enrollments in qualified (private) health plans (QHP) total 109,021. Enrollments in Medicaid by those who are newly eligible under the Affordable Care Act (ACA) total 222,607. Medicaid enrollments by those who were previously eligible but had not previously enrolled total 115,159.

Under the ACA, in order to avoid penalties, people must buy insurance by March 31. This is also the end of the open enrollment period for private plans. (Medicaid sign-ups may occur throughout the year.) As it is the last chance to purchase private plans, we would expect a spike in enrollments this month. The current enrollment report does not show any ramp-up so far, as you can see from the charts below. (That said, there also wasn’t much of a ramp-up to the spike in the December 24 report.)

Still, you would think there would be a spike, particularly from young people who had not been previously insured. As Megan McArdle wrote earlier this week:

So my general assumption — which is also what a lot of other people are assuming — is that the “young invincibles” are going to show up later. Unlike the sick or the previously insured who wanted to maintain continuous coverage, the young invincibles do not feel an urgent need for insurance. Maybe they’ll get around to it, but they weren’t rushing to make a December deadline.

And now it looks like there will be even less reason for them to do so this month. As the Wall Street Journal reported yesterday,

. . . last week the Administration quietly excused millions of people from the requirement to purchase health insurance or else pay a tax penalty. . . .

That seven-page technical bulletin includes a paragraph and footnote that casually mention that a rule in a separate December 2013 bulletin would be extended for two more years, until 2016. Lo and behold, it turns out this second rule, which was supposed to last for only a year, allows Americans whose coverage was cancelled to opt out of the mandate altogether.

In 2013, HHS decided that ObamaCare’s wave of policy terminations qualified as a “hardship” that entitled people to a special type of coverage designed for people under age 30 or a mandate exemption. HHS originally defined and reserved hardship exemptions for the truly down and out such as battered women, the evicted and bankrupts.

But amid the post-rollout political backlash, last week the agency created a new category: Now all you need to do is fill out a form attesting that your plan was cancelled and that you “believe that the plan options available in the [ObamaCare] Marketplace in your area are more expensive than your cancelled health insurance policy” or “you consider other available policies unaffordable.”

This lax standard—no formula or hard test beyond a person’s belief—at least ostensibly requires proof such as an insurer termination notice. But people can also qualify for hardships for the unspecified nonreason that “you experienced another hardship in obtaining health insurance,” which only requires “documentation if possible.” And yet another waiver is available to those who say they are merely unable to afford coverage, regardless of their prior insurance. In a word, these shifting legal benchmarks offer an exemption to everyone who conceivably wants one.

blog.031314a

blog.031314b

blog.031314c

Categories: Categories , Health.