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Paul Demko, Modern Healthcare

At least 80% of exchange customers making payments, insurers tell Congress

May 8, 2014 - 9:21am

Health Exchange Premium Payments


At least 80% of exchange customers are making their initial premium payments, according to three major insurers that testified before a congressional hearing Wednesday.

WellPoint Inc. reiterated that roughly 90% of the company's new members are following through with payments, while Aetna Inc. and Health Care Services Corp. indicated that at least 80% of individuals had paid their initial bills.

Those figures stood in contrast to a report issued last month by the House Energy and Commerce Committee that indicated only two-thirds of exchange customers were following through on payments. That survey of insurers included many customers whose payments were not yet due and therefore still had time to follow through.

The share of individuals who have made their first premium payments — and therefore actually have coverage — has been one of the enduring unknowns of the recently concluded open-enrollment period. The Obama administration has not released figures regarding how many of the 8 million individuals who selected coverage through the state and federal exchanges have made payments.

House Democrats seized on the encouraging data from insurers as evidence that Republicans are distorting facts about the law's implementation to justify their entrenched opposition to Obamacare.

“Over and over Republican leaders have fabricated criticisms of the Affordable Care Act and none of them have been true,” Rep. Henry Waxman, D-Calif., said during the hearing before the Energy and Commerce Committee's subcommittee on Oversight and Investigations. “It's a sad and, I believe, reprehensible record.”

Republicans countered that they would not have to try to conduct their own research if the Obama administration was more cooperative and willing to provide data on the number of individuals actually enrolled in healthcare plans. “The facts are the facts, and while the administration and its allies furiously try to muddy reality, the public deserves transparency,” Rep. Fred Upton, R-Mich., chairman of the Energy and Commerce Committee, said during the hearing.

Republicans also sought to turn the discussion toward 2015 premium rates and whether consumers should expect to see large increases when they shop for plans during the next open enrollment period. But none of the insurance industry representatives present — which also included officials from Cigna Corp., America's Health Insurance Plans and the Blue Cross and Blue Shield Association — were willing to speculate about how much rates would go up in 2015.

“We're at the start of the rate filing process,” said Paul Wingle, Aetna's executive director of individual business and public exchange operations and strategy. “It's too early to say.”

Dennis Matheis, WellPoint's president of central region and exchange strategy, was similarly noncommittal. “We are just now understanding what membership we have attracted,” he said.

Republicans also sought to illuminate the continuing problems with back-end operations of the federal exchange. Most notably, insurance officials testified that they still must manually submit data to the CMS to receive premium subsidy payments from the federal government.

“There are certainly more manual processes than we anticipated,” said Brian Evanko, president of Cigna's individual segment.

But Democrats, including Rep. Diana DeGette, D-Colo., the ranking minority member of the subcommittee, also utilized the hearing to highlight additional encouraging data about the health care law's implementation. In particular, they repeatedly invoked a recent Gallup poll showing that the number of respondents indicating that they lacked insurance coverage was 13.4%, the lowest level since the polling firm began asking the question in 2008.

“By any rational, reasonable measure, we can call this law a success,” Rep. DeGette said.

Paul Demko writes for Modern Healthcare, a sister publication of Business Insurance.

 



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