ROBERT PEAR AND ABBY GOODNOUGH NY TIMES Some New Frustrations as Health Exchanges Open

Problems with Health Exchange Health insurance marketplace opened for business Saturday Long delays in accessing HealthCare.gov  Difficulty with identity proofing, retrieving old passwords and logging into account Average time to complete applications was 90 minutes Projected 13 million enrollment now down to 9.1 million Two tasks  Enrolling more of uninsured  Renewing coverage for those that already had it

Problems with Renewing Coverage Health Insurance prices set to increase up to 20%  Center for Medicare and Medicaid Services estimates prices rise 5% for average person New data suggest that many of nearly 7 million people who bought insurance will have to change to different health plans to avoid paying more  An inconvenience for consumers A 40 year old with cheapest midlevel or silver plan will pay $220 a month next year compared to $181 a month this year Failure to re-enroll suggest even with subsidized premiums not worth the benefit they received

Problems with Renewing Coverage Lower premiums to entice customers but much higher deductibles Premiums increased much more sharply in places where fewer insurers were competing for customers  Muscogee County: 74 plans available  52 plans deductibles>$2,500, 17 plans >$5000  In Charleston: 14 plans available  9 plans deductibles>$2,500, 3 plans>$5,000 Caroline F. Pearson, vice president of Avalere Health: “Next year will see another reshuffling. Eventually in a year or two, we will start to stabilize”

Number of Insurers State by State

Problems with Expanding Coverage Enrollment events, tax penalties ($325 or 2% income), more emphasis on rural and minority groups Coverage Gap in states not expanding Medicaid  Income above current Medicaid eligibility but below lower limit for Marketplace premium tax credits Kaiser Family Foundation poll from October found 9/10 uninsured Americans had no idea when open enrollment starts, 38% had no intention of buying coverage

Further Challenges Supreme Court agreed to hear a case about subsidies for the ACA Republicans captured senate Obama ratings low (40% approval)

ACA in the Future 25% more insurers participating next year Leads to increase in supply which leads to: Increase in quantity Decrease in Price ACA will stabilize in future with more entry

Market Failure? Lower supply due to uncertainty  Insurers do not want to enter without knowing how supreme court decision and congress handle ACA Adverse selection  Prices rise due to less entry  Healthy people withdraw  Prices rise even further If subsidies are declared unconstitutional further exacerbate this problem.

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