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Looking at ACA enrollment, experts say N.J. marketplace is doing well

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Ray Castro, senior policy analyst for New Jersey Policy Perspective.
Ray Castro, senior policy analyst for New Jersey Policy Perspective. - ()

At last, New Jersey wasn't at the top of the list of “most expensive places for” something.

That was one of the biggest takeaways industry experts noticed about the 2017 Affordable Care Act marketplace enrollment numbers in the state, released by the Centers for Medicare and Medicaid Services on Wednesday.

“That’s unusual to see New Jersey in that category,” said Ray Castro, a senior policy analyst at New Jersey Policy Perspective.

Although the increase in enrollment was small, as anticipated, it shows “the marketplace is not melting down,” Castro said.

That being said, the marketplace in New Jersey did boil down to just two insurers of choice for exchange members: AmeriHealth New Jersey, a subsidiary of Independence Blue Cross in Pennsylvania, and Horizon Blue Cross Blue Shield of New Jersey.

UnitedHealthcare left the exchange, but still sells plans in the state, as does Aetna, which did not join the exchange as originally anticipated for this year. Oscar Health, a startup in New York, left the state, and the state liquidated the co-op Health Republic of New Jersey.

AmeriHealth said it enrolled more than 100,000 individual members, both on and off the exchange.

“As one of only two carriers offering plans on (the) exchange in the N.J. marketplace for 2017, we saw a significant influx of new members,” spokeswoman Jill Roman said. “In fact, nearly 50 percent of our consumer membership is new this year.

“Our Top 5 counties for overall consumer membership are Bergen, Camden, Monmouth, Ocean and Middlesex.”

The marketplace saw a bump in enrollment toward the end of 2016, just before the holidays.

The timing is interesting, Castro said, because that was the time “there was criticism and the (Obama) administration stopped outreach.”

Linda Schwimmer, CEO and president of the Health Care Quality Institute, said, “New Jersey did very well on enrollment, surpassing last year, despite the lack of direct marketing.”

Another observation about the data from CMS was that there was a larger population of older enrollees in the state, mostly in the 55-64 age range, Schwimmer said.

This doesn’t bode well for those enrollees who stand to be affected by the proposed American Health Care Act.

“Those are the ones hit hardest under the new bill,” Castro said. “The other big population (enrolled for 2017) is the low-income population. Those are the two groups hit the hardest in the (Republican) House plan, and they make up most of the (enrolled) population in New Jersey.

“That doesn’t bode well for the bill.”

In the AHCA, subsidies based on incomes were replaced by single amounts for individual and family plans, and seniors, who are higher utilizers of health care, will pay more.

Some other takeaways from the enrollment numbers:

  • In rankings of financial assistance and consumers who switched plans, New Jersey was placed in the bottom half of the list.
  • The majority of enrollees, more than 234,000, signed up for silver plans. Nationally, 71 percent of enrollees signed up for the silver plans.
  • The average premium paid by New Jerseyans was $479, ranking it 27th on the list of average premiums around the country, and placing it on par with the national average.

For AmeriHealth, overall enrollment showed an anticipated trend.

As many industry experts have repeatedly said: Tiered and narrow networks are the future and are here to stay.

“Once again, our tiered health plans remain most popular among consumers,” Roman said. “We saw 75 percent of individuals enroll in a tiered health plan available through our Advantage suite (Tier 1 Advantage EPO and AmeriHealth Advantage EPO). Introduced in 2013, these products have expanded and evolved as our hospital collaborations have grown.”

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