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

More than 7 Million Selected Affordable Health Coverage in ACA Marketplace Since Start of Open Enrollment Period

  • Enrollment increases continue as the deadline for January coverage fast approaches

Nearly 7.3 million people have selected an Affordable Care Act (ACA) Health Insurance Marketplace plan since the 2024 Marketplace Open Enrollment Period (OEP) opened on November 1. This represents activity through December 2 (Week 5) for the 32 states using HealthCare.gov and through November 25 (Week 4) for the 18 states and the District of Columbia with State-based Marketplaces (SBMs). Total plan selections include more than 1.6 million people (23% of total) who are new to the Marketplaces for 2024, and 5.7 million people (77% of total) who have active 2023 coverage and returned to their respective Marketplaces to renew their coverage or select a new plan for 2024.

via Pennie, Pennsylvania's state-based ACA exchange:

Action required by December 15th for Pennsylvanians seeking health coverage. To get the lowest costs on high-quality coverage, visit Pennie, PA’s health insurance marketplace.

Watch press conference, including customer testimonials here.

Harrisburg, Pennsylvania – December 5, 2023 – Today, Pennsylvania leadership held a virtual press conference to highlight the upcoming deadline of December 15th to enroll in health coverage for 2024 through Pennie.

Pennie is Pennsylvania’s official health insurance marketplace (pennie.com) and the only place where Pennsylvanians can get financial savings to reduce the cost of coverage and care. Currently, 9 in 10 enrollees qualify and save over $500 a month on average.

Right now, during the annual Open Enrollment period, it is the only time of year to apply, shop and enroll in coverage from the top insurance companies with financial savings.

Upcoming Deadline

Since Donald Trump was defeated in the 2020 Presidential election, most people seemed to be under the impression that the Republican Party's decade-long obsession with tearing down President Obama's signature legislative accomplishment, the Patient Protection & Affordable Care Act, was finally over.

Healthcare journalist extraordinaire Jonathan Cohn even pulled the trigger on publishing his definitive history of the ACA, The Ten Year War...although honestly, there was still one remaining major legal loose end to tie up which wouldn't happen until about eight months later.

Rate Changes

 As regular readers know, every year I pore over hundreds of annual health insurance policy rate filings from carriers participating in the individual and small group markets, attempting to run weighted average rate changes on a state-by-state level. I then compile all 50 states (+DC) into a national weighted average rate change table.

I generally do this twice for every state: First, over the spring and summer, I crunch the numbers for the carriers preliminary rate change requests. These are submitted to the state regulatory authorities (or in a few cases, federal regulators), who run their own actuarial analysis and then either approve the requests as is, lower the requested rates or (in a few cases) even raise rates more than requested, since part of the regulators job is to ensure that the insurance carriers have enough cash flow to actually pay their claims over the upcoming year.

Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.

Since December 2022, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow , along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of August 2023:

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

  • In August 2023, 89,994,594 individuals were enrolled in Medicaid and CHIP.
    • 83,029,628 individuals were enrolled in Medicaid in August 2023, a decrease of 1,488,269 individuals (1.8%) from July 2023.
    • 6,964,966 individuals were enrolled in CHIP in August 2023, a decrease of 30,312 individuals (0.4%) from July 2023.
  • As of August 2023, enrollment in Medicaid and CHIP has decreased by 3,862,970 individuals since March 2023, the final month of the Medicaid continuous enrollment condition under the Families First Coronavirus Response Act (FFCRA) and amended by the Consolidated Appropriations Act, 2023.
    • Medicaid enrollment has decreased by 3,699,342 individuals (4.3%).
    • CHIP enrollment has decreased by 163,628 individuals (2.3%).
  • Between February 2020 and March 2023, enrollment in Medicaid and CHIP increased by 22,982,495 individuals (32.4%) to 93,857,564.
    • Medicaid enrollment increased by 22,649,177 individuals (35.3%).
    • CHIP enrollment increased by 333,318 individuals (4.9%)

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

Plan Selection Snapshot

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2024. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2024 is December 15, 2023. Consumers who select a plan between December 16, 2023 and January 16, 2024 will have coverage beginning February 1, 2024. 

CoverME.gov Activity Through November 28, 2023

Via Access Health CT's News/Press Releases page:

Stats as of December 1, 2023

Qualified Health Plans (QHP):

  • QHP Enrollment In 2023 Coverage: 102,606
  • 2024 OE Acquisition Summary: 9,847

Medicaid:

  • Completed applications/redeterminations processed through the integrated eligibility system: 30,435

It's my understanding that "Acquisition Summary" refers to CT residents who are brand-new enrollees (never enrolled via the exchange before).

The 102.6K figure includes auto-renewals being piled on top of the new/active renewal tally.

By comparison, last year Access Health CT reported enrolling 89,975 people through December 1st (one extra day since Nov. 1st fell on a Tuesday last year); this also included auto-renewals:

  • 2023: 89,975 in 31 days (2,902/day)
  • 2024: 102,606 in 30 days (3,420/day)

In other words, Connect's ACA exchange has enrolled 17.8% more people per day so far.

Normally, states will review (or "redetermine") whether people enrolled in Medicaid or the CHIP program are still eligible to be covered by it on a monthly (or in some cases, quarterly, I believe) basis.

However, the federal Families First Coronavirus Response Act (FFCRA), passed by Congress at the start of the COVID-19 pandemic in March 2020, included a provision requiring state Medicaid programs to keep people enrolled through the end of the Public Health Emergency (PHE). In return, states received higher federal funding to the tune of billions of dollars.

As a result, there are tens of millions of Medicaid/CHIP enrollees who didn't have their eligibility status redetermined for as long as three years.

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