Mazel Tov to the #ACA on its bar mitzvah! #ACA13 (Part 6)

Note: I'm breaking this analysis into several sections:

Part 1Part 2 / Part 3 / Part 4 / Part 5 / Part 6 / Part 7


If you've ever wondered why healthcare wonks (myself included) almost never even bring up the ACA's Catastrophic Level plans and why the only time I ever discuss Platinum Plans is in the context of high-CSR enrollees being eligible for "Secret Platinum" plans (labeled as Silver), this table should explain why.

Catastrophic ACA plans aren't available at all 9 states, and only 0.4% of enrollees choose Catastrophic plans in the other 41 states (+DC)...just 64,000 nationally. Of the states that even offer them, Catastrophic plans don't reach higher than 3% of the ACA exchange market, and that's only in DC where you're talking about fewer than 500 enrollees.

At the opposite end, Platinum plans are only available in 16 states (+DC)...and again, less than 1% of all exchange enrollees choose Platinum plans. This ranges from 0.2% in Illinois to 17.8% in, again, DC. It's kind of interesting that DC has the highest percent of both low-end (Catastrophic) and high-end (Platinum) plans...I don't know if this is tied to DC having such a low percent of CSR-eligible enrollees (due to Medicaid covering residents earning up to 210% FPL) or what, but it's a bit curious.

In any event, of the other three levels of ACA exchange plans, about 1/3 chose Bronze, 55% chose Silver and the remaining 12% chose Gold plans this year, at least nationally. New Mexico has been incredibly successful in their 2nd year of mandated Premium Alignment, with a whopping 73% of enrollees choosing Gold plans (highest in the nation) vs. just 5.9% choosing Bronze (lowest in the nation).

Texas, which just launched Premium Alignment this year, hasn't seen nearly as dramatic an impact yet, but it might take a second year for word to get out; they're running almost even between Bronze and Gold (21% and 23% respectively).