START OF 2018 OPEN ENROLLMENT PERIOD

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MOTHER LODE: HHS releases detailed, EFFECTUATED QHP enrollment data BY STATE

This actually isn't as much of a surprise to me as you might think. Between the increased transparency during the 2nd Open Enrollment Period (weekly state-by-state snapshot reports for HC.gov) and especially with the King v. Burwell Supreme Court decision coming up later this month, I was expecting HHS to release some sort of update about just how many people are currently enrolled in exchange-based private policies...in particular, the number who are receiving Advance Premium Tax Credits across the 34 states at risk of losing theirs.

HOWEVER, even I wasn't expecting this level of comprehensiveness and detail, and I applaud HHS for doing so. I'll be posting a separate post with a detailed analysis, but for the moment, here's the press release:

March 31, 2015 Effectuated Enrollment Snapshot

About 11.7 million Americans selected plans through the Health Insurance Marketplaces as of February 22, the end of the “in-line” special enrollment period for 2015 Open Enrollment for individual market coverage. On March 31, 2015, about 10.2 million consumers had “effectuated” coverage which means those individuals paid for Marketplace coverage and still have an active policy in the applicable month.1  These numbers are consistent with HHS’s effectuated target for the end of 2015. About 6.3 million consumers were enrolled in health coverage through the Marketplaces and had paid their premiums on December 31, 2014.

Of the approximately 10.2 million consumers with effectuated Marketplace enrollments nationwide at the end of March 2015, 85 percent, or nearly 8.7 million consumers, were receiving an advanced premium tax credit to make their premiums more affordable throughout the year.  The average advanced premium tax credit for those enrollees who qualified for the financial assistance was $272 per month.2 

There were 7.5 million consumers with effectuated enrollments for March of 2015 through the 37 Federally-Facilitated Marketplaces (including State Partnership Marketplaces) or supported State-based Marketplaces (collectively known as HealthCare.gov states) and 2.7 million through the remaining State-based Marketplaces.3   Effectuated enrollment for the 34 states that are part of the Federally-facilitated Marketplaces on March 31, 2015 was 7.3 million and for State-based Marketplaces, including New Mexico, Nevada, and Oregon who are State-based Marketplaces using the HealthCare.gov platform, effectuated enrollment was 2.9 million.

“The Health Insurance Marketplaces are working,” said HHS Secretary Sylvia Burwell. “Thanks to the Affordable Care Act, millions of Americans now rely on the health and financial security that comes from affordable coverage through the Marketplaces. We’ve seen a historic reduction in the uninsured and consumers are finding the coverage they need at a price they can afford.”

This enrollment snapshot covers effectuated enrollment on March 31, 2015. In 2015, CMS plans to release Marketplace state-by-state effectuated enrollment snapshots on a quarterly basis detailing how many consumers have an effectuated enrollment, how many are receiving advanced premium tax credits and/or a cost-sharing reduction and enrollment by qualified health plan metal level.  Today’s snapshot provides an update on the number of individuals with citizenship, immigration status, or household income data matching issues; this information will be released periodically as has been done in the past.

The Marketplace effectuated enrollment snapshot provides point-in-time estimates. CMS expects enrollment numbers will change over time when consumers find other coverage or experience changes in life circumstances such as employment status or marriage, which may cause consumers to change, newly enroll in, or cancel their plans.  Supporting these types of changes is an important function of the Health Insurance Marketplace.

Today’s snapshot also provides a more detailed look at effectuated enrollment in December 2014, including state-by-state breakdowns of how many consumers received financial assistance through advanced premium tax credits and/or cost-sharing reductions as well as the number of consumers who were enrolled in catastrophic, bronze, silver, gold or platinum health plans as of December 31, 2014. This snapshot also includes an update on information for 2014 on citizenship, immigration status or household income data matching issues.

The following tables are included in the March 2015 Marketplace Effectuated Enrollment Snapshot:

Table 1: March, 2015 Total Effectuated Enrollment and Financial Assistance by State
Table 2: March, 2015 Average Advanced Premium Tax Credit by State
Table 3: March, 2015 Total Effectuated Enrollment Data by Metal Level by State
Table 4: December, 2014 Total Effectuated Enrollment and Financial Assistance by State
Table 5: December, 2014 Average Advanced Premium Tax Credit by State
Table 6: December, 2014 Total Effectuated Enrollment Data by Metal Level by State

March 2015: Total Enrollment and Financial Assistance

Of the approximately 10.2 million consumers who had effectuated Marketplace enrollments at the end of March 2015, 85 percent or about 8.7 million consumers were receiving an advanced premium tax credit to make their premiums more affordable.4  In addition, 57 percent or about 5.9 million consumers were receiving cost-sharing reductions to lower the amount they pay out-of-pocket for deductibles, coinsurance, and copayments. This financial assistance generally is available if a consumer’s household income is between 100 percent and 250 percent of the federal poverty level, the consumer is otherwise eligible for advance payments of the tax credit, and the individual chooses a health plan from the silver plan category.

The ten states with the highest rate of consumers who received financial assistance through advanced premium tax credits were: Mississippi (94.5%), Florida (93.5%), North Carolina (93.2%), Wyoming (92.9%), Louisiana (92.0%), Arkansas (91.1%), Georgia (91.1%), Alabama (90.7%), Wisconsin (90.7%), Alaska (90.5%) and South Carolina (90.2%). The states with the lowest rate of consumers who received advanced premium tax credits include: District of Columbia (10.0%), Minnesota (49.5%), Colorado (55.3%), Hawaii (59.3%), Vermont (64.3%), New Hampshire (65.8%), Massachusetts (66.7%), Utah (67.3%), Maryland (68.2%) and Kentucky (69.3%).

Nine of the ten states with the highest rate of consumers receiving financial assistance (all but Arkansas) have not taken the Medicaid expansion option under the Affordable Care Act.  As such, those residents with income from 100 to 133 percent of the federal poverty level who are otherwise eligible qualify for coverage through the Marketplace with tax credits.

AFTER the above, there's a half-dozen detailed state-by-state tables with all sorts of numbers for both 2015 and 2014, along with some info on "matching" 2015 data to 2014 data.

In short, this press release includes a mountain of official data/numbers to compare against my own unofficial data, and will take some time to sort through, so please bear with me.