BHPs

ACA Signups Logo

Back on May 11th, I noted that total enrollment in healthcare policies either specifically created by (or expanded to more people by) the Affordable Care Act had likely broken 30 million Americans...an all-time high for the healthcare reform law signed by President Obama 11 years ago.

Last weekend, the Health & Human Services Dept. confirmed this, putting the actual total at around 31 million:

Today, the U.S. Department of Health and Human Services (HHS) released a new report that shows 31 million Americans have health coverage through the Affordable Care Act – a record. The report also shows that there have been reductions in uninsurance rates in every state in the country since the law’s coverage expansions took effect. People served by the health Marketplaces and Medicaid expansion have reached record highs.

ASPE Logo

Moments ago I posted the news that the HHS Dept. (via the Centers for Medicare & Medicaid) has confirmed what I wrote about nearly a month ago: Enrollment in ACA healthcare policies are at an all-time high, with over 31 million Americans currently covered by either ACA exchange plans, ACA Medicaid expansion or ACA Basic Health Plan coverage.

This news is based on a formal report issued by the Assistant Secretary for Planning & Evaluation (ASPE). Let's take a closer look!

Health Coverage Under the Affordable Care Act: Enrollment Trends and State Estimates

Based on enrollment data from late 2020 and early 2021, approximately 31 million people were enrolled in Marketplace or Medicaid expansion coverage related to provisions of the Affordable Care Act (ACA), the highest total on record.

KEY POINTS

ACA Signups Logo

A month ago I noted that by my back-of-the-envelope math, total enrollment in ACA healthcare coverage had likely reached 30 million people, concluding that:

#ACA Enrollment Is At An All-Time High Right Now Almost Any Way You Slice It.

I based this on a rough comparison of ACA enrollment in 2016 (which saw the highest ACA Open Enrollment Period enrollment to date, with nearly 12.7 million people selecting Qualified Health Plans (QHPs) during the official OEP) versus the most recent data available as of spring 2021.

My rough math was as follows (spring 2016 / spring 2021):

New York State of Health

Yes, that's right: I'm finally getting over my obsession with county-level COVID-19 vaccination data analysis.

New York State of Health, NY's ACA exchange, just issued the following press release:

Press Release: Governor Cuomo Announces Enrollment through NY State of Health Tops 6 Million

  • State Marketplace Reaches Record-Breaking Levels
  • American Rescue Plan Offers Significantly More Financial Assistance for Consumers 

Governor Andrew M. Cuomo today announced that New York State of Health - the state's official health plan Marketplace - has reached a record-breaking enrollment total of 6 million New Yorkers who have signed up for health insurance through the Marketplace across Medicaid, Essential Plan, Child Health Plus and Qualified Health Plans. This momentous milestone coincides with the new and increased financial assistance now available to New Yorkers through the American Rescue Plan for consumers enrolling in commercial coverage.

New York State of Health

It's been awhile since I've written anything about the ACA's Basic Health Plan (BHP) provision. BHP is a program which every state has the option of taking advantage of, but so far only two have: Minnesota and New York State. I'll let Louise Norris explain:

Under the ACA, most states have expanded Medicaid to people with income up to 138 percent of the poverty level. But people with incomes very close to the Medicaid eligibility cutoff frequently experience changes in income that result in switching from Medicaid to ACA’s qualified health plans (QHPs) and back. This “churning” creates fluctuating healthcare costs and premiums, and increased administrative work for the insureds, the QHP carriers and Medicaid programs.

This Just In from the New York State of Health exchange...

Press Release: NY State of Health Announces 2019 Enrollment is Up in First Month of Open Enrollment Period
Dec 5, 2018

  • More than 930,000 Consumers Enroll in a Qualified Health Plan or the Essential Plan
  • December 15 is the Deadline to Enroll for January 1, 2019 Coverage

ALBANY, N.Y. (December 5, 2018) - NY State of Health, the official health plan Marketplace, today announced in the first four weeks of the 2019 open enrollment period, enrollment is outpacing last year. More than 930,000 consumers have enrolled or renewed coverage in a Qualified Health Plan or the Essential Plan for 2019. Consumers must enroll or renew by December 15, for coverage beginning January 1, 2019.

 

The Basic Health Program is one of the more obscure provisions of the Affordable Care Act. Very few people outside of the healthcare wonk community know anything about it...unless they live in Minnesota or New York State.

The short version is that it's an optional low-income healthcare program designed for people at the income tier just above Medicaid expansion...138% - 200% of the Federal Poverty Line, or between around $16,600 - $24,100/year for a single adult. In most states people in that income range would be expected to enroll in heavily-subsidized ACA exchange policies. In New York and Minnesota, however, they've instead set up Basic Health Programs (BHPs) for this population instead.

 

If you look at The Graph for the 2018 Open Enrollment Period, you'll notice that in addition to the large green section (Qualified Health Plan (QHP) selections across the 39 Healthcare.Gov states) and the smaller blue section (QHP selections across the 12 State-based exchanges), there's a much smaller burgundy slice at the top labelled "BHPs (MN/NY only). This represents around 820,000 people in Minnesota and New York only who are enrolled in Basic Health Plans, or BHPs.

When NY State of Health released their first Open Enrollment update a week or so ago, they reported over 140,000 QHP selections in the first 28 days (up 13% vs. the same point last year) and 700,000 BHP enrollees (which is 5% more than they enrolled in all of last year's open enrollment period).

Today they've issued another update:

  • Enrollment in Qualified Health Plans and Essential Plan Reaches Nearly 900,000
  • December 15th is the Deadline to Enroll for January Coverage
  • New Yorkers Urged to Enroll Now

ALBANY, N.Y. (December 7, 2017) - NY State of Health, the state’s official health plan Marketplace, today announced enrollment in Qualified Health Plans (QHP) and the Essential Plan have reached nearly 900,000—continuing to outpace enrollment at the same point last year by 13 percent.

Breaking out of Minnesota:

More than 91,000 Minnesotans have Enrolled in Private Health Plans through MNsure for 2018

November 15, 2017

ST. PAUL, Minn.—Today, MNsure announced 91,623 Minnesotans have enrolled in private health plan coverage for 2018 through MNsure.

The numbers reported include new consumers, renewing consumers who have come back and shopped for a new plan for 2018, and renewing consumers who are continuing their previous plan for 2018.

"Our first two weeks have gone very smoothly," said CEO Allison O'Toole. "MNsure's enrollment is looking strong out of the gate. This year, we renewed twice as many people into coverage than last year, and we're also seeing a steady stream of new consumers."

By the Numbers