christine stuart / ctnewsjunkie
Access Health CT CEO James Michel (christine stuart / ctnewsjunkie)

HARTFORD, CT — The calculation doesn’t include the last day of open enrollment, but Access Health officials reported Thursday that enrollment was down 2.7% in 2020.

An estimated 106,376 Connecticut residents enrolled with either ConnectiCare or Anthem Health Plans. That’s fewer than the estimated 111,066 who signed up for coverage last year.

It was the fourth year in a row that there was a drop in customers qualifying for federal tax credits to off-set the cost of the monthly premiums. An estimated 69% of those who enrolled this year are eligible for a subsidy. That’s a drop from 78% in 2016.

“The economy is improving and one can assume that increasing incomes is putting folks above the 400% of the federal poverty level,” Rob Blundo, director of technical operations and analytics for Access Health CT, told board members Thursday.

In future reports Blundo said they will track how many customers have fallen in and out of the financial assistance category.

He said there were not a lot of policy changes that occurred this year, but the “economy is improving,” and the assumption is that people are getting jobs that offer health benefits.

A survey of those who left the exchange found 76% of them had coverage in 2020 and for 70% of those with coverage in 2020 it was with an employer, Blundo said.

Office of Health Strategy Executive Director Vicki Veltri worried about making that assumption since enrollment in Medicaid also increased this year.

She cautioned that they will have to look at whether people fell out of the subsidized category and found it unaffordable.

“I think we need to probe whether that’s going on,” Veltri said. “… It’s making me a little nervous that folks in that unsubsidized bracket are finding it hard to afford.”

Blundo said there’s no doubt that affordability is “the biggest challenge for our customers.”

The median unsubsidized monthly premium increased about $65 a month.

Blundo was asked if the elimination of the individual mandate penalty had any impact, but he said he didn’t have any data.

There’s also a chance that enrollment will go down in 2020 because about 20% of customers still need to make their first premium payment. There’s another group of individuals who still need to verify their income or immigration status. Access Health officials said there are still 14,000 households who need to submit their documents to the exchange for verification.

Meanwhile, Medicaid was up 7% by 50,717 individuals. That’s likely due to the increase in the income limit for low-income adults with children.

Access Health CT CEO James Michel also announced that they will hire a consultant to perform an actuarial and economic report on what it would take for Connecticut to apply for a reinsurance waiver. The report is expected to be completed by the end of February.

Access Health CT plans on spending $100,000 from its reserves to hire a consultant to complete the report. The report is expected to tell them how much money the state and the federal government would have to contribute to help lower premiums on the exchange. 

The state, according to previous reports and estimates, would likely have to contribute $15 to $20 million a year to help lower premiums on the exchange.

Lawmakers struggled last year with how to pay for it.

A Democratic bill that passed the House and not the Senate would have levied the states share from a portion of customer premiums. Republicans felt the state would have gotten more help from the federal government if it used part of the state budget to fund its share. 

Healthcare Advocate Ted Doolitte said because of how the Affordable Care Act works other states have found reinsurance programs help provide direct savings to unsubsidized people and increase rates for those who are subsidized.

“I do believe we need to look at how to hold harmless our subsidized enrollees,” Doolittle said while admitting that the unsubsidized enrollees have “taken on the chin” since the beginning.

He said there are ways to minimize the financial impact on both populations.