Is Covered California Struggling to Woo Repeat Customers?

California ranked in the bottom five states on overall growth during open enrollment this year, according to an analysis by Avalere Health, in large part because it trailed only Vermont and Washington state in retaining 2014 enrollees among states that reported full results.

It was unclear Tuesday why California ranked so low, but the data reveals problems with how much traction the state’s fledgling Obamacare exchange is gaining among Golden State residents.

Like any business, the goal is to get repeat customers, and Avalere Health’s figures suggest that California is struggling more than other states to do that.

The federal government’s exchange retained 78 percent of 2014 enrollees, while California’s total was just 65 percent, Washington, DC-based health care consulting firm Avalere reported Tuesday.

Although the Golden State’s Covered California exchange boosted overall enrollment slightly, by 1 percent, it only kept about two in three enrollees who signed up for its inaugural year. Part of the problem may have been that roughly 200,000 people who tried to sign up for Covered California were shifted into the state’s Medi-Cal program.

The new report by Avalere Health compares numbers at the close of the first enrollment period in 2014 to numbers at the close of regular open enrollment in 2015 to show overall traction in health benefit exchanges across the nation.

Enrollment in Covered California was down to 1.1 million by December 2014 due to the Medi-Cal shift and other factors like failure to pay premiums. Initial renewal figures for Covered California show more than 90 percent of the people left in the program at the end of the year renewed for 2015.

Overall, enrollment on the federal exchange jumped 61 percent in 2015 to 8.8 million. The state-run exchanges, cumulatively, increased enrollment by 12 percent, to a cumulative 2.8 million, although Florida (+62 percent) and Texas (+64 percent) outperformed Covered California.

The bottom five states in terms of overall growth this year:

-Vermont, -17 percent.
-Washington, -2 percent.
-California, +1 percent.
-Rhode Island and New York, tied at +10 percent.

In terms of re-enrolling 2014 enrollees, California’s 2015 tally of 65.3 percent trailed only Hawaii (36.7 percent), Minnesota (49.2 percent) and Washington state (62 percent), among states that reported full data, according to Avalere’s data.

Officials at Covered California couldn’t immediately be reached for comment, but previously had said that a larger than expected number of 2014 enrollees dropped out of the program without paying their initial premiums, thus reducing the pool of enrollees who might have re-enrolled this year.

Several states, including Oregon, Massachusetts, Nevada, Idaho, Maryland and the District of Columbia didn’t report renewal rates and other data and weren’t included in the tallies.

“Some of the higher 2015 enrollment may be attributed to initial technological issues with that may have depressed 2014 enrollment,” said Caroline Pearson, a senior vice president at Avalere, but “that alone does not explain why state-run exchanges did so poorly,” relative to the states that used the federal exchange.

Eleven states, including California, ran their own exchanges.

Covered California, headed by Executive Director Peter Lee, aimed to enroll 1.7 million during this year’s open enrollment period, which ended Feb. 15 (with an extension for people who didn’t understand tax implications), but reached just 1.4 million.

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