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PPACA Enrollment and the Insurance Industry

Hearing Description: The Oversight and Investigations subcommittee recently met to receive an update from major health insurers on the status of ACA implementation. While full information is not yet available, early numbers suggest that between 80% and 90% of enrollees have paid their premium.

Hearing Date: May 7, 2014

Hearing Summary: Prepared for AAPS by the Market Institute

The House Oversight and Investigations subcommittee recently to get an update on the implementation of the Affordable Care Act and how it’s affecting the insurance industry. Rep. Tim Murphy (R-PA) said in his opening statement the committee has been looking for answers from the administration about the ACA for months and months, but cannot seem to get straight answers. Chairman Fred Upton (R-MI) said in his opening statement that because the administration has been so defiant in providing enrollment figures, the committee has turned to the insurers themselves to determine sign ups and rates.

The first witness, Mark Pratt, Senior VP of State Affairs at America’s Health Insurance Plans testified in his opening statement that one reason there is uncertainty about the number of Exchange enrollees who have paid their premiums is that some insurers – to provide peace of mind for consumers and to protect them from potential gaps in coverage – have voluntarily decided to provide flexibility in the deadline by which Exchange enrollees must pay their first month’s premium. There will be a period of time before systemwide payment information is available. To further expand affordable, quality care, Congress can take one critically important step and that is to delay and eventually repeal the ACA’s health insurance tax.

The second witness, Frank Coyne, VP of Operations and Chief Transformation Officer at Blue Cross and Blue Shield Association testified in his opening statement that for 2014, OPM certified Blue Cross and Blue Shield Plans to offer MSP products in 30 states and the District of Columbia. The total number of MSP plans offered exceeds 150.

Consumers’ interest in the Multi-State Plan Program has been significant. As of April 1, 2014, a total of 283,783 individuals have selected an MSP plan.

The third witness, Paul Wingle, Executive Director of Individual Business and Public Exchange Operations and Strategy at Aetna testified in his opening statement that Aetna is currently participating in the individual market on the exchanges in 17 states. As of the third week of April, Aetna had over 600,000 members who had enrolled, and roughly 500,000 members who had paid.

The fourth witness, Brian Evanko, President, Individual Segment at Cigna testified in his opening statement that despite their large footprint, Cigna only offers individual plans in five states. They did this focused approach to better gain an understanding on consumer behaviors in the individual market.

The fifth witness, J. Darren Rodgers, Senior VP and Chief Marketing Officer at Health Care Service Corporation testified in his opening statement that his company has received just over 830,000 applications for coverage since October. Between 80% and 90% of those that signed up through an exchange have paid their premium. Those that signed up off the exchanges is significantly higher.

The sixth witness, Dennis Matheis, President of Central Region and Exchange Strategy at Wellpoint testified in his opening statement that they are seeing strong membership growth and large percentages of newly enrolled customers are successfully paying their premiums by the due date.

In response to questioning, Frank Coyne said:

  • They are working with providers to provide updates to member’s payment status

In response to questioning, J. Darren Rodgers said:

  • His company has no information on how many of their enrollees were previously uninsured

In response to questioning, Pratt said:

  • His company had to develop workarounds and manual processes to compensate for Healthcare.gov back end issues

Hearing Website: http://energycommerce.house.gov/hearing/ppaca-enrollment-and-insurance-industry

Links to Testimony:

Frank Coyne
Vice President of Operations
Chief Transformation Officer
Blue Cross and Blue Shield Association
Witness Testimony

Mark Pratt
Senior Vice President of State Affairs
America’s Health Insurance Plans
Witness Testimony

Paul Wingle
Executive Director of Individual Business and Public Exchange Operations and Strategy
Aetna
Witness Testimony

Brian Evanko
President, Individual Segment
Cigna
Witness Testimony

J. Darren Rodgers
Senior Vice President and Chief Marketing Officer
Health Care Service Corporation
Witness Testimony

Dennis Matheis
President of Central Region and Exchange Strategy
Wellpoint, Inc.
Witness Testimony

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