HHS celebrates “engaged consumers” in the “vibrant Marketplace”

Open Enrollment 2015 Re-Enrollment Snapshot

Department of Health and Human Services, February 25, 2015

Millions of consumers with coverage in 2014 actively selected a Marketplace plan or were automatically re-enrolled through the platform for coverage in 2015.

“These numbers tell a powerful story of a strong open enrollment and of engaged and satisfied consumers,” HHS Secretary Sylvia Burwell said. “More new consumers joined the Marketplace for 2015 than were covered through re-enrollment. More consumers actively selected a plan on than were automatically re-enrolled.  These are signs of a vibrant Marketplace where customers are actively engaged in choosing their health coverage – and of a product that families want, need and appreciate.”

“More than half of the 4.17 million people who re-enrolled in coverage during Open Enrollment came back and actively selected a plan and more than half of those consumers selected a new plan,” said Andy Slavitt, Principal Deputy Administrator of CMS. “Based on my experience looking at enrollment trends with employer-sponsored coverage and Medicare, it is clear that Marketplace consumers are more active, engaged, and eager to shop for the coverage that's right for them.”

Of the approximately 2.21 million 2014 consumers who actively returned to select a plan for 2015, about 1.20 million or 54 percent chose a new plan for their 2015 coverage.

These numbers will fluctuate over the course of the year based on consumers changing or canceling plans or having a change in status such as new job or marriage.



By Don McCanne, MD

So HHS Secretary Sylvia Burwell is celebrating the “powerful story” of “engaged and satisfied consumers” in the “vibrant Marketplace” of federally facilitated ACA exchange plans. Really? Does this unheard of rate of switching plans during an open enrollment period really represent the enthusiasm of of health plan shoppers in finding even better plans than they have, or does it represent dissatisfaction with the plans they have been stuck with during the past year?

What it most likely represents is relatively healthy people - the majority - who are shopping for the lower premiums available for the benchmark silver plans. Because of the clumsy administrative nature of pricing exchange plan premiums, there is a high turnover in the plans classified as benchmark plans. So these are healthier individuals who are more concerned about a better deal on the insurance premiums than they are about the specifics of their plans, since they hope that they won’t need to use them much.

This process of annually switching benchmark plans ensures instability of coverage which is especially problematic when considering that the narrow networks that are essentially universal in the exchange plans will often result in disruption of care whenever there is a change in the plan selected.

Thus the ACA Marketplace perpetuates instability of premiums, instability of plans selected, instability of provider networks, instability of out-of-pocket cost sharing, and instability of the innumerable devious insurer practices such as outrageous coinsurance for expensive drugs - a practice designed to chase chronically ill individuals away, dumping them on the insurer’s competitors.

This is how markets are supposed to work? The deceptive rhetoric of “a vibrant Marketplace where customers are actively engaged” is shameful. It is particularly disgusting when it is our own government that is perpetrating the dishonest and disproved dynamic that markets work well in health care. Nobel laureate Kenneth Arrow disproved that decades ago.

We need the government to take charge by enacting and then implementing a single payer national health program. But it appears that first we will have to replace our legislators and government administrators with more responsible stewards who are dedicated to the health of the people rather than to the medical-industrial complex. Are we up to that task?