iStock_000010703403XSmall

As Obamacare health insurance marketplaces move into the new year and deal with new challenges, they still have a long way to go even after the flurry of enrollments received during the last couple of days in December. They are still well below the targets set in October.

However, moving the target numbers aside, the way the administration has bounced back is commendable. People are starting to get in a position that will help them reap the promised benefits of Obamacare in the coming future. Although things are swiftly improving, there are some recent developments that are going to have an impact on how the next couple of months play out. Following are the top three developments expected to have long term effect on Obamacare.

1) Administration hires Accenture for Fixing Healthcare.gov – One of the major developments in the last couple of days is the announcement that Accenture will now be taking the reins on healthcare.gov. CGI, the firm that stood up the marketplace, will be moving out of the agreement when the contract expires in February. In this new role, Accenture will be responsible for application support around the clock, including eligibility and enrollment functions, generation and transmission of enrollment forms and other services. Additionally it will be responsible for the next round of open enrollment, starting in October.

2) Most of the enrollees are older than 45 – As the records released in the beginning of January show, more than 50 percent of the people who have enrolled in the federal and state exchanges are above the age of 45. From roughly 2.2 million of enrollments in the last quarter of 2013, nearly 1.3 million are between the ages of 45 and 64. Naturally, this is a concerning figure for the administration as it attacks the basic premise of affordable health insurance – enough young, healthy individuals in the mix to offset the risk.

However, Obamacare is not in a death spiral. According to under 35 statistics available, about 26 percent of enrollees are healthy and can work to offset the costs of health insurance, the administration points out. The mix of healthy to unhealthy enrollees is more important than the actual ages. Unfortunately, we can’t determine the health of the enrollees and, therefore, rely on age indicators.

3) Health Insurers still haven’t received payments from enrollees – Amidst celebrations and tall claims of Obama’s campaign, one noteworthy point has been slipping the scrutiny of experts until now – the collection of payments on the health payor’s side. While the administration has been portraying the successful increase in the number of enrollments in the last couple of weeks, health insurers contend that they haven’t received any kind of financial commitment from these enrollees, leaving things hanging in the air.

Technically, these numbers exist only on the paper and no enrollments can be processed until payment is received. As of now, there is a gap of nearly 2 million between the people who have enrolled with the system and people who have actually paid. Naturally, this is going to pose a major challenge for the administration and enrollees who are stuck in this no man’s land. In the coming weeks, this should, and probably will, be the top priority of the government.

Leave a Reply

You must be logged in to post a comment.