On February 4, 2016, the Centers for Medicare and Medicaid Services released its final enrollment snapshot for the 2016 open enrollment period which ended on January 31, 2016. Overall, 12.7 million individuals selected plans during the 2016 open enrollment period through HealthCare.gov and the state-operated marketplaces — one million more than selected plans during the 2015 open enrollment period.
The numbers from 2016 and 2015 are not truly comparable, however. The 12.7 million 2016 enrollees are net of plan cancellations; the 2015 numbers were not. In 2015, the total of 11.7 million plan selections shrank to 10.2 million effectuated enrollments. For 2016, the final 12.7 million net plan selections should be much closer to the final effectuated enrollment number.
The 2016 numbers also do not include individuals who are now enrolled in new Basic Health Programs: 400,000 in New York and 33,000 in Minnesota. In New York, 300,000 in the Basic Health Program were enrolled in Marketplace coverage in 2015 and included in last year's numbers. Some 2015 enrollees were also likely transferred to Medicaid in states that have recently expanded Medicaid eligibility.
The 12.7 million is comfortably within the range of 11 to 14.1 million enrollees projected by CMS for the 2016 open enrollment period and close to the 13 million enrollees recently projected by the Congressional Budget Office (CBO), although there will certainly be shrinkage during the course of the year.
Breaking Down The Numbers
During the last week of open enrollment (January 24 to February 1), 686,708 individuals selected plans through HealthCare.gov, bringing the total of HealthCare.gov plan selections to 9,625,982. This was fewer than signed up in the last days of enrollment for 2015. However, 61 percent (2.4 million) of new enrollees for 2016 signed up for January 1 coverage—compared to 40 percent for 2015—thus ensuring themselves a full year of coverage and a full year to reach their deductible, as well as providing their insurers a full year of premiums.
Four million new enrollees accounted for about 42 percent of total Healthcare.gov plan selections. About seven in 10 consumers with 2015 coverage actively selected a plan for 2016—rather than being automatically reenrolled—compared to about half who did so for 2015. Significantly, the percentage of enrollees actively reenrolling increased from about 50 to about 70 percent during January, when many who had not already done so returned to actively reenroll. Of those who actively reenrolled, 61 percent switched plans; 39 percent stayed where they were.
About 2.7 million consumers who selected plans were in the 18 to 34 year-old age group. The percentage of new selections in this age group was higher than last year, but the overall percentage of plan selections is about the same. Spokespersons for the marketplaces stated on a CMS call that younger consumers are increasingly aware of the individual responsibility penalty, which is driving them to the marketplaces for coverage.
The individual insurance market remains a residual market, and is thus highly dynamic. About half of all Americans are covered through their employment while another third are covered through public programs. Before 2014, most of the remainder were uninsured. The ACA has made a significant dent in the uninsured population. But many of those enrolled in the marketplace for 2016 will over the course of the year either gain employment-based coverage or move to Medicaid or Medicare coverage. Others may fail to pay their premiums and become uninsured.
Open Enrollment Is Now Closed, But Special Enrollment Periods Remain
Although open enrollment for 2016 is now closed, special enrollment periods remain for individuals who lose their coverage (for example through a loss or change of employment) or who undergo other major life changes. Insurers have in recent months asserted that special enrollment periods have attracted higher-risk enrollees and some insurers have stopped paying commissions to brokers as a way to discourage special enrollments.
If consumers experiencing life changes are unable to enroll through special enrollment periods, however, the marketplace becomes a one-way street, with consumers leaving as they find other coverage but no new consumers enrolling to replenish the pool. As Sarah Lueck has recently observed, insurers that wish to stabilize the risk pool need to encourage more, not fewer, special enrollments. If special enrollments are blocked, we can expect to see marketplace enrollment drop steadily over the year simply because of the dynamic nature of the market, with concomitant increases in the number of the uninsured.
from Health Affairs Blog http://ift.tt/20JRCDi
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