BISMARCK, N.D. — Health care providers told lawmakers Tuesday that new signups for health insurance are running below projections in the weeks following the open enrollment period under federal health care legislation.
Officials with Blue Cross Blue Shield of North Dakota and Sanford Health Plan took part in a panel discussion on implementation of the Patient Protection and Affordable Care Act at the state Capitol. The discussion was part of a meeting of the interim Health Care Reform Review Committee.
Luther Stueland, director of health policy impact and exchanges for Blue Cross, provided updated enrollment figures through Nov. 4 to the committee.
Stueland said the company had received 118 contracts for insurance since the open enrollment period through the Affordable Care Act began Oct. 1. Of those, 24 were through the federally-run state health insurance exchange. The rest were through other means, he said.
"While these numbers are smaller than we had projected, we expect greater enrollment as Jan. 1 approaches and throughout the open enrollment period which ends March 31, 2014," Stueland said.
Stueland pointed to the highly publicized glitches in the federal health care insurance website leading to enrollment problems across the country. He said it appears many people may be waiting for the issues to be corrected.
Stueland said notices are being sent out to approximately 31,600 individual and small-group market customers whose non-grandfathered plans are to be discontinued.
"This accounts for roughly 8 percent of the 400,000 North Dakotans we serve," Stueland said.
Rep. Jim Kasper, R-Fargo, asked Stueland about the effects of possibly moving back the date of the individual mandate for having health insurance. Recently, there has been debate on the federal level over moving back the mandate by one year, which would require people to have insurance or pay a penalty beginning in 2014.
Kasper asked Stueland if Blue Cross would continue providing the current policies to the 31,600 customers set to receive notices. Stueland replied that Blue Cross would comply with federal law in the event of that occurring.
Grandfathered plans are those that were in effect prior to the Affordable Care Act being signed on March 23, 2010, which haven't been changed in ways that significantly impact coverage or cost.
Sarah Delaney, an associate actuary with Sanford Health Plan, said a delay of the individual mandate could "impact solvency of the plans" on the state marketplace.
Delaney also touched on the difficulties surrounding the federal marketplace website, www.HealthCare.gov. She said in one instance, the company had a navigator who accessed the site and "didn't even realize that he had enrolled."
"They're supposed to be the experts," Delaney said.
The North Dakota Insurance Department provided lawmakers with data on the number of customers to be impacted by non-grandfathered plans. A total of 812 Sanford Health Plan customers would be affected by non-grandfathered plans. Medica, the third company providing insurance plans in North Dakota on the marketplace, has 3,173 customers who will be affected.
Department of Human Services Executive Director Maggie Anderson gave an update on Medicaid expansion.
Proposals from private insurers for the expansion of Medicaid coverage in North Dakota have been received, she said. Anderson said the department is to announce its notice of intent to award the project to a vendor this week.
"This is all a work in progress," Anderson said.
Anderson said the department's most recent numbers show that it has received 214 paper applications for Medicaid so far between the state and county offices. In addition, a total of 365 applications submitted by North Dakotans on the marketplace website have been deemed Medicaid eligible.