HHS Releases Updated Exchange Enrollment Numbers: Emerging Trends Continue to Raise Some Concerns

JANUARY 19, 2014 – 10:24 PMImage

On January 13, the U.S. Department of Health and Human Services (HHS) released updated enrollment figures for the Affordable Care Act’s (ACA) Exchanges during the first three months of operation. The report outlines the number of Americans who have accessed a state-based or federally facilitated Exchange as well as a demographic breakdown of new enrollees.   This blog highlights some of the key Exchange enrollment trends.

Federal Exchange Enrollment Tops State-Based Exchange Numbers

Federal Exchange enrollment outpaced state-based Exchange enrollment with 1.2 million of the 2,153,421 individuals selecting a federal Exchange policy, and 950,000 choosing a state-based option during the October 1 – December 28, 2013, open enrollment period. This is a significant difference from just a few weeks as the state-based exchanges had shown larger numbers most likely as a result of reporting timing.

One of the likely reasons the federal Exchange has enrolled more Americans is the demographic composition of where the Exchanges operate. There are currently 34 states, representing a majority of the country’s population, using the federally facilitated Exchange, while just 16 states (plus the District of Columbia) operate their own Exchange. Further there are generally larger numbers of uninsured Americans living in states using the federal system. Of the 17 states with the greatest proportion of uninsured people, 14 are using the federal Exchange. It follows that there would be larger enrollment in places where more people need insurance.

Young Adult Representation Lacks Luster

Enrollment demographics have received much attention since the consensus is that a large number of new enrollees must be younger, healthier Americans. This population tends to amass fewer claims, allowing their premiums to subsidize older consumers within a health plan. According to reports during the early phases of open enrollment, the government was hoping the younger population would represent at least 40% of the newly insured. The January 13 report points out that 24% of Exchange enrollees through December 28, 2013, were between the ages of 18 and 34. This is proportionate to the number of Americans in this age group (26%), but lower than the proportion of uninsured people in this demographic (about 38%).

The report also indicates young adults may be waiting longer than the rest of the population to enroll in coverage. “The general expectation is that people who are older and sicker are more likely to select coverage earlier in the initial enrollment period,” the report states, “while younger and healthier people will tend to wait until towards the end of the open enrollment period (which concludes March 31, 2014).” 
The growth in enrollment for young adults from October to December was larger than growth in other age groups, indicating that the overall share of young adults enrolling in plans is growing. Perhaps the initial technological difficulties caused some young consumers to disengage from the Exchange websites. Now that those glitches have largely been fixed, some may be giving the system a second chance.
While the main takeaway of the HHS report is the lower than expected young adult enrollment, there are other important facts to emerge from the first half of open enrollment.

Silver Plan Option Most Popular

In deciding what level of coverage to purchase, 60% of Americans have opted for “silver level” plans, meaning an average of 70% of health care expenses will be paid by the health plan. All other metal levels were significantly less popular: bronze (20%), gold (13%), platinum (7%), and catastrophic (1%).

Nearly 80% Receive Federal Subsidy

It’s also notable that 79% of consumers who have selected a health plan through an Exchange will receive a federal subsidy. Subsidies are available to those who do not qualify for Medicaid, but earn below 400% of the federal poverty line.
We will continue to keep you apprised of any updates to the enrollment figures and any additional information on demographic trends relevant to our clients. In the meantime, please visit www.BeWellInsurance/wordpress.com to view past blogs and Legislative Alerts. Or you may visitwww.HealthcareExchange.com for more blog posts, polls, surveys and numerous resources.

It’s important to note that the federal health care reform initiative discussed in this blog is referred to by several different acronyms including ACA, PPACA and ObamaCare. No matter what the term, Be Well Insurance Solutions will continue tracking and reporting on key health care reform trends that are impacting Brokers, payroll personnel and key stakeholders. 

[Author:  Michael Gomes, Executive Vice President, BenefitMall]


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Chart outlines impact of ACA provisions

understanding the affordable care actChart outlines impact of ACA provisions

June 30, 2013

The Affordable Care Act (ACA or health care reform law) is made up of many different parts. The phased implementation began September 23, 2010, and will continue through at least 2018.

Not all parts of the law affect every line of business (individual, small businesses, large businesses) or funding type (fully insured, self-funded).  Also, not all are put in place at the same time. To help clearly show the impact of the ACA we’ve updated an easy-to-reference chart with recent guidance and made it easier to tell what applies to grandfathered plans and nongrandfathered plans.

This document is a reference guide only. Information on each provision can be found in the provision-specific fact sheet or FAQ documents on our health care reform website.

This article applies to:

  • California
  • Small Group, Large Group, and Individual (under 65)