Alabama residents are seeing more choices and somewhat higher prices during the second open enrollment period on the health insurance marketplace. You have until Feb. 15 to participate in open enrollment; purchase a policy by Dec. 15 to have coverage as of Jan. 1.
UnitedHealthcare joined the exchange for 2015, and its plans are now available through the marketplace in all 67 Alabama counties. Previously, United policies were available only outside the marketplace.
Blue Cross and Blue Shield of Alabama, which dominates the health insurance market in the state, and Humana sold individual health insurance through the federal marketplace in Alabama for 2014. According to HHS, Alabama consumers had the fewest choices among the 36 states with partnership or federally facilitated marketplace for 2014 coverage. Historically, Alabama’s health insurance market has been considered one of the least competitive in the nation.
HealthCare.gov working well
The federal marketplace is in much better shape than last year. No major difficulties or outages have been reported since open enrollment started on Nov. 15.
Health and Human Services (HHS) that 1,032,129 people across the U.S. submitted applications on HealthCare.gov between Nov. 15 and Nov. 21. More than 462,000 people selected a health plan; the signups were roughly evenly split between new and renewing customers. Alabama-specific information won’t be released until sometime in December.
Take action to re-enroll
Most people who bought coverage in 2014 will see their plans auto-renew for 2015, and they will receive the same subsidies. While that option is effortless, chances are it won’t give you the best results.
Experts are urging everyone to check their 2015 options. There are many reasons a new health plan may be a better choice: your personal situation changed, a new plan has a lower premium, or you qualify for a different subsidy amount.
Rates rise less than in previous years
While 2015 premium rates in Alabama are going up in most counties, the jump isn’t as sharp as in the years leading up to the ACA launch. A New York Times analysis shows rates in most areas of Alabama going up about 8 percent. For comparison, a national study showed rates for individuals increasing about 10 percent each year between 2008 and 2010, prior to the passage of the Affordable Care Act.
Nearly 125,000 found coverage in 2014
Nearly 98,000 Alabama residents signed up for qualified health plans (QHPs) during 2014 open enrollment. That was about 21 percent of estimated 464,000 people eligible to use the marketplace, according to the Kaiser Family Foundation. Nationally, about 28 percent of eligible people actually enrolled in a health plan through the ACA marketplaces. In addition, Kaiser also reported 22,564 people qualified for either Medicaid or the Children’s Health Insurance Program (CHIP) under existing eligibility criteria.
Alabama’s uninsured rate dropped 2.6 percentage points following the 2014 “Obamacare” open enrollment period, falling to 15.1 percent as of mid-2014 based a Gallup survey. The 2.6 point drop is slightly above the average decrease seen in other states that defaulted to the federal exchange and/or did not expand Medicaid in 2014.
How Alabama is handling health care reform
The federal government operates the health insurance marketplace in Alabama, based on Gov. Robert Bentley’s November 2012 decision against a state-run marketplace. Bentley cited annual operating costs of up to $50 million as his reason for opting for a federally operated exchange. Bentley also ruled out an expansion of Medicaid in the state.
The decision against a state-run exchange came somewhat as a surprise. While the Republican governor consistently opposed many provisions of the Affordable Care Act, he repeatedly expressed support for a state health insurance exchange. He supported exchanges during his campaign for governor, and as governor, he used an executive order to establish the Alabama Health Insurance Exchange Study Commission. In November 2011, that commission unanimously recommended Alabama implement a state-run exchange. However, bills to establish a state-run exchange failed to pass in both the 2011 and 2012 sessions.
An August 2014 study published by the Urban Institute shows the impacts of not expanding Medicaid. For the low income, uninsured Alabamians, the decision against Medicaid expansion means 254,000 people will not qualify for Medicaid coverage through 2016. In terms of financial impact, the authors calculated that while Alabama would spend $1.08 billion to expand Medicaid over a ten-year period, the state is losing out on $14.4 billion in federal spending and state hospitals are losing $7.0 billion in reimbursement over the same period.
Gov. Bentley’s position against Medicaid expansion has become the subject of campaign ads, editorials, billboards, and websites. A coalition of health care organizations and advocacy groups, Alabama’s Best, is also advocating for Medicaid expansion.
Alabama health insurance exchange links
Alabama Department of Insurance – Health Insurance Reform Information Center
State Exchange Profile: Alabama
The Henry J. Kaiser Family Foundation overview of Alabama’s progress toward creating a state health insurance exchange.