Back in late January, I crunched the numbers on the total number of Americans who currently have healthcare coverage directly via the Affordable Care Act. This includes three categories: Exchange-based Qualified Health Plans (QHPs); the Basic Health Plan (BHP) progams in Minnesota and New York; and Medicaid Expansion in the 38 states (+DC) which had implemented it as of that point.
I concluded that the total numbers for each were roughly 15.4 million QHPs, 1.2 million BHPs and 23.5 million Medicaid expansion enrollees, or around 40.1 million people total.
Earlier this week, the Centers for Medicare & Medicaid Services (CMS) confirmed my estimates and even came in slightly higher, at around 40.2 million. They put effectuated QHPs at 15.6 million and Medicaid expansion enrollment at around 23.4 million.
There's still likely between 40,000 - 80,000 Qualified Health Plan (QHP) enrollments to be added to the 2023 Open Enrollment Period (OEP) tally from the states which have extended deadlines (through Tuesday, January 31st), but I decided to throw this together today for the hell of it.
The table below charts the first ten years of ACA Open Enrollment Periods, broken out by state. I've also included Basic Health Plan (BHP) enrollment in Minnesota & New York, the only states where BHP programs have been implemented to date.
The states which jump out at me the most in terms of enrollment growth, at least visually, are Florida, Georgia, New York (BHPs) and Texas.
No further analysis or comment here; I just think this is a pretty cool graphic.
Biden-Harris Administration Announces Record-Breaking 16.3 Million People Signed Up for Health Care Coverage in ACA Marketplaces During 2022-2023 Open Enrollment Season
Nearly 50% increase in HealthCare.gov signups since President Biden took office, and 3.6 million people signed up for health care coverage on the Marketplaces for the first time this year
Today, the Biden-Harris Administration announced that a record-breaking more than 16.3 million people have selected an Affordable Care Act (ACA) Marketplace health plan nationwide during the 2023 Marketplace Open Enrollment Period (OEP) that ran from November 1, 2022- January 15, 2023 for most Marketplaces. President Biden promised to strengthen and build on the Affordable Care Act, and this year, the 10th year of ACA Open Enrollment, more Americans signed up for high-quality, affordable health insurance through the ACA Marketplaces than ever before. Since President Biden took office, the number of people who have signed up for an affordable health care plan through HealthCare.gov has increased by nearly 50%. Because of the President’s plan, millions of working families saved an average of $800 on their health insurance premiums last year.
As I noted in yesterday's analysis of the semi-final 2023 Open Enrollment Period report released by the Centers for Medicare & Medicaid Services, one of the most striking data points we're seeing this year is a significant drop in year over year on-exchange enrollment across a number of states operating their own ACA exchanges...even as enrollment continues to surge across states hosted on the federal exchange (HealthCare.Gov).
Overall, QHP enrollment in HC.gov states (Federally Facilitated Marketplaces, or FFMs) is up 19.6% vs. the same point last year, while QHP enrollment in state-based marketplace states (SBMs) is down 2.8% year over year:
As I noted this morning, Florida has by far the highest percent of its total statewide population enrolled in on-exchange ACA policies, with over 3.15 million Floridians enrolled so far (likely around 3.24 million when the final weekly numbers are included). This is 14.2% of Florida's total 2022 population according to the U.S. Census Bureau, or 1 in 7 residents of the state.
What about the other states? The table below sorts total 2023 OEP enrollment as of either 1/07/23 for federal exchange states (HC.gov) or 12/31/22 for state-based marketplace states (SBM) by what percent of the total state population has signed up so far. For New York and Minnesota the percent of total population includes each states Basic Health Plan (BHP) enrollment as well, since everyone enrolled in those plans would normally be eligible for a QHP instead:
Nearly 16 Million People Have Signed Up for Affordable Health Coverage in ACA Marketplaces Since Start of Open Enrollment Period
This record-breaking enrollment represents a 13% increase over last year, including over 3 million people new to the Marketplaces.
Open enrollment continues through January 15
Today, the Biden-Harris Administration announced that about 15.9 million people have selected an Affordable Care Act (ACA) Marketplace health plan nationwide since the start of the 2023 Marketplace Open Enrollment Period (OEP) on November 1. This represents activity through January 7, 2023 (Week 10) for the 33 Marketplaces using HealthCare.gov and through December 31, 2022 (Week 9) for the 18 State-based Marketplaces (SBMs) in 17 states and the District of Columbia that are using their own eligibility and enrollment platforms. Total plan selections include 3.1 million people (20% of total) who are new to the Marketplaces for 2023, and 12.8 million people (80% of total) who had active 2022 coverage and made a plan selection for 2023 coverage or were automatically re-enrolled. About 1.8 million more people have signed up for health insurance, or a 13% increase, from this time last year.
However, as I noted, the actual confirmed 2023 OEP tally is over a million higher than that thanks to the nearly 1.2 million Basic Health Plan (BHP) enrollees in New York and Minnesota, as well as some other more recent oddball enrollment data released by various state-based exchanges. All told, this brought the grand total up to over 6.8 million.
HOWEVER, it turns out the actual confirmed total is much higher than that as well, thanks to another ~2.9 million current exchange enrollees across the 18 state-based exchanges who have already been automatically re-enrolled in their current policies for another year (or, alternately, auto-mapped to a similar healthcare plan in cases where their current policy is being discontinued).