President Obama's top health official announced that the new health insurance marketplaces have seen a 25 percent increase in the number of insurers planning to sell coverage in the upcoming 2015 enrollment period, which administration officials cited as a sign of the private market's confidence in the Affordable Care Act.
“When you consider the law through the lens of affordability, access and quality, the evidence points to a clear conclusion: the Affordable Care Act is working,” said Burwell, who made just her second speech since winning confirmation to the post in June.
Participation in the 36 states using the federal enrollment Web site, HealthCare.gov, is expected to increase from a combined 191 insurers in the 2014 enrollment period to 248 in 2015, according a HHS report issued Tuesday. Eight states running their own marketplaces will see insurer participation increase from 61 last year to 67 in 2015.
“We’re seeing evidence that these are attractive marketplaces,” said a senior HHS official, speaking with reporters Tuesday on the condition of anonymity.
The department did not have data for state-run marketplaces in Hawaii, Kentucky, Minnesota, Massachusetts and Vermont. Nor did it report insurer participation for Nevada and Oregon, which are planning to join HealthCare.gov after experiencing severe technical problems during enrollment in 2014 health plans.
Consumers in some states with especially limited choices in 2014 will see increased competition during the next enrollment period, according to the HHS report. The number of insurers in New Hampshire’s health insurance marketplace will increase from one to five in 2015. West Virginia, which also had just one insurer in its exchange last year, will now have two.
When the 2015 enrollment period begins in November, 77 issuers in all plan to offer marketplace coverage for the first time or in states that they haven't participated in yet, the HHS report said. That includes some major players like United Health Group, the nation’s largest insurer, which will participate in about two dozen exchanges in 2015 after selling in just five this year.
According to the HHS report, 13 insurers that offered exchange plans in state and federal marketplaces this year are planning to drop out in 2015. That figure does not include last week’s withdrawal of the largest insurer in Minnesota’s state-run marketplace.
However, HHS still hasn’t finalized contracts with insurers to sell in the insurance marketplaces, meaning some could still pull out. Senior HHS officials could not say when they will have a final insurer headcount for the 2015 enrollment period, nor did they provide details about plan pricing or whether insurers plan to sell statewide or in just certain areas.
Some insurers sat out the first signup period because they feared the earliest enrollees would be sicker, since the ACA bans insurers from discriminating against patients' pre-existing conditions. Industry consultant Robert Laszewski, president of Health Policy and Strategy Associates, said insurers now joining the marketplaces avoided the riskiest patients, who were thought to be the most motivated to obtain coverage in the first enrollment period.
"The health plans that waited a year will benefit from the first-year health plans picking up what are sure to be all of those sick people wanting to get covered," Laszewski said.
The administration last week announced that 7.3 million people as of mid-August were enrolled in marketplace coverage, which was down from the 8 million people who signed up at the end of open enrollment in April. That figure, however, doesn’t indicate how many people stopped paying their premiums, signed up for other coverage or obtained new marketplace coverage through a special enrollment period. Senior HHS officials said they plan to update the marketplace enrollment figures before the start of the next enrollment period.
The HHS report came shortly after the independent HHS inspector general’s office released a report on Tuesday finding one "critical vulnerability” in HealthCare.gov security when it tried breaking into the site in the same way a hacker might. However, the federal watchdog said the site’s security features detected and defended against the simulated cyber attack.
Burwell said improving the enrollment Web site's security, as well as making it easier for consumers to shop for health plans this year, ranks among her top priorities.
“In order to make sure that Americans continue to access affordable choices, we have to get HealthCare.gov right,” she said.
Burwell, who in her short tenure has been received better on Capitol Hill than her predecessor Kathleen Sebelius, also urged a more polite conversation around the president's signature health-care law.
“I think we need a bit of a course correction in this country when it comes to how we talk about these issues – and it starts with collectively turning down the volume a bit,” she said.