Monday, November 3, 2014

Bankrate poll confirms instability of exchange enrollment

November 3, 2014
Obamacare users wary of new enrollment season
By Jay MacDonald

Those who experienced the rocky rollout of the Obamacare health
exchanges firsthand are feeling nervous about prices and wary of
technical glitches on the eve of the second open enrollment period,
according to the latest Bankrate Health Insurance Pulse survey. All of
the survey respondents were from households that used the exchanges
during the initial open enrollment last fall and winter.

Poll question:

Do you think you or someone in your household will again shop in a
health insurance exchange website this fall?

43% - Yes
51% - No
6% - Don't know/refused to answer

Where will the exchange-phobes go?

What about the more than half of the respondents who say they won't
return to the exchange for the second open enrollment? What's their plan B?

"That's a good question," says Kominski (Gerald Kominski, director of
the UCLA Center for Health Policy Research). "Going without insurance is
far more risky than trying to make the exchange work. My guess is they
don't qualify for a subsidy and therefore are going to shop for coverage
outside the exchange. That's a reasonable alternative because the law
regulates those so-called 'mirror' policies to where there aren't
significant differences. But I don't think there are any huge bargains

Schlesinger (Mark Schlesinger, a professor at the Yale School of Public
Health) says changes in employment, income or family status also could
pull some people away from the exchange and onto either employer plans,
Medicare or Medicaid.

"Some of it may be that they're just in different circumstances," he says.

Auto-renew to avoid revisiting exchanges?

But Hough (Doug Hough, associate director of the Bloomberg School of
Public Health at Johns Hopkins University) predicts that those who
currently have exchange policies and simply don't bother to log onto
their state exchange may be surprised by the result.

"They're going to be auto-renewed," he says. "With 43 percent saying
their experience last time was somewhat or very bad, they're not looking
forward to doing it again. That in itself will encourage people to just
go with auto-renew. I predict we'll see lots and lots and lots of


Comment by Don McCanne

This Bankrate poll confirms once again what we have said many times
before. The exchanges are a highly unstable source for obtaining health
care coverage. From year to year, individuals and families cannot rely
on the adequacy and choices in their insurer-dictated networks of
providers, nor on their anticipated exposure to out-of-pocket spending
on health care.

Under a single payer system, there is no year to year process in
changing coverage. There is no necessity to use networks to limit
provider choice, plus exposure to financial hardship is essentially
eliminated by first dollar coverage.

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