Ohio health insurance exchange
Ohio health insurance exchange
By Louise Norris
July 24, 2014
A report released by HHS in June compared after-subsidy premiums paid by exchange enrollees in the 36 states where HHS is running the exchange. In Ohio, the average after-subsidy premium is $121 per month – significantly higher than the $82 per month average across all 36 states. Ohio’s after-subsidy premiums are the fourth highest among the 36 states (only New Jersey, North Dakota and Deleware are higher), but the discrepancy is a factor of the enrollees’ incomes and the plans they selected: The ACA completely levels the field for people with the same incomes who select the second-lowest-cost silver plan in their exchanges. But among enrollees who qualify for subsidy, there are significant differences in income, and enrollees are free to apply their subsidies to any “metal” plan in the exchange. Although the average after-subsidy premiums are higher in Ohio than in most other states, the overall average premiums in Ohio are slightly lower than the national average. The addition of four more carriers for 2015 will increase competition, but early rate filings in Ohio point to a possible average rate increase of up to 13 percent, varying considerably from one carrier to another (final rate increases have not yet been approved by the state insurance department).
The 2014 open enrollment period ended in April, but enrollment has continued in the Ohio exchange through the summer due to qualifying events that trigger special enrollment periods. HHS will release updated enrollment numbers in November, when the 2015 open enrollment period begins. By April 19, 154,668 Ohio residents had completed their Obamacare enrollment, selecting private plans in the exchange – nearly double the number who had done so by March 1. And by the end of April, 184,671 people in Ohio had enrolled in the expanded Medicaid program, along with another 124,195 people who qualified for Medicaid based on the old guidelines but have only recently enrolled. Their enrollment is due in large part to the attention that ACA implementation has brought to the Medicaid program. All told, that’s over 463,000 people in Ohio who obtained new health insurance in the first few months of 2014, thanks to Obamacare. Medicaid enrollment and special enrollment periods are year-round, so the total is likely to be significantly higher by the end of the year.
CMS announced on November 22 that the technology necessary for applicants to enroll in exchange plans directly through insurers was working and being piloted in three states, including Ohio. The program was summarized in a presentation by Families USA in early March.
Ohio Governor John Kasich is not an ACA proponent, but he’s long been a supporter of expanding Medicaid in Ohio, which was approved in late October 2013. Eligible residents were able to begin enrolling in expanded Medicaid on December 9, 2013 and the state received 1,165 applications on the first day of enrollment. However, opponents of Medicaid expansion brought a lawsuit against the Ohio Department of Medicaid and the state’s Controlling Board because the General Assembly was bypassed in the decision to expand Medicaid. The plaintiffs hoped to block the state from expanding Medicaid to cover approximately 366,000 residents who would be newly eligible under the expanded guidelines. But on December 20th, the Ohio Supreme Court sided with Governor Kasich and kept Ohio Medicaid expansion on track.
In November 2012, Governor Kasich formally announced that Ohio would not implement a state-run health insurance exchange. In the same letter, Kasich indicated that Ohio would retain control of plan management activities and determining eligibility for the state’s Medicaid and Children’s Health Insurance Plan (CHIP).
In June 2013, the Ohio Department of Insurance issued a press release announcing that 14 insurers filed plans to offer more than 200 options for individual insurance, and seven insurers would offer 84 options for small businesses. Lt. Gov. Mary Taylor, who also directs the state’s insurance department, stated in the press release that “consumers will have fewer choices and pay much higher premiums for their health insurance starting in 2014.” Both opponents and supporters of the Affordable Care Act jumped on the press release. Opponents claimed Ohio was the latest example of “rate shock.” Supporters dismissed the announcement for making “apples-to-oranges” comparisons and pointed out that both Kasich and Taylor have been outspoken about their opposition to the ACA.
By the time the exchange opened in October, two of the original carriers had backed out, leaving 12 carriers and roughly 200 plans in the still very robust Ohio exchange. Averaged across all age groups, the lowest cost bronze plan in the Ohio exchange is $263/month, and the lowest cost silver plan is $304/month. Rates in the Ohio exchange are just slightly lower than the average of the 36 states where HHS is running the exchange.
The twelve carriers that ultimately ended up offering 2014 coverage in the Ohio health insurance exchange include: AultCare, Ambetter from Buckeye Community Health Plan, Anthem Blue Cross Blue Shield of Ohio, CareSource (expanding into Kentucky and Indiana exchanges for 2015), HealthAmericaOne, HealthSpan, Humana Health Plan of Ohio, Medical Mutual, Molina Healthcare, Kaiser Foundation Health Plan of Ohio, Paramount Insurance Company, and SummaCare.
It mid-June 2014, HHS had confirmed that four additional carriers would be joining the Ohio exchange lineup for the 2015 open enrollment period that begins on November 15.
On June 10, CieloStar announced that it had partnered with the Ohio Chamber of Commerce to launch a private health insurance and benefits exchange, which they said was open for business in early June. The private exchange in Ohio purports to offer a variety of major medical and supplemental plans for individuals, along with coverage options for small and large groups. But as of July 9, the web page for individuals had no clickable links for the various types of coverage mentioned, and the small business page had a “no plans found” result for twenty different zip codes in the Columbus and Cleveland areas.
Laws were enacted in Ohio to make it more difficult for navigators to be certified, which means that the state has fewer people available to assist applicants, and there was a delay in getting them started as navigators after the exchange opened on October 1.
Ohio residents can compare plans, determine subsidy eligibility and enroll in coverage at Healthcare.gov.
Ohio health insurance exchange links
State Exchange Profile: Ohio
The Henry J. Kaiser Family Foundation overview of Ohio’s progress toward creating a state health insurance exchange.