There could be a late surge in enrollment under the Patient Protection and Affordable Care Act.
That might be the case if millions more consumers who qualify for subsidies to help them buy health insurance realize their eligibility, researchers from Avalere Health say.
But to date, enrollment fueled by subsidies has fallen way short of projected totals.
New analysis from the consulting firm shows that, as of Nov. 2, 30 percent of exchange applicants are eligible for subsidies, far below the 84 percent of enrollees ultimately expected to qualify for financial assistance.
“The figures show the potential for increased exchange enrollment in the coming weeks as we get closer to the deadline for 2014 insurance,” said Dan Mendelson, CEO of Avalere Health. “As lower-income Americans determine they have access to subsidized commercial insurance products, we can expect to see many enroll to save money.”
Avalere’s analysis also found that state-based exchanges are tracking behind states with federal exchanges, with 23 percent of applicants being subsidy-eligible in SBEs compared with 34 percent in federally run exchanges.
By comparison, Avalere Health projects state-run exchanges will ultimately have 88 percent of subsidized enrollees and federally run states will have 83 percent of them.
Enrollment numbers released by the Department of Health and Human Services showed the state exchanges are enrolling more consumers than their federal counterparts.
The reason for less-than-expected subsidized applicants in October? Blame the glitched website, and the consumer confusion.
“First, many ‘eligible’ applicants, particularly those who did not apply for subsidies, are unlikely to finish the application process,” Avalere researchers wrote. “HHS defines eligible individuals as those who create an account and verify their identity via the federal data hub. Many of these people could be exploring the marketplace website and have other sources of coverage (e.g., through their employer) making them unlikely to complete the enrollment process.”
Secondly, the website problems plaguing the exchanges are also to blame. Avalere said subsidy-eligibles were more likely to be affected by IT problems because that application process is more complex.
Lastly, the initial numbers “highlight the challenges associated with reaching lower income individuals via outreach and awareness campaigns.”