Nearly 294K Mich. consumers get health plans

Karen Bouffard
The Detroit News

Nearly 294,000, or about 86 percent, of Michigan consumers who enrolled for insurance at HealthCare.gov paid at least their first month’s premium and were actively covered as of March 31, according to numbers released Tuesday by the federal government.

It means 14 percent of the state’s consumers or 47,340 may have lost their coverage because they didn’t pay their premiums as required under the Affordable Care Act or gotten it through a private employer or other source. The number represents an estimate.

Nationwide, 10.2 million paid their bills and were covered as of March 31. About 11. 7 million Americans enrolled for federally required plans during the 2015 open enrollment, which ended Feb. 22. It means roughly 1.5 million who signed up dropped off the insurance rolls.

The number of Marketplace enrollees who put their plans into action by paying their bills and remaining insured is on target to meet a federal goal of 9.1 million enrollees by the end of 2015, federal officials said. The goal was set by the U.S. Department of Health and Human Services in November 2014.

The Congressional Budget Office originally had forecast 13 million enrollees.

Federal officials said the figures didn’t capture consumers who paid their first month’s premium after March 31 because their insurance companies provided an extension.

Nearly 8.7 million consumers nationwide received an average premium tax credit of $272 per month to make their premiums, including more than 228,00 in Michigan. But about 7.3 million live in states where federal subsidies could be jeopardized by a looming U.S. Supreme Court case.

The nation’s highest court is expected to rule this month in the King v. Burwell case challenging the legality of federal subsidies paid to consumers in states like Michigan that don’t run their own health insurance exchanges. About 2.9 million consumers with active plans live in states that run their own exchanges.

“A ruling against the tax credits could cost Michigan as much as $350 million this year in financial assistance,” said Marianne Udow-Phillips, director of University of Michigan’s Center for Healthcare Research and Transformation.

Gerry Konal, principal and office business leader for Southfield-based consulting firm Mercer Health and Benefits LLC, said the future of the exchanges is uncertain regardless of King v. Burwell. More than half of Michigan insurers are seeking rate increases of 5 percent or more in the individual health insurance market, and others are requesting hikes of 10 percent or more across the country.

“There’s certainly more individuals recognizing that the public exchanges are a viable solution for buying health insurance.” Konal said Tuesday. “(But) there may be some challenges ahead … to ensure the mechanisms are in place to continue to allow (marketplace insurance) to be offered at a reasonable rate.”

HHS Secretary Sylvia Burwell lauded Tuesday’s numbers.

“The Health Insurance Marketplaces are working,” Burwell said in a statement. “Thanks to the Affordable Care Act, millions of Americans now rely on the health and financial security that comes from affordable coverage through the Marketplaces.

“We’ve seen a historic reduction in the uninsured, and consumers are finding the coverage they need at a price they can afford.”

kbouffard@detroitnews.com