AmRescuePlan

Open Enrollment 2022

IMPORTANT: The official 2022 Open Enrollment Period has now ended in most of the country, but there's 8 states where residents still have time to #GetCovered, with their new healthcare policies going into effect starting either February 1st or March 1st.

The 2022 OEP is by far the best ever for the ACA coverage, with dramatically expanded financial help for millions more people (including many who weren't eligible last year), reinvigorated expert, unbiased assistance, more choices in many states and counties, and FREE policies for more people than ever before.

If you've never enrolled in an ACA healthcare policy before, or if you looked into it years ago but weren't impressed, please give it another shot now. Thanks to the American Rescue Plan (ARP), it's a whole different ballgame.

Here's some important things to know when you #GetCovered for 2022:

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January 10th was the last time that the Centers for Medicare & Medicaid Services (CMS) issued a detailed 2022 Open Enrollment Snapshot report which broke out 2022 ACA enrollment across every state.

As of 1/10/22, it had already reached an all-time record of nearly 14.9 million people (13.8 million via Qualified Health Plans, or QHPs, and another million or so who have enrolled in Basic Health Plans (BHPs) in Minnesota and New York specifically).

A few days later, CMS issued another update just ahead of the official January 15th OEP deadline (in most states) which updated the top line QHP tally to over 14.2 million. They broke this out by "over 10 million" enrollees on the federal exchange (HealthCare.Gov), plus another 4.2 million or more in the 18 states which operate their own ACA exchanges.

Tack on the 1.0M BHPs and that's at least 15.2 million nationally.

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On Monday morning, the Centers for Medicare & Medicaid Services (CMS) reported that total 2022 ACA Open Enrollment had reached an all-time high of 13.8 mllion people selecting Qualified Health Plans (QHPs) via the federal & state-based ACA exchanges. In addition, over a million more Americans had enrolled in the ACA's "Basic Health Plan" (BHP) programs in Minnesota & New York. Combined, this means that the 2022 ACA Open Enrollment Period (OEP) had enrolled nearly 14.9 million people as of late December.

In my blog post/analysis about this report, I concluded:

The big question now is how many more new enrollees will be added by January 15th (final deadline in 44 states), January 23rd (Massachusetts) or January 31st (CA, DC, NJ, NY & RI)? (Idaho is the only state which had their final deadline for 2022 Open Enrollment back in December).

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This Just In from the Centers for Medicare & Medicaid Services:

The Centers for Medicare & Medicaid Services (CMS) reports that 13.8 million Americans have signed up for or were automatically re-enrolled in 2022 individual market health insurance coverage through the Marketplaces since the start of the 2022 Marketplace Open Enrollment Period (OEP) on November 1. This includes 9.7 million plan selections in the 33 states using the HealthCare.gov for the 2022 plan year, through December 15, 2021, the deadline for January 1 coverage.

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A month ago, I made what seemed to be a reasonable prediction based on the data available at the time:

That would put the national final QHP total at somewhere between 12.9 - 13.2 million people nationally as of January 31st, 2022; call it around 13.1 million.

...I completely forgot to mention BASIC HEALTH PLAN (BHP) enrollment in New York and Minnesota. It totalled 975,337 people during the 2021 OEP (883,451 in New York, 91,886 in Minnesota)...I'm willing to bet total BHP enrollment across both states will end up perhaps 10% higher year over year, which would put it at around 1.1 million.

When you add that to my QHP projection above, you get a grand total of perhaps 14.1 million QHPs + BHPs combined.

If this projection had proven accurate, it would have meant total ACA exchange enrollment was up ~9 - 10% year over year, which would have been impressive but not stellar.

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Now that we have two weeks worth of 2022 Open Enrollment data under our belt (well...for 33 states, anyway), I thought this would be a good time for me to try and put together a spitball estimate of how many Americans are likely to enroll in ACA exchange coverage during the 2022 Open Enrollment Period (OEP).

There's really two main numbers to try and project: How many current enrollees will renew/re-enroll for 2022 (whether actively or automatically); and how many new enrollees will jump into the ACA exchanges?

For each of these, due to how the data is reported, I have to further break the states out between those using the federal ACA exchange (HealthCare.Gov) and those which operate their own state-based ACA exchanges (Covered California, NY State of Health, etc.) This is further complicated by the fact that three states (Kentucky, Maine and New Mexico) switched from the federal exchange to their own state-based exchange starting with the 2022 OEP.

Small Business

As longtime readers know, every summer/fall I run analyses of the annual premium rate change filings for both the individual and small group health insurance markets for all 50 states +DC. However, I tend to put most of my focus on the individual market, since that tends to have a lot more interest and activity surrounding it.

The individual market has been rocked by both economic and policy changes from year to year (in both good and bad ways) far more than the small group market, which hasn't been in the news nearly as much. You tend to read a lot of stories about the Individual Market (both ACA-compliant as well as so-called "junk plans" like Short Term, Sharing Ministries, Farm Bureau and the like), and of course the Large Group market is massive (something like 40% of the U.S. population), so even minor changes to that are big news...but the Small Group market (which generally includes companies with 50 or fewer full-time employees, though a few states include companies with 100 or fewer) tends to get short shrift in both the news as well as healthcare wonkery.

New York

via the Centers for Medicare & Medicaid Services (CMS):

Biden-Harris Administration Extends Hundreds of Millions of Dollars to New York’s Essential Plan, its Basic Health Program, Key Connection to Coverage Supported by American Rescue Plan

The Centers for Medicare & Medicaid Services (CMS) is providing approximately $750 million in additional funding in 2022 to support the Essential Plan, New York’s Basic Health Program (BHP), as well as added funds for 2020 and 2021. The additional funds, made available through the American Rescue Plan, increase New York’s ability to provide health care coverage to approximately 1 million individuals.

Minnesota

via the Centers for Medicare & Medicaid Services (CMS):

Biden-Harris Administration Extends Millions in Funding to Minnesota for MinnesotaCare, its Basic Health Program, Key Connection to Coverage Supported by American Rescue Plan

The Centers for Medicare & Medicaid Services (CMS) is providing approximately $100 million in additional funding in 2022 to support MinnesotaCare, Minnesota’s Basic Health Program (BHP), as well as added funds for 2020 and 2021. The additional funds, made available through the American Rescue Plan, increase Minnesota’s ability to provide affordable, quality health care coverage to approximately 100,000 individuals.

White House Logo

Last Friday I took an in-the-weeds look at the healthcare provisions of the pared-down (but still hugely significant) Build Back Better Act.

Well, as the long-gestating legislation finally heads into the endgame this week, there's been a last-minute rush to add to & change some provisions of the bill before it actually gets voted on, and earlier today, the House Rules Committee released a revised/updated version of the bill, including a handy comparison version which shows exactly what legislative language has changed since the prior version.

Many of these changes are either simple grammatical or wording tweaks to make sure it all passes legal muster, while others simply provide clarification. Other changes involve simply increasing or decreasing the amount of federal money which would be allocated to one program or another.

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