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An inside look at Ohio’s Affordable Care Act Enrollment

Thursday, December 19, 2013 at 6:00 PM

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Medical Mutual Chief Executive Rick Chiricosta

The Affordable Care Act and roll out of the federal marketplace have dominated the news much of the past few months. As the year ends, one of Ohio's biggest health insurers reports that the technological glitches have largely subsided, enrollment is picking up and new concerns have arisen. ideastream health reporter Sarah Jane Tribble sat down with Medical Mutual's Chief Executive Rick Chiricosta and has this report.

Medical Mutual’s Chief Executive Rick Chiricosta says his staff has been working at a hectic pace since the federal exchange launched Oct. 1

They’ve dealt with changing enrollment deadlines and technology snags.

As of Friday, Dec.13, about 5,000 people were enrolled in a Medical Mutual plan through the federal exchange. But Chiricosta warns that there are a couple of caveats to those numbers.

Only 510 of those who have signed up for Medical Mutual policies have paid their first month’s premiums, which they must do before Dec. 31 to start coverage on January 1.

“The fact that only 13 percent have actually paid, is kind of a telling statistic. I wonder how many of those 5,000 people are actually going to end up purchasing the coverage,” Chiricosta says.

Then there is the concern of who is signing up. Medical Mutual, which is based in Cleveland but provides insurance across Ohio, had predicted that a little more than half of their enrollees on the exchange would be under 40 years old.

That hasn’t happened: Only 25 percent of those who signed up could be considered young and assumingly healthier than older enrollees .

“So clearly the biggest trend that’s emerged is older people are buying more than younger people and that’s always been the no. 1 concern.  Are young people going to pay $200 or something approximating that for a policy that you have to satisfy a moderately high deductible and pays out of pocket costs. You know, young people don’t expect to get sick. So I think we’re finding, at least so far, they are not flocking to these products,” Chiricosta says.

Instead, Chiracosta says, 63 percent of those 5,000 enrolled in Medical Mutual coverage on the exchange are over 50 years old.

“In a way, it’s a good thing the enrollment is lower. If that was 50,000, I would tell you I would be a lot more nervous about it than I am because if in fact those 5,000 people turn out to have a really poor experience, it won’t devastate the financials of the company,” Chiricosta says.

Now that healthcare.gov is working, Chiricosta says he worries individuals who are signing up for one of the bronze, silver, gold and platinum plans are not able to fully compare the plans side-by-side. 

“Is it easy enough for them to determine what you’re buying with insurance is not just the protection but the access to the doctor’s and the hospitals and I’m not sure if people really understand that or if a lot of people think they are going to go on there, pick the lowest and be done with it. And that could be a dangerous decision that people will find out about when it comes time to get a service done,” Chiricosta says.

Chiracosta concurs with critics of the Affordable Care Act who complain that delays in the individual and employer mandates create instability in the insurance market.  He says the transition insurers prepared to meet at the start of 2014 has effectively been pushed back a year “and that frustrates me a little because the uneasiness and the uncertainty, it’s hard. It’s hard to sleep at night knowing that some big dramatic change is going to happen. Who knows half of our small group customers will drop their plans. And what does that mean for us. And now we are not going to be able to find out about it until a year down the road, a year-and-a-half down the road.”

In the longer term, Chiricosta predicts that by the year 2020 the Affordable Care Act will have changed the landscape of the insurance industry.  The individual insurance market will be enormous, he says. Small employers will be much less likely to offer insurance. And big employers will likely give their employees a lump sum and tell them to find insurance on their own.

“From Medical Mutual’s perspective, we’ve really changed the company significantly. Ten years ago we did not have any individual products. And all the sudden we think it’s going to be the future of the company. Not tomorrow morning, employer market is not going away any time soon. You know, it’s just like it wasn’t that long ago when almost every big employer had a defined benefit pension plan. Walk out in the street now and try to find any big employers who still have that. It’s pretty difficult to find any. I really do believe that health care is headed down the same path,” Chiricosta says.

The only question, he says, is will it be in three years, five years or 15 years.


Government/Politics, Health

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