Breakdown of The More Than 4.2 million Who Selected Marketplace Plans From Oct. 1, 2013, Through Mar. 1, 2014

1. 1.55 percent are female and 45 percent are male 2. 2.31 percent are age 34 and under 3. 3.25 percent are between the ages of 18 and 34 4. 4.63 percent selected a Silver plan (up one percentage point over the prior reporting period), while 18 percent selected a Bronze plan (down one point) 5. 5.83 percent selected a plan and are eligible to receive Financial Assistance (up one point) Source: U.S. Department of Health & Human Services

OIG Reaches $3.75 Million Settlement with Carousel

Carousel Pediatrics has agreed to repay the state of Texas $3.75 million after an investigation by the Health and Human Services Commission Office of Inspector General found a pattern of billing errors.

According to a recent report,

73% of employers say the Affordable Care Act is having an impact on benefits service and support, and 69% report there is an impact on benefits communications. Source: "Despite delayed key provision, health care reform triggers benefits action among employers," Prudential News Release, March 3, 2014, http://news.prudential.com/article_display.cfm?article_id=6788

Health Insurance Marketplace Enrollment Update

More than 4.2 million (4,242,300) people selected Marketplace plans from Oct. 1, 2013, through Mar. 1, 2014, including 1.6 million in the State Based Marketplaces and 2.6 million in the Federally-facilitated Marketplace. About 943,000 people enrolled in the Health Insurance Marketplace plans in the February reporting period, which concluded March 1, 2014. Of the more than 4.2 million: • 55 percent are female and 45 percent are male; • 31 percent are age 34 and under; • 25 percent are between the ages of 18 and 34; • 63 percent selected a Silver plan (up one percentage point over the prior reporting period), while 18 percent selected a Bronze plan (down one point); and • 83 percent selected a plan and are eligible to receive Financial Assistance (up one point). Source: U.S. Department of Health & Human Services

Today's Datapoint

$399 million … is the projected annual Affordable Care Act penalty for Texas employers as a result of the state’s decision to forego Medicaid expansion, according to a recent study by Jackson Hewitt Tax Service Inc.

Quote of the Day

“Our very, very last resort [when faced with cuts for Medicare plans] is to reduce benefits, but first we look at our administration, our unit costs, networks, programs around reducing utilization as a last resort whether to tinker with benefits. Our members rely on us for a comprehensive package; they don’t like change.” — Lisa Rubino, senior vice president of Medicare, duals and marketplace for Molina Healthcare, Inc., told AIS’s Health Plan Week.

Why Privately Insured Seek Care in Emergency Departments

Patients' perception of the severity of their medical problem and who they first contact for help or advice are the factors most associated with whether they seek emergency care, according to a Center for Studying Health System Change (HSC) study based on the National Institute for Health Care Reform's (NIHCR) 2012 Autoworker Health Care Survey. Nearly a quarter of respondents (23%) reported having an urgent medical problem in the three months before the survey, and almost half (44%) of those with an urgent condition ultimately went to an emergency department for treatment. Of people with an urgent problem, nearly half first contacted their regular source of care-typically a primary care clinician-and those patients were less likely to go to emergency departments, the study found. Source: Center for Studying Health System Change (HSC)