Insurers: 80 to 90 Percent Have Paid Premiums
Policy + Politics

Insurers: 80 to 90 Percent Have Paid Premiums


Executives from some of the largest insurance companies in the country just poured cold water on Republicans’ claims that a significant portion of Obamacare enrollees had not paid their premiums.

In congressional testimony on Wednesday, executives from Aetna, Blue Cross Blue Shield, Cigna and WellPoint estimated about 80 to 90 percent of people who had signed up for plans on the state or federal exchanges had paid their first month’s premiums.

Related: Obamacare Update: Lots of Unanswered Questions

For months, Republicans have attacked the Obama administration for not releasing figures on how many people had paid their first month’s premiums. Though the administration still has not cited official figures, they have previously cited insurers’ estimates that about 80 percent had paid.

Unsatisfied with those estimates, Republicans from the House Energy and Commerce Committee released their own survey of insurers last week showing that 67 percent of people had paid their premiums.

GOP lawmakers rallied around the report, suggesting that the Obama administration’s declarations of the law’s success were “unfounded,” as Chairman Fred Upton (R-MI) said in a statement.

"These numbers stand in stark contrast to the White House’s previous assertions. While the administration was eager to declare that Obamacare’s mandate had worked, it has so far not provided any substantive data to back that up," Cantor said.

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However, when the lawmakers released the data, insurers cautioned that the figures were not “final verified numbers.” The data only captured how many people had paid through April 15—the end of the special open enrollment period. However, people who signed up through special enrollment had until at least April 31 to pay for their plans—meaning the committee’s data was incomplete.

At the time it was released, officials and Human Services Department pushed back saying the information was inaccurate and outdated.

“These claims are based on only about half of the approximately 300 issuers in the federally-facilitated Marketplace and they do not match up with public comments from insurance companies themselves, most of which indicate that 80 to 90 percent of enrollees have paid their premium," said CMS spokesman Aaron Albright. "Additionally, given the significant surge in enrollments at the end of March, it stands to reason that not all enrollees would have paid by the date of this so-called report since many people’s bills were not even due yet,” he said.

Still, the administration has not provided their own official estimate of how many people have paid their first month’s premiums. Julie Bataille, communications director for the Centers for Medicare and Medicaid Services, said that information won’t likely be available until later this year.

Through April 15, the Obama administration said more than 8 million people had signed up for plans through the new law’s insurance exchanges. The final enrollment number soared far above the administration’s original target of 7 million.

Still, insurers said that the enrollment total includes “many duplicate enrollments” for consumers who had trouble signing up on the website.

Related: Insurers on Obamacare: Expect Premium Prices to Soar

“Insurers have many duplicate enrollments in their system for which they never received any payment,” Mark Pratt, a senior vice president of America’s Health Insurance Plans, an industry trade group, told The New York Times. “It may be a matter of months,” Mr. Pratt added, “before insurers know how many people activated their coverage by paying their share of premiums.”

If insurers’ estimates are accurate and between 80 to 90 percent of enrollees pay their first premium, actual enrollment will be somewhere around 6.4 million to 7.2 million—in line with the administration’s pervious expectations.

Still, health policy experts caution that meeting the White House’s targets will mean very little to the price of premiums next year—instead, it is more important that enrollment lines up with what insurers were expecting when setting their rates.

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