The number of Connecticut residents covered by health insurance purchased through the state’s individual market rose by nearly 60,000 since last year, a 55 percent increase since the implementation of major provisions of Obamacare, according to figures released by the Connecticut Insurance Department.
The data also show that more than half the people who bought their own health insurance last year have maintained their old policies or other plans purchased late in 2013. But more than 50,000 of them won’t be able to keep their health plans beyond this year, potentially setting up a repeat of last fall’s turmoil and frustration among people whose policies were discontinued.
Last fall, the insurance department surveyed major carriers and found that 108,287 Connecticut residents had individual-market policies as of Nov. 21.
The department repeated the survey this year, and found that on June 30, individual policies covered 167,838 people. Insurer ConnectiCare saw a major gain in membership, eating into the dominance of Anthem Blue Cross and Blue Shield.
The new data appear to answer a major question posed by critics of the health law, who wondered whether people signing up for coverage through the state’s new health insurance exchange had been uninsured or were simply buying different policies because their old plans had been discontinued. The growth indicates that the individual market has new members, not just old customers with new policies.
“It was hard for us to know whether people were just moving from off-exchange to on-exchange, and it turns out that in fact there were quite a few net new participants and policy owners,” said Deputy Insurance Commissioner Anne Melissa Dowling, who leads the department’s health insurance initiatives.
Dowling said that finding is consistent with the department’s experience handling customer service calls in recent months, many of which have been from people who seemed to need help understanding how to use an insurance policy for the first time.
The growth is also consistent with the findings of a survey of people who signed up for coverage through the state’s exchange, Access Health CT. It found that 52 percent of people who bought private insurance through the new marketplace had previously been uninsured.
But in the absence of data from the rest of the insurance market, particularly employer-sponsored coverage, it’s impossible to tell the extent to which the increase represents a gain in the total number of insured Connecticut residents, since some could have moved into the individual market after their employers stopped offering coverage.
The insurance market figures offer a snapshot of the individual market on two given days, but might not be representative of the full years. That’s because many people in the individual market don’t maintain their coverage for a full year. Some use it as a short-term patch between jobs or stop paying premiums and lose coverage.
The figures don’t include coverage offered by small carriers like Celtic and Time insurance companies, which have fewer than 1,000 members.
Many old plans that will soon end
Connecticut’s individual insurance market is currently a mix of plans from different eras, subject to different rules.
The Affordable Care Act — the health law — made significant changes to rules governing insurance policies, many of which took effect Jan. 1.
More than 60,000 state residents still have insurance policies that began before Jan. 1 and don’t meet the new requirements of Obamacare.
Of them, just over 10,000 people have “grandfathered” plans — meaning they were purchased before the health law passed in 2010 — and can keep them as long as they’re offered by the insurers.
The other 50,947 people will have to find new plans for next year because their plans can’t legally be renewed.
Last fall, as insurers notified members they were discontinuing plans that didn’t meet the health law’s requirements, the companies allowed some members to renew their old plans or buy new ones before the start of 2014. That allowed people to get 12 months of coverage from a plan that didn’t meet the coverage requirements of the health law — or carry the costs associated with those rules, which include covering benefits that weren’t usually offered in the past.
Since non-grandfathered plans that don’t meet the Obamacare rules can’t be purchased or renewed anymore, people with those plans will have to find new coverage when their plans expire.
(The federal government announced earlier this year that states and insurers could allow people to keep their noncompliant plans for another two years, but the insurance department and Gov. Dannel P. Malloy’s administration decided against allowing it. The reasoning, according to the insurance department, is that since no new members can join the noncompliant plans, the risk pools will continue to shrink, likely leading those who have the policies to face higher premiums.)
There’s a temporary exception for some: People who bought their plans Dec. 1, 2013 will be allowed to keep them for an extra month, rather than having to buy a new policy for one month until 2015 plans begin.
| Company | Total members | Grandfathered plans | Exchange plans | Off-exchange plans | Non-ACA compliant,non-grandfathered plans |
|---|---|---|---|---|---|
| Aetna | 32,809 | 3,928 | 0 | 4,587 | 24,294 |
| Anthem | 63,226 | 0 | 37,189 | 12,943 | 13,094 |
| ConnectiCare | 55,312 | 1,836 | 32,269 | 17,103 | 4,104 |
| Golden Rule | 13,713 | 4,258 | 0 | 0 | 9,455 |
| HealthyCT | 2,778 | 0 | 2,287 | 391 | 0 |
| Total | 167,838 | 10,022 | 71745 | 35,024 | 50,947 |
Obamacare-compliant plans
Just over 106,000 state residents have health plans that meet the requirements of the health law, which include covering maternity care and pediatric dental and vision benefits — services that weren’t typically covered by individual-market plans before.
Of those customers, 71,745 bought their plans from Access Health, the state’s exchange. The health law allows people with low and mid-range incomes to receive federal financial assistance to help discount their premiums, but it’s only available to people who buy coverage through public exchanges.
Another 35,024 people are covered by individual plans that meet the Obamacare rules and were purchased outside the exchange.
ConnectiCare, Anthem picked up members
The bulk of the growth in membership went to two of the three insurers selling plans on the exchange, ConnectiCare and Anthem.
ConnectiCare quadrupled its membership and jumped from 11.7 percent of the individual market last year to 32 percent, a gain of 42,635 people. Among people who bought Obamacare-compliant plans outside the exchange, nearly half — 17,103 of 35,024 — chose ConnectiCare.
Anthem’s membership grew from 45,940 to 63,226, but its overall share of the individual market fell from 42 percent to 37 percent.
HealthyCT, a new insurer selling plans through Access Health, lagged behind the others with 2,778 members.
Aetna, which is not selling plans through the exchange, saw a slight gain in membership, from 31,900 to 32,809. But the vast majority of customers are in plans that don’t comply with the health law, and most — 24,294 — will have to be discontinued by the end of this year.
Aetna covered 4,587 people in Obamacare-compliant plans.
Golden Rule, which is owned by UnitedHealthcare, had 13,713 members, all in plans that are not Obamacare compliant. UnitedHealthcare has plans to begin selling individual-market plans on and off the exchange in 2015.