Maine: CoverME publishes 2024 OEP report; mystery of enrollment drop solved

via CoverME.gov, Maine's state-based ACA exchange:

KEY TAKEAWAYS

Open Enrollment (OE) for 2024 marked the third year Maine operated a state-based marketplace through CoverME.gov, after transitioning from a federally facilitated marketplace model.1 CoverME.gov is operated by the Office of the Health Insurance Marketplace at the Department of Health and Human Services. The structure of the state-based marketplace provides greater control and flexibility, in terms of operational components such as special enrollment periods, customization of the shopping experience, and marketing and outreach. This allows the marketplace to better meet and respond to the needs of Maine residents.

CoverME.gov continues to meet the needs of more than 60,000 Mainers, providing them with one-stop shopping for affordable health coverage. Because CoverME.gov is the only place Mainers can go to get financial help to reduce the cost of private health insurance plans, the marketplace provides many Mainers with health coverage they otherwise could not afford. As such, Maine’s state-based marketplace continues to play a critical role in the state’s ability to maintain an uninsured rate lower than the national average despite having a relatively smaller proportion of its residents covered by employer-sponsored coverage.

Highlights of the 2024 Open Enrollment:

• More adults were covered by health plan selections during the 2024 OE compared to 2023. Despite a slightly lower number of overall plan selections in 2024 (62,586 compared to 63,388 in 2023), nearly 600 more adults were covered in 2024 in comparison to 2023.

• The slight decline in overall plan selections year-over-year is likely due almost entirely to more Maine children being eligible for MaineCare because of legislative action taken in 2022, that went into effect on October 1, 2023. As a result, over 1,300 fewer children were enrolled in marketplace plans during the 2024 OE.

• More than 10,200 new consumers enrolled in health coverage during the 2024 OE, topping the number of new consumers who signed up in 2023.

• Financial savings available to consumers through CoverME.gov continue to provide Mainers significant premium relief on high-quality, comprehensive health insurance, making it easier to afford other rising costs straining household budgets. Overall, financial savings provided through CoverME.gov saved Mainers approximately $30 million.

• Enhancements made to CoverME.gov’s marketing and outreach plans led to significant increases in website traffic, use of CoverME.gov’s Plan Compare Tool, and calls to CoverME.gov’s Consumer Assistance Center.

2024 OPEN ENROLLMENT TRENDS

1. More than 62,500 Mainers, including more than 10,200 new consumers, selected health insurance plans through CoverME.gov during the 2024 OE. The remainder were returning consumers who actively re-enrolled or were automatically re-enrolled in a plan. Another 7,950 consumers, including over 2,000 new consumers, selected standalone dental plans through CoverME.gov during 2024 OE.

2. While more adults enrolled in health coverage, fewer children enrolled, likely as a result of expanded eligibility for MaineCare. As expected, the marketplace saw a decrease in enrollment of consumers aged 20 and younger following the Legislature’s expansion of eligibility for MaineCare (Medicaid) coverage for children under age 21, which took effect in October 2023. Eligibility increased to 300 percent of the federal poverty level, or $90,000 annually for a family of four. CoverME.gov saw 13 percent fewer individuals aged 20 and under enrolling in health coverage during open enrollment for 2024 compared to 2023.

This is the key mystery I've had since the 2024 Open Enrollment Period ended; every other state in the country saw a net OEP enrollment increase except for Maine (and DC), which had a 1.3% drop in enrollment...855 fewer enrollees, to be precise. Had those ~1,300 children (well, children & 18 - 20 yr olds) been enrolled in ACA exchange plans instead, net OEP enrollment in Maine would have increased just a hair.

I admit to completely missing the news about Maine expanding MaineCare (Medicaid) coverage to more children a couple of years back.

3. Expanded financial assistance helped shield eligible CoverME.gov consumers from significant premium increases. While average premiums set by insurance companies rose in Maine and many other states in 2024, premiums paid by consumers qualifying for financial assistance increased by less than $33 per month, on average, thanks to ongoing enhanced premium assistance from the federal government.

4. Consumers with financial assistance chose comprehensive coverage with lower out-of-pocket costs. Fifty-seven percent of those who qualify for financial assistance to pay monthly premiums enrolled in a plan that covers at least 70 percent of out-of-pocket costs (i.e., silver, gold, or platinum plans), compared to 42 percent of those who do not receive premium assistance. Sixty percent of those who do not receive financial savings chose plans with relatively higher deductibles and copays.

More details w/charts & graphs here.