CDC finds weakness in off-exchange health enrollment

February 10, 2016 at 12:26 PM
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U.S. health carriers may have had more trouble holding on to enrollees in group plans and off-exchange individual policies this summer than they did at holding on to enrollees in public exchange plans.

Officials at the Centers for Disease Control and Prevention (CDC) have published data raising the possibility of enrollment weakness at private insurers' off-exchange programs in a new batch of preliminary National Health Interview Survey (NHIS) data.

The new numbers cover the third quarter of the year, which ran from July 1, 2015, through Sept. 30, 2015.

The overall U.S. uninsured rate for U.S. residents under age 65 was 10.8 percent. That was down from 13.2 percent a year earlier — in the third quarter of 2014 — but it was up from 10.3 percent in the second quarter of 2015.

Recently, another survey report, this time from the Census Bureau, showed a big drop in the U.S. uninsured rate. But that report compared 2014 data with 2013 data. The new report compares much newer data, from late 2015, with 2014 data.

Critics of the Patient Protection and Affordable Care Act (PPACA) exchange system have noted that it loses some business to disenrollment as the year goes on.

In 2015, however, the percentage of U.S. residents under age 65 who had PPACA exchange coverage increased over the course of the year. Public exchange plans were covering 4.2 percent of U.S. residents under age 65 in the third quarter. That was up from 4 percent in the second quarter of 2015, and it was up from 2.5 percent in the third quarter of 2014.

The CDC broke out the coverage data for people with incomes under 100 percent of the federal poverty level (FPL), people with incomes from 100 percent to 200 percent of FPL, and people with incomes over 200 percent of FPL.

The percentage of people using Medicare, Medicaid and other government health programs increased in all three income categories, both sequentially and year over year.

In the highest income category, for example, the percentage of people with government plan coverage increased to 9.6 percent in the third quarter. That was up from 8.8 percent in the second quarter of 2015, and it was up from 8.3 percent in the third quarter of 2014.

Private, off-exchange plans lost market share in all three income categories.

Only 60.3 percent of all people under 65 had off-exchange private coverage in the third quarter of 2015. That was down from 62.7 percent in the second quarter of 2015, and it was down from 61.5 percent in the third quarter of 2014.

In the highest income category, 79.5 percent of people under age 65 had off-exchange private coverage. But that figure was down from 81.4 percent in the previous quarter, and it was down from 81.7 percent a year earlier. 

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