Imbalance in the Health Benefits Exchange


The RI Center for Freedom & Prosperity’s chart on the costs per HealthSource RI enrollee now has the latest data, through January 4, broken down by the categories of application progress. All told, the health benefits exchange received in direct federal grants $10,011 per current paid enrollee, $8,422 per person on applications for paid policies, and $2,752 per person on all applications, including those who’ll be getting their plans for free, through Medicaid or RIte Care.

The complete picture, however, requires recognition that the percentages of people getting their plans for free versus those who will receive no additional taxpayer subsidies have not changed. So far, 24,252 (i.e., 67%) of the 36,022 applicants are eligible for Medicaid or RIte Care, while only 1,545 (4%) will buy their insurance with no additional subsidies at all. In other words, it remains true that only the $3.9 million of the $99.1 million spent to get the Web site up and running is actually the total taxpayer burden for those beneficiaries.

The post on the Center’s site goes into additional detail about the applicants receiving free care, but one additional observation that bears mentioning is that the 1,868 people who have completed applications but have not paid any premiums, yet, outnumber the applicants who are under 25, as well as the number who are not eligible for any additional subsidies.

One of the great concerns about the Affordable Care Act is that not enough young, healthy, and/or paying customers will buy insurance to offset the risks and costs for those who are old, sick, and unable to pay their full premiums.  The latest numbers from HealthSource RI paint a worrying picture in every way.

Not only is it theoretically possible that not a single person under 25 or paying their full freight has finalized his or her application with a first payment, but 54% of applicants are women.  For a variety of reasons, women use more healthcare services, but the Affordable Care Acts prevents their being charged a different cost than men.

Perhaps more significantly, though, 33% of applicants are older than 55 and 56% are older than 45.  That contrasts with the 29% who are under 35.

One doesn’t have to be much of a cynic to expect the government to look for ways to hide the costs of health care reform, and it doesn’t take much analysis to conclude that they’re likely to be much, much higher than projected.