Enrollment in the Affordable Care Act through Colorado’s health insurance exchange is barely half the state’s worst-case projection, prompting demands from exchange board members for better stewardship of public money.
The shortfall could compromise the exchange’s “ability to deliver on promises made to Colorado citizens” and threatens the funding stream for the exchange itself, according to board e-mails obtained by The Denver Post in an open records request.
The exchange, meant for individuals and small groups buying insurance, had projected a lowest-level mid-November enrollment of 11,108, in a presentation to a board finance committee. The exchange announced Nov. 18 that it had signed up 6,001 Coloradans so far.
The midlevel scenario for November was 20,186 members, and the highest projection 30,944 members.
As federal startup grants taper off under Obamacare funding, the exchange is meant to pay for itself with per-member charges on the private insurance companies offering policies. It needs 136,300 enrollees in 2014 to raise $6.5 million of its $51.4 million expenses.
Significant operational issues are not being addressed in the wake of bumpy local and national startups for Obamacare, said board member Ellen Daehnick, whose e-mails and comments are sharply critical of board leadership.
“The enrollment numbers are not meeting the projections,” Daehnick said in an interview. “They are behind even the low projections. This board has moved from looking at a plan to looking at actual performance that has not met expectations, at least from my perspective.”
Colorado is one of 14 states running its own exchange, while the troubled federal healthcare.gov site handles the exchanges for 36 other states.
The exchange has not hit either internal projections or those made earlier by consultants supportive of the Affordable Care Act, said board member Dr. Mike Fallon, a conservative voice on the board who calls the act overly complex and expensive.
“None of this surprises me,” Fallon said of the shortfall. “I don’t know what we as a board could have done. Health insurance is a difficult product to sell.”