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Private insurance coverage up 10 percent in ND since before Affordable Care Act

BISMARCK – Private insurance coverage has increased by more than 10 percent in North Dakota since before passage of the federal Affordable Care Act, an Insurance Department official reported Wednesday in the first such measure of the controversial law’s impact.

Deputy Insurance Commissioner Rebecca Ternes said the department recently asked the state’s four largest insurance carriers for their overall enrollment numbers as of July 1, 2009, and July 1, 2014, to try to gauge whether the number of insured had increased since the year before Congress passed the health care reform law.

While the department is still trying to reconcile differences in the data, Ternes said it appears private coverage through Blue Cross Blue Shield, Sanford Health Plan, Medica and Assurant Health, as well as the Children’s Health Insurance Program and the Comprehensive Health Association of North Dakota, has increased by 10.54 percent.

Ternes noted that the figure doesn’t include Medicaid and Medicare, and that North Dakota’s estimated population grew by 7.6 percent from 2010 to 2013, from 672,591 to 723,393.

“So far, we aren’t really seeing a huge change when you consider the population shift,” she told the Legislature’s interim Health Care Reform Review Committee.

The data also doesn’t indicate whether those contributing to the increase may have previously had insurance coverage or moved from another state, she said.

As of July 6, 9,953 North Dakota residents were covered by private insurance plans obtained through the federal marketplace, up from 8,374 reported at the committee’s last meeting May 14, according to Insurance Department figures.

That’s still lower than the 10,597 enrollment figure cited by the Obama administration in April, in part because the state counts only those who have actually paid their first month’s premium. Either way, enrollment fell short of the administration’s projection that 11,000 North Dakotans would enroll in private plans through the marketplace during its first six months.

The next enrollment period runs from Oct. 15 to Feb. 15.

“Hopefully they’re more prepared than last year. I can’t imagine they wouldn’t be,” Ternes said.

Insurers also shared concerns about the enrollment process.

Lisa Carlson, director of planning and regulation for Sanford Health Plan, said the insurer has learned that people who signed up during the first open enrollment period but later had their plan terminated for nonpayment of premium can’t be denied coverage for past-due accounts if they sign up in the next open enrollment period.

Blue Cross Blue Shield of North Dakota is concerned that there’s “no real way for us to verify” that somebody has a special reason to enroll through the exchange, said Luther Stueland, director of health policy impact and exchanges. The marketplace allows for a special enrollment period of 60 days after certain life events that involve a change in family status, such as marriage of the birth of a child, or the loss of other health coverage.

“We’re really stuck accepting any new enrollment that we get through the (federally facilitated marketplace) as gospel,” Stueland said.

Meanwhile, enrollment in Medicaid expansion continues to climb steadily, said Julie Schwab, director of medical services for the North Dakota Department of Human Services. About 10,600 individuals had enrolled as of July 1, up from about 7,900 as of May 6.

Reach Nowatzki at (701) 255-5607 or by email at