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As we reported last week nearly 360,000 people have enrolled in health insurance plans through the federal Marketplace established by the Affordable Care Act in North Carolina. According to the federal data, 91 percent of these enrollees will receive financial help to pay their premiums.

Although impressive, this top line number does not tell the full story.

The fact sheets released by Health & Human Services also show that 74 percent of North Carolinians purchasing coverage through the Marketplace chose a Silver plan. As many people now know, insurance plans were listed on the federal website according to metal levels. These metal levels correspond to different cost sharing requirements. So an insurance policy that pays about 60 percent of costs is rated “Bronze,” and a plan that pays out 70 percent of costs is ranked as a “Silver” policy.

For individuals and families earning less than 250 percent of federal poverty level, about $58,000 for a family of four, Silver plans provide additional financial assistance by capping deductibles and co-insurance. That means the federal government will not only help with premiums, it will also ensure that families are not left with financially catastrophic deductibles.

The high rate of enrollment in Silver plans should be some comfort to physicians and hospitals that worried about patients facing unaffordable deductibles.

North Carolina’s robust enrollment figures, and the demographics of the enrollees, are good news for the stability of the state’s insurance market. Navigators, health insurance agents and brokers, providers and insurance companies all played a major part in driving consumers to the Affordable Care Act Marketplace. The state’s largest insurer, Blue Cross and Blue Shield of North Carolina, had a lot at stake.

BCBSNC was the only company to offer plans in every county. Weak enrollment would have meant a small pool of customers for the insurance company. With a modest customer base a few sick enrollees could drive up premiums for everyone. A large number of enrollees, on the other hand, means more stable and predictable costs for the company and should moderate premium hikes when new rates are released later this year.

There is also a good age mix among enrollees through the Marketplace in North Carolina. Insurers and analysts often draw arbitrary lines when setting age targets for enrollment. But, generally, younger people use fewer health services so insurance companies need them to offset the older folks to create a balanced pool of customers. Oftentimes analysts look at the percentage of enrollees younger than 35.

In North Carolina, 35 percent of enrollees are younger than 35. Also, 54 percent of enrollees are under the age of 45, what some may consider roughly middle aged.

So what is the bottom line from these figures? Obamacare will not, as critics charged, collapse under its own weight or create what some in the insurance industry call a “death spiral.” In fact, more insurance companies may see the success we’ve had in North Carolina and get into the market.

Also, it is critical to remember that those calling for the repeal of health reform are trying to transport us back to the bad old days when pregnancy was a pre-existing condition and insurance companies could deny coverage to uninsured customers for a broad range of reasons.

Instead of attempting to take coverage from 360,000 North Carolinians legislators should work to improve a law that is already working in our state.

 

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In case you missed it over the weekend, Raleigh’s News & Observer hit the nail on the head Sunday morning with this lead editorial entitled “The Affordable Care Act surpasses goals in NC”. Today’s Fitzsimon File “Monday Numbers” edition provides further confirmation. This is from the editorial:

“To hear the Republican candidates for the U.S. Senate in North Carolina tell it, “Obamacare” is about the worst thing that ever happened to the people of America and certainly North Carolina. They’ll repeal and replace it, they say, or certainly repeal it, and leave consumers to the wonderful world of the free market….

But here’s the problem with the Republican rant. It has been outrun by Obamacare’s successes. Read More

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Health-Reform-SBHere’s this morning’s most important and thus far under-reported news story in North Carolina: the huge spike in enrollment numbers in health insurance as the result of the Affordable Care Act.

This is from a story (buried on the business page, for some reason) in Raleigh’s News & Observer:

“North Carolina enrollments for health insurance surged to 357,000 as tens of thousands of residents signed up for subsidized coverage in the final weeks of eligibility, the U.S. Department of Health and Human Services said Thursday.

The late rush of insurance enrollments under the Affordable Care Act elevates North Carolina to the fifth-highest slot in the nation, surpassing most expectations for the law’s first year of enrollment, particularly in a Republican-controlled state that did not run its own insurance exchange.

Enrollments here represent a third of the state population eligible for health insurance, and are expected to take a significant chunk out of North Carolina’s uninsured population, which was 17 percent in 2012. Almost all of North Carolina’s enrollments came with federal subsidies for the applicants, suggesting that many of those signing up had been unable to afford coverage in the past.”

Moreover, another 74,000 have been obtained coverage under Medicaid. As Chris Fitzsimon notes this morning in Friday Follies, despite all of the imperfections and all of the relentless opposition and innumerable obstructions thrown at the ACA by the ideologues on the right, President Obama and the other architects of health care reform have fashioned a remarkable achievement — they have dramatically improved the lives of millions of Americans (including more than 430,000 North Carolinians) in a profound and irreversible way.

No wonder conservative politicians are getting more and more concerned about the political implications of their ongoing and increasingly futile efforts to oppose and repeal the ACA.

Read more here: http://www.newsobserver.com/2014/05/01/3825943/nc-enrollments-for-subsidized.html?sp=/99/104/#storylink=cpy
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Medicaid efficiencyThe wonks at the Center on Budget and Policy Priorities released an outstanding little report this week about America’s health insurance program for low-income people and some of the biggest myths that have been perpetuated about it.

The overarching message: Despite the far right propaganda, Medicaid remains an efficient and flexible program that dramatically improves the lives of participants, promotes work and is an outstanding deal for states that expand it under the Affordable Care Act.

Read the entire report by clicking here.

Meanwhile, if you’re looking for the  inside political scoop on the Medicaid battles and the real reason the right refuses to allow its expansion in states like North Carolina, Nobel prize-winning economist Paul Krugman had the answer in yesterday’s New York Times: Read More

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As reported by CNBC:

“US says Medicaid enrollment jumps by 3 million under Obamacare

At least 3 million more people were enrolled in Medicaid or CHIP programs by the end of February than before the beginning of Obamcare sign-ups, federal officials revealed Friday morning.

That post-Obamacare number is expected to grow, possibly significantly, because February’s data is not complete, and because it does not now reflect a huge influx of visitors to government-run Affordable Care Act exchanges in March.

Those exchanges both enroll people in private insurance, and determine whether applicants are eligible for the government-run Medicaid and CHIP programs, which give health coverage to poor adults and children, at no cost to enrollees….”

In other words, for all of its imperfections and the shameless obstructionism of the right wing, millions of Americans who were previously uninsured now have health insurance and millions more soon will. This will mean improved health outcomes for millions and overall lower health care costs as millions of people stop using the emergency room as their doctor.

Read the entire story by clicking here.