The latest data on healthcare exchange enrollment underscore a troublesome fact for Republicans: These online marketplaces are quite popular in some very red states.
A prime example is Florida, according to Jodi Tonkin, who along with fellow researcher Brian Berndt will highlight some surprising facts on the exchanges in a Decision Resources Group webinar on Thursday. Although Florida and New York have similar populations, red-state Florida has enrolled twice as many people in its exchange as blue-state New York.
In fact, the exchange is a hit in Florida, whose governor, meanwhile, is spending millions in campaign money highlighting his opposition to ObamaCare. He may want to change tactics: more than 750,000 people in Florida have signed up and paid their premiums for exchange plans; others have chosen a plan but not yet paid. With one of the highest rates of uninsured in the country (21 percent), Florida had a lot of pent-up demand. New York had a fewer percentage of uninsured to begin with, part of the reason its exchange enrollment is lower.
Other factors may also be at work. Tonkin points out that Florida has 67 rating areas compared to New York's eight. Rating areas are geographic regions that can vary in premium cost (under ObamaCare, insurers are only allowed to rate premiums based on age and geography and not on the health status of populations.) New York's insurers, stuck with large rating areas, can't offer as many choices, so they may be pricing people out of affordable insurance. (Since it already had guaranteed issue for individuals, New York had pricey individual plans to begin with; insurers were hedging their bets because they had to take all comers, including the very ill.)
Another fascinating fact about the two states: A very large Blue Cross Blue Shield plan and national carriers Humana and Aetna dominate the Florida exchange, but the top three in New York are completely new to commercial insurance. The largest, Health Republic, is one of the new nonprofit Consumer Operated and Oriented Plans that received federal start-up loans. The other two are Medicaid plans hoping to cash in on Medicaid enrollees who transition into subsidized plans in the exchanges. They bring the experience of providing coverage for low-income populations who may have gone long periods without healthcare.
Thursday's webinar will also look at the government sector, including this: The overall uninsured rate dropped by 22 percent in the 27 states (including D.C.) that have chosen to expand Medicaid, but by just 7 percent in those that did not expand the program.
There are a million ways to slice and dice the latest exchange and Medicaid enrollment numbers. Tonkin and Berndt will dissect the DRG view on Thursday at 2 p.m. Eastern.
Follow Sheri Sellmeyer on Twitter @SheriSellmeyer