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Many Pennsylvanians fail to pay first premiums under Obamacare

Monday, Feb. 17, 2014, 11:06 p.m.
 

At least one in 10 Pennsylvanians who selected coverage through Healthcare.gov never paid their first premium, according to insurance companies, which extended deadlines at the urging of President Obama on the troubled rollout of his signature health-reform law.

The Obama administration has said 2.2 million Americans selected health plans with coverage to start Jan. 1, including more than 81,000 in Pennsylvania. But their enrollment isn't complete until the first monthly premium is paid, meaning thousands of people who were counted as enrolled under the Affordable Care Act never received coverage.

“There is a lot of confusion about every step of this process,” said Mike Stahl, vice president of marketing for HealthMarkets, which sells Obamacare plans online and in all 50 states. “We hear from customers that sometimes the fact that they didn't pay wasn't of their own volition. They just weren't sure what to do.”

Premiums weren't paid because HealthCare.gov and state exchanges couldn't collect payments when people selected plans, Stahl said. Insurers had to wait for enrollment data from the government and bill consumers.

In Pennsylvania, Highmark Inc. and Independence Blue Cross said 12 percent and 16 percent of their respective enrollees never made a payment. That's nearly 8,900 people out of their combined enrollment of 64,600 through the end of December. The two companies have sold about 80 percent of the individual Obamacare policies in the state.

UPMC Health Plan gave people who selected one of its plans until Jan. 14 to pay if they wanted coverage to start retroactively on Jan. 1, spokesman Paul Wood said. About 17 percent didn't pay by the deadline, he said.

Nationally, the rate of unpaid premiums may be worse.

About 30 percent of people who selected Obamacare health plans from Aetna Inc., including its subsidiaries Coventry and HealthAmerica, failed to pay in time to have coverage start on Jan. 1, spokesman Walt Cherniak said.

Aetna's deadline to pay was pushed back to Jan. 14, and Coventry and HealthAmerica's was extended to Jan. 17. Aetna, one of the nation's largest health insurers, enrolled 135,000 paid members in 15 states in health plans, Cherniak said.

Inexperience with buying a health plan may have contributed to the large number of people not paying premiums, he said.

“There are a lot of people who purchased insurance on the exchanges that are inexperienced health care consumers,” he said. “They haven't had to shop for insurance before.”

After a chaotic rollout of Healthcare.gov, in which many shoppers had trouble accessing the site or completing the buying process for much of October and November, Obama asked insurers to push back deadlines to select plans and pay for them so that uninsured Americans could have coverage at the start of the year.

Officials with the Department of Health and Human Services have said they are not able to provide a breakdown of the number of enrollees who paid their first premiums. As of Feb. 1, 3.3 million Americans have selected health plans through Healthcare.gov and state-based exchanges, the department said last week.

Highmark has not set a hard deadline when a payment must be received, spokeswoman Kristin Ash said. It “will be canceling individuals who have enrolled but not paid when we determine that all of our attempts to reach them for payment have gone unanswered.”

Philadelphia-based Independence Blue Cross extended its deadline for payment to Jan. 28, spokeswoman Judimarie Thomas said. But in some cases, bills were delayed and so the company “changed the date when their premiums were due to Feb. 15.”

“If the first monthly payment was not received by the deadline, the member's coverage will not be effective as of Jan. 1,” she said.

Uninsured Americans have until March 31 to enroll in a health plan and pay their first premium to avoid tax penalties for not having coverage.

Alex Nixon is a Trib Total Media staff writer. Reach him at 412-320-7928 or anixon@tribweb.com.

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