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Big Week Expected In Obamacare Sign-Ups As Jan. 31 Deadline Nears

The Record (NorthJersey.com) — January 22, 2016

By LINDY WASHBURN
STAFF WRITER | The Record

Health care advocates and federal officials are bracing for an expected last-minute surge as this year's open enrollment period for Obamacare health plans ends on Jan. 31. With 266,000 New Jersey residents already signed up, total enrollment in individual plans for Year 3 of the Affordable Care Act already exceeds that of previous years.

But if the past is a guide, the next week should be very busy on the federal marketplace for New Jersey, HealthCare.gov.

Last year, 30,000 New Jersey residents selected insurance during the final 11 days of the enrollment period, triple the prior weekly average.

The penalty for going without insurance in 2016 has increased to $695, or 2.5 percent of income, compounding the pressure. And this year, no special enrollment period is planned around the April 15 tax filing deadline, when people realize how large the penalty is.

National enrollment in the plans made available by the Affordable Care Act reached 11.3 million as of Dec. 26, compared with the 10 million goal set last fall by Sylvia Burwell, the secretary of Health and Human Services. After plans are selected, customers must pay their premiums, so there is usually considerable attrition before the number who actually gained insurance is known.

Meanwhile, enrollment in New Jersey Medicaid, expanded by Governor Christie in 2014 to allow poor, childless adults to gain coverage for no premium, has dropped by more than 43,000 since peaking in June at 1,762,000. The Medicaid expansion had accounted for 475,000 additional enrollees, as of June.

The reasons for the dip are not clear yet, and could include improvements to the state economy that resulted in gains in employment and higher incomes, rendering some enrollees ineligible. Alternatively, some of the newly enrolled could have failed to fulfill the renewal requirements, such as proof of income, that allow them to continue on Medicaid.

Jackie Cornell-Bechelli, director of Health and Human Services for Region 2, which includes New Jersey, said Friday that she was not worried about declines in Medicaid enrollment unless the overall total of people with insurance declines. If Medicaid enrollees are switching to marketplace plans as their income increases, that's a positive development, she said.

"If there's fewer people in Medicaid because they're making more [money] and have graduated to marketplace status, that's a sign they're doing better financially," she said. "A decrease is only negative when it's a decrease in the insured total. It's a little tricky for us to say one way or another now."

A significant drop in Medicaid enrollment could have repercussions for hospitals, if the amount of patient debt or the need for charity care increases. Patients with Obamacare policies, rather than Medicaid coverage, have much higher out-of-pocket expenses. The least costly marketplace plans come with high deductibles and cost-sharing.

A spokeswoman for the state Department of Human Services, which runs Medicaid, said the change in enrollment was not unusual.

"Medicaid enrollment fluctuates regularly," said Nicole Brossoie, the spokeswoman. "People can become eligible/ineligible based upon changing income. Members also must recertify every year in order to remain in active status. New Jersey's unemployment rate dropped throughout the year and the economy is in recovery, which also may be a factor in the lower enrollment."

State Medicaid programs, under federal law, must make sure each year that beneficiaries are still entitled to coverage through a process known as recertification. Last year, that requirement was waived for New Jersey because of the huge backlog in actually enrolling new members, which took several months. Now, with all 1.7 million members to be recertified, it's possible that some enrollees have been dropped if they didn't provide the necessary paperwork or were found to be ineligible, either rightly or wrongly.

Working together

The leader of a statewide coalition of non-profit groups helping with insurance enrollment said outreach efforts for people losing their Medicaid coverage showed how public and private groups can work together. The state's notification letters to those losing Medicaid includes information about other insurance options through HealthCare.gov and enrollment assistance, said Maura Collinsgru of New Jersey Citizen Action.

"We have been able to put in place a very good system and a safety net to try to capture them," she said.

So far, people who signed up for marketplace coverage in New Jersey are paying an average of $172 monthly for premiums, after their tax credits are calculated, according to a report released this week by the federal government.

The average premium, before tax credits, was $499 in New Jersey, compared with $408 in the 37 states using HealthCare.gov.

More than three-quarters of the New Jersey residents who signed up or were automatically reenrolled, as of Dec. 26, received a tax credit to help pay for coverage. The tax credits averaged $328 monthly, about two-thirds of the premium cost.

Copyright 2016 North Jersey Media Group Inc.

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