By Carla Anderson
March 31, 2014
Alabama saw a healthy increase in the number of people who enrolled in private insurance through the federal marketplace during February. Enrollment grew to 55,034 as of March 1, up about 26,000 as of Feb. 1. An additional 17,980 people have qualified for Medicaid or the Children’s Health Insurance Program (CHIP) since Oct. 1, 2013. Alabama is not expanding Medicaid; the nearly 18,000 newly qualified are eligible under the current criteria.
In Alabama 28 percent of those selecting a health plan are between the ages of 18 and 34. Kaiser estimates that young adults need to make up 40 percent of enrollment to keep rates stable. However, others say the age mix assumed by insurers is what really matters. If insurers were cautious and assumed a higher average age when setting 2014 rates, they won’t be forced to hike rates for 2015.
Eighty-six percent of those in Alabama who selected a health plan qualified for financial assistance, which is slightly above the national rate of 83 percent. Eight percent selected a bronze plan, 75 percent selected a silver plan, 10 percent selected a gold plan, 6 selected a platinum plan, and 2 percent selected a catastrophic plan. Nationally, the breakouts were 18 percent bronze, 63 percent silver, 11 percent gold, 6 percent platinum, and 1 percent catastrophic.
March 31 is the last day to apply for private health insurance coverage for 2014. However, federal officials announced that anyone who has started an application on HealthCare.gov but not completed it as of March 31 can have until April 15 to finish enrolling. The extension is available in Alabama and all other states using HealthCare.gov for enrollment. Consumers can qualify for the extension just by clicking a box on HealthCare.gov; no documentation is needed.
Enrollment for Medicaid or CHIP continues throughout the year.
Individuals who remain uninsured after March may face a tax penalty of $95 or one percent of income, whichever is greater.
The federal government is operating 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.
Blue Cross and Blue Shield of Alabama, which dominates the health insurance market in the state, and Humana are selling individual health insurance through the federal marketplace in Alabama. Blue Cross and Blue Shield of Alabama and United Healthcare are selling small-business policies. According to HHS, Alabama consumers have the fewest choices among the 36 states with partnership or federally facilitated marketplace. State residents have an average of seven health plans from which to choose; the national average is 53.
According to a report released by HHS, the average cost for a bronze plan —the lowest-cost option — in Alabama is $247 a month. The national average for a bronze policy is $249 a month.
More than 640,000 people in Alabama (16 percent of the population) are uninsured and eligible to use the marketplace.
State Exchange Profile: Alabama
The Henry J. Kaiser Family Foundation overview of Alabama’s progress toward creating a state health insurance exchange.
Let your Alabama governor and legislators know how you feel about the state’s proposed health insurance exchange.Alabama Governor Robert Bentley