Final 2025 Open Enrollment Report: Metal Levels

Next up: METAL LEVELS.

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 10 states, and only 0.24% of enrollees choose Catastrophic plans in the other 40 states (+DC)...just 54,000 nationally (which is also down several thousand y/y). Of the states that even offer them, Catastrophic plans don't reach higher than 2.4% of the ACA exchange market, and that's only in DC and Minnesota...just 4,000 people in both.

At the opposite end, Platinum plans are only available in 19 states (+DC)...and again, just 0.5% of all exchange enrollees choose Platinum plans (even in those 20 states it's only 1.0%). This ranges from virtually none in TN, WV & IN to 15.7% in Hawaii.

In any event, of the other three levels of ACA exchange plans, 30% chose Bronze, 56% chose Silver and the remaining 13% chose Gold plans this year nationally.

The states with the highest Gold plan uptake this year are New Mexico (a whopping 68.6%), followed by Wyoming (53.2%) and Alaska (48%). The states with the lowest Gold uptake are Mississippi (just 1.1%), New Jersey (1.2%) and Massachusetts (2.0%).

However, it's important to note that a stunning 74.4% of Mississippi enrollees have "Secret Platinum" plans (ie, CSR Silver plans w/actuarial values of 87% or higher), which means 75.5% effectively have Gold or Better (Gold+) plans.

AGAIN, THESE PERCENTAGES ARE LIKELY TO BE COMPLETELY UPENDED IF THE IRA SUBSIDIES EXPIRE & SILVER LOADING ENDS.