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Health Insurance Marketplace Enrollment on Target

Latest data shows 9.9 million with effectuated enrollment

The Centers for Medicare and Medicaid Services (CMS) has released data showing that about 9.9 million consumers had effectuated Health Insurance Marketplace coverage at the end of June — which means those individuals had paid their premiums and had an active policy. These numbers are consistent with the Department of Health and Human Service’s effectuated enrollment target of 9.1 million for the end of 2015.

Of the 9.9 million consumers with effectuated enrollment in marketplace plans at the end of June 2015, 1% were enrolled in catastrophic plans, 21% in bronze plans, 68% in silver plans, 7% in gold plans, and 3% in platinum plans.

The marketplace effectuated enrollment snapshot provides point-in-time estimates on a quarterly basis. The first marketplace enrollment snapshot for 2015 covered effectuated enrollment through March 31, showing that 10.2 million consumers had effectuated coverage.

Why the drop in effectuated coverage from the first quarter to the second quarter? As of June 30, 2015, the marketplace has ended 2015 coverage for approximately 423,000 consumers with 2015 coverage who failed to produce sufficient documentation on their citizenship or immigration status. The marketplace has also adjusted advanced premium tax credit (APTC) and/or cost-sharing reductions (CSRs) for about 967,000 households. CMS expects enrollment numbers will continue to change over time as consumers find other coverage or experience changes with life circumstances such as employment status or marriage, which may cause consumers to change, newly enroll in, or terminate their plans.

The Wall Street Journal quotes Larry Levitt, a senior vice president at the Kaiser Family Foundation, who says “it’s a lot of people losing coverage, but it’s very much the way the system is supposed to work. … It explains the slight decrease in enrollment.”

The open enrollment period ran from mid-November to mid-February, with an extension for some consumers. Additional customers have signed up outside of the open enrollment period because they became eligible due to a change in life situation, such as having a baby.

Of the approximately 9.9 million consumers nationwide with effectuated marketplace enrollments at the end of June 2015, about 84%, or more than 8.3 million consumers, were receiving an APTC to make their premiums more affordable throughout the year. The average APTC for those enrollees who qualified for the financial assistance was $270 per month.

 “Consumers from coast to coast are continuing to show how important health coverage is to their families,” said HHS Secretary Sylvia Burwell. “Millions of Americans are benefiting from the peace of mind that comes with having quality coverage at a price they can afford as they access coverage through the Affordable Care Act’s marketplace.”

The Wall Street Journal points out that robust sign-ups and premium payments are critical for the Obama administration because Republicans hoping to repeal the health law would likely seize on lackluster enrollment as a sign the ACA was faltering.

Sources: CMS; September 8, 2015; and WSJ; September 8, 2015.

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