Open enrollment kicks off tomorrow for individuals and businesses looking to purchase health insurance, and with the healthcare landscape more politicized than ever, there will be plenty to watch for.
Federal officials significantly downsized expectations this year, after a tumultuous, bitterly partisan but ultimately successful start to last year’s inaugural season under Obamacare that enrolled some 15 million people into health plans. By all accounts, this year will be harder. Last year, enrollment season extended six-and-a-half months; this year it’s only three.
On top of that, the Supreme Court earlier this month said it would hear a case that challenges the federal government’s ability to provide subsidies for those buying health plans on the federal exchange, healthcare.gov — a linchpin of the legislation for those in states that did not set up exchanges.
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Several states stood out last year for their success: Covered California enrolled the most individuals; Connecticut’s successful efforts are now being duplicated in Maryland and its leader was tapped to lead the federal exchange this year; and Kentucky — among the reddest of states — bucked all of its neighbors and successfully and significantly expanded its Medicaid rolls.
Other states were miserable failures, notably Oregon, which scrapped its state-run exchange after a disastrous roll-out and deferred to the federal exchange.
There will undoubtedly be many story lines to follow this year, but here’s a small glimpse of what to watch for:
Idaho
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A somewhat surprising new entrant into the state-based exchanges. From Kaiser Health News:
Idaho on Saturday becomes the latest state to launch its own health insurance exchange under the federal health law, with marketplace officials promising an easier shopping experience for consumers and greater responsiveness to insurance agents.
But the exchange, yourhealthidaho.org, will be challenged to do as well as the federal insurance exchange during the first open enrollment period that ended last March. About 76,000 Idahoans signed up for private coverage at healthcare.gov, one of the most successful enrollments in any state.
Idaho will be one of a dozen states, along with Washington, D.C., to run its own online marketplace this year — and the only one whose state government is completely controlled by Republicans.
California
While the feds downsized projections, Peter Lee, executive director of Covered California, did the precise opposite, saying the exchange expected a 43 percent increase — some 500,000 people — over last year’s 1.2 million. If that proves true, Covered California would clearly be doing something right.
Kentucky
The peculiar (given the politics) success of the Blue Grass state was well documented last year. Can it repeat its success? It’s made upgrades to its exchange, including a mobile app and a storefront (first pioneered by Connecticut’s exchange, Access Health CT). Should it succeed again, it would prove to not be a one-off.
The three Ms — Maryland, Massachusetts and Minnesota
Each state had disappointing showing last year, despite wide-spread support from citizens. Massachusetts was especially surprising given that it pioneered the concept — and much of the framework for the ACA . Minnesota faced political infighting from its legislature, while Maryland struggled with outreach.
Healthcare.gov
After downgrading it exceptions, and with plenty of people hoping it fails, all eyes will be on the feds.
