Lack of premium payment thwarts enrollment

Twenty percent of Americans who signed up for health insurance under the Affordable Care Act didn't pay their premiums despite extended deadlines and remained without coverage last month, The New York Times reported. So the government's count of 3.3 million newly-insured people pursuant to the ACA may be inflated, The Hill's Healthwatch noted.

"The biggest risk now is people thinking that, by picking a plan, that they're insured, when in fact, the final step is paying the premium," Kaiser Family Foundation Senior Vice President Larry Levitt told Healthwatch.

High payment delinquency rates could stem from consumers not receiving invoices from insurers, the Times reported, or people forgetting to disenroll after changing their minds about buying particular plans. Further, some customers have been unable to reach their insurers due to massive ACA-related call volumes, FierceHealthPayer reported. And other new customers have tried to pay their bills, only to find that their insurer didn't cash their checks or charge their credit cards.

The experiences of large insurers show the extent of the late payment problem: About 25 percent of 200,000 new exchange coverage applicants didn't pay Humana by Jan. 31 for coverage effective last month. Similarly, WellPoint received more than 500,000 applications for marketplace coverage, but only 76 percent of applicants paid on time, according to the Times. And Aetna has 135,000 paid enrollees out of 200,000 people who began enrollment through the exchanges.

Local and regional health plans have had better success closing the enrollment loop, the Times reported. For example, 95 percent of people who enrolled for exchange coverage offered by Blue Cross and Blue Shield of Minnesota paid their premiums.

Meanwhile, the Centers for Medicare & Medicaid Services is building a system to track enrollees who have made premium payments. The government is using an 834 form generated on the back end of the system for this purpose, Healthwatch reported. The new system aims to give the government a communication line with payers to report ACA enrollment figures accurately.

For more:
- see the New York Times article
- read the Healthwatch blog post