Kansas insurance execs describe experiences with the ACA marketplace

A staunch opponent concedes it's "the biggest opportunity I've seen"

0 | Health Reform, Insurance

Panelists at a discussion on the ACA marketplace sponsored by the Kansas Health Institute. Left to right: Matt All of Blue Cross Blue Shield of Kansas, Kevin Curry of Coventry Health Care of Kansas, Scott Day of the Kansas Health Underwriters Association, and Linda Sheppard of the Kansas Insurance Department.

Panelists at a discussion on the ACA marketplace sponsored by the Kansas Health Institute. Left to right: Matt All of Blue Cross Blue Shield of Kansas, Kevin Curry of Coventry Health Care of Kansas, Scott Day of the Kansas Health Underwriters Association, and Linda Sheppard of the Kansas Insurance Department.

— Leading representatives of the Kansas health insurance industry talked today about their experiences with the Affordable Care Act's marketplace and were generally positive in their assessments despite the problems that have plagued the new exchange's first few months of operation.

"I've fought this law (Obamacare) for three years, but this is going to be our best year; a record year. It's time to write business," said Scott Day, president of the Kansas Association of Health Underwriters and the co-owner of an agency with offices in Topeka and Ozawkie that specializes in selling health insurance products.

'Biggest opportunity I've ever seen'

"I don't like the law. I don't like where I think it's going to take us. But on the other hand, it's the biggest opportunity I've ever seen," Day said, talking to a crowd of about 25 people gathered for a panel discussion sponsored by the Kansas Health Institute, a Topeka-based think tank that specializes in health policy issues. KHI News Service is an editorially independent part of the institute.

Day was one of four featured panelists at the 90 minute event held in a basement conference room across the street from the Kansas Statehouse. The others were Linda Sheppard, a top Kansas insurance regulator; Matt All, a ranking officer of Blue Cross Blue Shield of Kansas, the state's largest private health insurer; and Kevin Curry, a sales director with Coventry Health Care.

All four described the frustrations and problems they or their organizations have experienced since the marketplace was officially launched on Oct. 1, 2013. But each also said that they had seen improvements in how it is functioning.

'Like a light switch went on'

"It's fair to say the roll-out was a debacle," Sheppard said. "But it was like a light switch went on about Dec. 1," and consumers and marketplace navigators began reporting they were having greater success with the enrollment process.

The panel discussion started minutes after federal officials released new numbers showing that 22,386 Kansans had enrolled in marketplace plans as of Jan. 31; a significant increase over the 14,242 reported at the end of December. Enrollment for 2014 coverage closes the end of March, so officials are expecting at least several thousand more signed up by then.

According to the numbers released today, 76 percent of Kansans enrolled through the marketplace will get federal subsidies to help them pay health plan premiums.

'Driving off with Cadillacs'

Day said most of the people he has worked with have low incomes and have gotten plans with good coverage at relatively little personal expense.

"They are driving off with Cadillacs and paying peanuts for them," he said, noting that most of his customers ended up paying about $25 a month in premiums with the rest covered by federal subsidy.


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Scott Day

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"We're writing a lot of low-income business," he said.

Day said he and his customers mostly rely "on the phone lines" to the marketplace call centers because the government's website remains difficult to use. But the telephone process can still be slow and tedious.

"The best day, I enrolled nine people," he said.

As for the call center representatives, "some are very good," he said. "And some are mean and hateful."

Day said his company previously sold a lot of health savings account plans but that the new law had made those more expensive.

Hoping for a youthful 'surge'

Curry, the Coventry representative, said the company early after the program's launch "definitely had our internal struggles," trying to deal with the customer information it was supposed to get via the marketplace clearinghouses. He said even now much of the information that comes over is "inaccurate."

"They are working on that," he said of federal officials. "And it's gotten a lot better in recent weeks."

He said Coventry officials were still uncertain whether the company would offer plans on the marketplace next year, because they can't tell yet if they will make or lose money with them.

"2015 is a question mark right now," he said. "We have to make that decision without knowing what our claims experience is."

There are only four companies offering plans on the marketplace in Kansas: Two are Coventry companies, plus Blue Cross Blue Shield of Kansas and Blue Cross Blue Shield of Kansas City. Together they offer 65 plans available to individuals. Another seven plans are offered by Blue Cross of Kansas for small employers.

Curry said the company was hoping for "a surge" in enrollment from younger customers.

"Right now, our average age is about 42," he said.

Included in the new federal statistics released today were these: Of the Kansans enrolled through the marketplace, 28 percent were between the ages of 18 and 34, a slightly higher percentage than nationally and in surrounding states.

'Improv work'

All, speaking for Blue Cross Kansas, said October and November "were very, very frustrating," but since then things have improved considerably and now the "vast majority" of the customer enrollment information the company gets from the marketplace is "good data."


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Matt All

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"It's OK," he said. "It's what we do. We aren't stomping our feet angry. But it's taken a lot of improv work."

He also noted that the ACA marketplace plans represented a small portion of the company's business.

"Most people get coverage through their employers," he said.

All also said it would be good to remember that the marketplace is still quite new and it could take at least a couple of years or more before it can be fairly judged or its ramifications understood even by insurance companies.

"What we think might happen in 2015, may not happen," he said. "And the vast majority of this story for 2014 remains to be told."

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