Good news: Obamacare enrollments are up, much of it thanks to the work of independent agents. Bad news: those agents aren't always doing a great job. Andrew Sprung runs down the numbers for Obamacare applications submitted by agents:
- 16% lacked a Social Security number.
- 26% had data matching problems (income, immigration status, etc.).
- 17% of people qualifying for free CSR silver plans were instead steered toward low-quality bronze plans.
How do you forget a Social Security number? But at least that's easily fixed. The bigger problem is the number of poor people who qualify for Cost Sharing Reduction silver plans, which are cheap and high quality, being signed up instead for bronze plans with big deductibles and out-of-pocket expenses. That's a tragedy for the people who can least afford it.
CSR has always been a bit of a problem. Not everyone knows about it, and it's not always obvious on the online enrollment forms. Maybe the feds need to make a new metal level between silver and gold and rename the whole program. Electrum plans?
I don't have time to read Sprung's report right now, but I wonder at what point he is tracking an "Obamacare application." Is it only once the applicant is signing up for a marketplace plan, or is it before they are funneled to the marketplace, when they are seeing if they might qualify for expanded Medicaid?
Because that might explain why so many applicants lack an SSN. The undocumented have been eligible in California to apply for Medicaid since the beginning of the year, so they might be contributing to the numbers not submitting an SSN, in addition to people who just can't remember theirs or had other irregularities.
"How do you forget a Social Security number?"
Perhaps, this more an issue that folks lack, typically because of immigration status, a Social Security number. Some blue states, such as California, allow undocumented to participate in some social welfare programs: thus, one can imagine some confusion in the populous.
Note, this is my speculation versus having any data to support this statement.
The whole metal levels has been confusing for me for the past few years. Early on I was getting those Silver CSR plans and they were pretty good. And my understanding was that Bronze = cheap with no benefits for healthy young kids, Silver = modest price for modest average benefits, and Gold = pay a bit more and get lower copays and deductibles and out-of-pocket maximums.
But for the past few years, after much browsing, I've found that the Silver and CSR plans turn out being pretty expensive for me, while the Gold plans actually end up being LESS expensive, with roughtly equivalent or slightly better copays/deductibles/maximums.
I'm greatly thankful for the ACA (was on it for years, got off when I got coverage through my partner's job, had to get back on last month when he was laid off) but the levels have gotten really weird. Maybe because I never went through an agent.
That happened because Congress is unable to fix anything, because the Republican line is that it's terrible and should be gotten rid of.
There was a bit of a gimmick called Silver Loading. You can Google it, I forget the exact details.
The bottom line is that the subsidies are based on the price of a silver plan. So, the companies all make their silver plan expensive and the gold plan cheaper. That way the subsidies are bigger. Gold plans are often the best deal now.
Charles Gaba explains:
https://acasignups.net/24/01/05/my-simplified-silverloading-explainer
Short version, Trump tried to sabotage the ACA but in the end it resulted in higher subsidies for more people. The problem is that for those CSR eligible, it's still a better deal to get silver using the subsidies.
Wow … thank you, that actually makes sense now. I knew Trump had tried to sabotage things and Biden tried to fix them again (and I saw that generally in the overall monthly rates and subsidies), but didn't realize CSR had been specifically screwed like that.
Also, my income had trended a bit higher the past few years … not enough that I don't still get a decent subsidy, but it's probably affected where I fall on the scale of those CSR plans being as beneficial.
Since this is all done online, how hard is it to code a filter to catch these things?
could the folks that lack a SSN not be citizens? I thought anyone could participate in the ACA including non citizens?
If these are problems with insurance agent submissions, I wonder how bad individuals do.
HHS should be accumulating these stats and feeding them back to insuance companies. Blacklist agents and then companies if they don't meet some reasonable standards.