More than 100,000 people bought private health plans through the state’s health insurance exchange for this year, but a survey of customers found that more than one in three haven’t used their coverage and more than one in four don’t have a primary care physician.
Both figures were an increase from last year. In 2014, 26 percent of members surveyed said they hadn’t used their coverage, compared to 36 percent this year. And last year, 23 percent of members surveyed said they didn’t have a primary care physician, compared to 28 percent in 2015.
Ensuring that people who gained coverage under the federal health law actually use it to get care – and seek preventive services rather than waiting until they’re sick – has become a major focus of state officials, insurance companies and advocacy groups. State Healthcare Advocate Victoria Veltri said she worried that some customers with deductibles – which require them to pay thousands of dollars in medical costs before the plan starts chipping in – didn’t realize that they could get certain preventive services for free.
Access Health CT, the state’s exchange, has included a plug for people to see a primary care provider in radio ads being run this summer.
“Primary care physicians really help our customers navigate the health care system, and they’re the liaison between that primary care and specialty care, so we want to make sure that people understand this is very important to have,” Access Health Marketing Director Andrea Ravitz said Thursday during a meeting of the exchange’s board.
The data Ravitz presented to the board Thursday were based on a telephone survey of Access Health members and people who had coverage through the exchange but subsequently dropped it. It was conducted in English and Spanish. Exchange officials plan to release more extensive survey data in September.
Among the findings were that 51 percent of new private health plan customers in 2015 did not have coverage before enrolling. When exchange members were surveyed last year, 43 percent of those with private insurance plans said they did not have coverage in the year before signing up.
Access Health officials have suggested that those survey findings indicate that the exchange has reduced the number of people without insurance in the state, although the survey data don’t provide a glimpse at the rest of the insurance market. The number of people covered through Connecticut’s individual market, which includes plans sold to individuals through the exchange, grew by 0.1 percent from 2014 to 2015, from 167,838 to 167,933, according to figures submitted to insurers to the Connecticut Insurance Department.
In all, 110,095 people signed up for private insurance plans through the exchange during the open enrollment period for 2015 coverage. But since then, the number of people covered has dropped to 96,966.
Access Health Operations Director James Michel said there was a similar decline in enrollment last year in the months after the enrollment period, before membership plateaued in July and August.
Why did people drop coverage? Michel said major reasons included not paying premiums or not having information needed to maintain their coverage verified. In addition, he said, some people dropped coverage because they gained coverage through Medicaid or Medicare.
The survey also offered insights into why people dropped their coverage. Nineteen percent of former customers said they terminated their coverage because they couldn’t afford either the coverage in general, their premiums, copays and deductibles, or prescriptions. Seven percent said they dropped coverage because they didn’t use it, while 3 percent said it was not valuable or poor coverage and 8 percent cited poor customer service or experience with either Access Health or their insurer.
Ravitz noted that 33 percent dropped coverage for reasons that were out of the exchange’s control, including qualifying for Medicaid or Medicare, moving or getting a job that provided coverage.
And she noted that 64 percent of those who dropped their insurance plans said they were either very or somewhat likely to revisit the exchange for coverage in the future.
| Reason for terminating coverage | Percent |
|---|---|
| Too expensive/can’t afford it, general | 14% |
| Personal situations (marriage, divorce, death in family, etc.) | 13% |
| I/my spouse got a job with health insurance | 12% |
| Qualified for Medicare | 12% |
| Didn’t use it | 7% |
| I moved | 6% |
| Poor customer service/Poor experience dealing with Access Health | 6% |
| Not worth it/not valuable/poor coverage | 3% |
| I qualified for Medicaid | 3% |
| Too expensive/can’t afford it, copays and deductibles | 2% |
| Too expensive/can’t afford it, premiums | 2% |
| Poor choice in doctors/hospitals/my doctor wasn’t covered | 2% |
| Poor customer service/poor experince dealing with insurer | 2% |
| Too expensive/can’t afford it, prescriptions | 1% |
| Other | 15% |
| Don’t know/refused | 3% |