Obamacare: the grind isn't over

Whew! We've lived through the Obamacare launch (finally -- why did this have to take 4 years?) and we learned a new concept: "exchanges." 7,000,000 signed up nationally through the exchanges; another 4.5 million or so through Medicaid expansion in the states that don't want their poor people to just die. Not bad. Now we need to learn another one new concept as Obamacare moves forward: that is, "churn."

Churn refers to the fact that lots of people lose and gain health insurance through various life changes in any given year. I don't have any trouble understanding this. Partner and I will be among the churners later this year when she takes an unpaid semester leave to promote her book and we are suddenly without her employer-provided health coverage. This sort of thing happens all the time.

The good folks at the UC Berkeley Labor Center have looked into the implications for Obamacare from churn in California -- in this state the exchanges are called Covered California. They figure there is going to be a lot of coming and going.

Researchers at the U.C. Berkeley Labor Center released estimates Wednesday showing that about 20 percent of Covered California enrollees are expected to leave the program because they found a job that offers health insurance. Another 20 percent will see their incomes fall and become eligible for Medi-Cal, the state’s insurance program for people who are low income.

... In addition to the 40 percent of enrollees who move to Medi-Cal or job-based insurance, between 2 and 8 percent of those who sign up for Covered California are estimated to become uninsured, the analysis noted. [Presumably this is the small fraction that don't pay their premiums or just disappear.]

Yet just as people will move out of Covered California and Medi-Cal, other people will move in. While open enrollment in Covered California ended on Monday (with a grace period until April 15 for people who had tried to enroll, but could not for technical reasons), many people are expected to sign up if they experience a life event that triggers a “special enrollment period.” These events include divorce, marriage, birth of a baby or loss of job-based insurance.

Partner's human resources department says she should look at the exchanges when she goes on leave; we'll also be able to take advantage of what's called COBRA (the right to buy into an existing insurance plan when you leave a job.)

All of this just goes to show that the end of the Obamacare sign-up period doesn't mean its over. This law will continue to help millions stay insured year round.