The open enrollment period for state and federal health exchanges officially ends on?March 31. So far, the Connect for Health Colorado website has signed up more than 250,000 residents. Nationally, more than 5 million Americans have enrolled./Photo by Steve Eginoire

The final countdown

Closing time nears for state and federal health care exchanges

by Tracy Chamberlin

It’s no joke. Not a simple prank or trick to fool the foolish. On April 1, the state and federal health care exchanges will close for business and won’t reopen until mid-November.

So, if getting health insurance is anywhere on the to-do list, it might need to jump to the top.

“If (Coloradans) want to purchase health insurance, they should get started as soon as possible,” said Jamie Robb, program manager for the Southwestern Colorado Area Health Education Center.

Once the March 31 deadline passes, the tax penalty for not having health insurance kicks in. The amount of the tax depends on how much a person makes, with a $95 minimum or 1 percent of the taxable income for 2014.

The enrollment door is left ajar for only a few specific reasons, called life-changing events. These include things like getting married, having children or moving.

The list also includes a bullet point about enrollment troubles, stating that a customer can shop for a new plan if he or she has “inadvertently or inappropriately enrolled or not enrolled in a health plan as a result of error, misrepresentation, or inaction by the Marketplace or one of its instrumentalities.”

Some shoppers might need those caveats with so many hiccups at HealthCare.gov, the federal exchange. The Centennial state’s website is another matter.

“I think that Colorado is really doing a great job,” Robb said. “(It’s) one of the leading exchanges.”

So far, the Connect for Health Colorado site has signed up more than 250,000 residents. About 100,000 of those bought commercial insurance and 150,000 received Medicaid.

Nationally, more than 5 million Americans have enrolled, according to the Department of Health and Human Services.

A recent HHS report on enrollment admits the millions of enrollees include “those who have paid a premium and those who have not yet paid a premium,” so it’s unclear how much money is really going into the industry pot.

Nationally, statewide and locally, though, those numbers have started leveling off with more than 1.1 million enrollments in January and less than 950,000 in February. 

Kevin O’Connor, a Health Coverage Guide with San Juan Basin Health, doesn’t necessarily feel the downtime. “There was a brief lull in activity for me personally right after Jan. 1,” he said. “But it did not last long.”

Commercial and internet campaigns for the federal site are everywhere as well as updates on progress. In Colorado, the state exchange is getting the word out, even going so far as to open an enrollment store on the 16th Street Mall in downtown Denver.

Locally no events are planned, but guides in the Southwest are aren’t likely to get a lot of sleep until April 1.

Robb admits the application process on the state exchange requires a lot of information, and he recommends starting with the help of a guide, who can be found at the La Plata Family Center or San Juan Basin Health.

Once someone has applied for coverage, it’s time to choose a plan. “That’s where the broker comes in,” Robb said.

Guides aren’t allowed to help individuals choose between plans offered by the different insurance companies; they can only assist with the application process. Brokers, on the other hand, can help with that decision by breaking down the pros and cons of premium costs, deductibles, doctor networks and more.

The Connect for Health Colorado website lists several area brokers, or insurance agents, who also can help with enrollment.

At a recent sign-up event, which Robb attended, 86 people came in for help with either the initial enrollment in the Connect for Health Colorado website; deciding which plan would work best for them; or needing answers to general questions about the law, the deadline or the exchange.

He also said about half the people who came to the event and applied for insurance were surprised to discover they got some kind of assistance, either federal subsidies or coverage under the state’s Medicaid.

According to O’Connor, the number of Medicaid recipients in Colorado includes families, adults without children, and some who have suffered health issues for years without the ability to get covered. Now that they have coverage, they might be able to return to work and get their health issues resolved.

“I’ve had people leave my office with tears of joy in their eyes because they can now get help,” he added.

It’s widely understood and acknowledged by HHS officials that the young and healthy are the cornerstones of the law’s success. By paying into the system but not often using it, they help offset the costs of those who do.

That key demographic, considered ages 18-34, made up only 24 percent of the enrollment nationwide at the end of 2013. As of March 1, that number had gone up slightly to 27 percent.

O’Connor said about one-third of Colorado enrollees were under 35 years old. “So, younger Coloradans are just as interested in health insurance as everyone else,” he added.

Of course, that also includes the under-26 crowd, which is now eligible to remain on parents’ plans.

Marc Goldfarb, Fort Lewis College’s director of Orientation and Student Health Services, said that could explain why enrollment in the college’s plan has declined significantly in recent years.

The insurance plans offered through the Student Health Center are something the college has offered for years. The policy changed recently to comply with the law; this also increased the cost by about 50 percent.

As the deadline approaches, enrollment has not increased and the college is not planning any specific sign-up events; although, one local agent is looking to help students enroll.

In less than two weeks, on March 31, the open enrollment period for the exchanges officially ends, so the push is on to get people to sign up.

Robb said some are scrambling as the clock ticks down. “I think people are starting to get the message,” he added.