As I noted in the prior entry, QHP enrollment is running ahead of last year so far in 45 states so far, with it running more than 50% higher in over a dozen of them and more than twice as high in Mississippi.
Another way of looking at this is to compare the confirmed current QHP enrollment in every state as of the most recent data (12/02/23 for HC.gov states; 11/25/23 for SBM states) against the final total QHP enrollment as of the end of the 2023 Open Enrollment Period.
This is obviously isn't a fair comparison since there's still a full 40 days left for people to enroll and because auto-renewals still have to be added to the federal exchange states. However, it's still interesting to take a look.
For the SBM states, I've included their auto-renewals as reported in either the CMS snapshot report or, in a few cases, even more recent combined enrollment data from the SBMs themselves.
...The graph below shows how these numbers have increased since the same time period last year. I've had to adjust slightly for the fact that there's one fewer day included for both the federal exchange (32 days vs. 33) and the state exchanges (25 days vs. 26).
I've also had to adjust for the fact that Virginia moved from the federal exchange to its own state-based exchange this year, which is further complicated by CMS reporting 5 weeks for the federal exchange but only 4 weeks for state-based exchange. Otherwise, the subtotals are accurate, while the new/returning breakout for 2023 are estimates,but should still be pretty close:
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.
...The graph below shows how these numbers have increased since the same time period last year. I've had to adjust slightly for the fact that there's one fewer day included for both the federal exchange (18 days vs. 19) and the state exchanges (11 days vs. 12).
I've also had to adjust for the fact that Virginia moved from the federal exchange to its own state-based exchange this year, which is further complicated by CMS reporting 3 weeks for the federal exchange but only 2 weeks for state-based exchanges. I've done my best to adjust for all of these factors below (the subtotals are accurate; the new/returning breakout for 2023 are estimates but should be pretty close):
The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)
Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of proposed tweaks to some of the specifics of how the ACA is actually implemented for the following year (actually, it's the year after the following year, since the final rule is generally released in mid-December).
OK, there isn't supposed to be a formal Open Enrollment Period report out for another week, but President Biden just tweeted out a pretty impressive topline number for the first week of the 2024 ACA Open Enrollment Period:
In the first week of Open Enrollment, 1.6 million people have signed up for a plan at HealthCare.Gov, including 301,000 new consumers – that’s a 50% increase from last year.
The Marketplace Open Enrollment Period on HealthCare.gov generally runs from November 1 to January 15. Consumers who enroll by midnight December 15 (5 a.m. EST on December 16) can get full-year coverage that starts January 1, 2024. In 2024, January 15 is a federal holiday; accordingly, consumers will have until midnight on Tuesday, January 16 (5 a.m. EST on January 17) to enroll in coverage. Consumers who enroll after December 15 but before the deadline in January will have coverage that starts February 1, 2024.
Consumers continue to have more choices and stable premiums
The Biden-Harris Administration believes health coverage is a right, not a privilege, and is committed to investing in a robust Marketplace Open Enrollment campaign so everyone who needs health coverage can easily sign up for it. Starting today, HealthCare.gov consumers can preview their health care coverage options and see detailed information about 2024 health insurance plans and prices offered in their area ahead of the Open Enrollment period that begins November 1.
As we begin the 11th Open Enrollment period, the Marketplace is stronger than ever with lower out-of-pocket premiums thanks to the continuation of enhanced financial assistance under the Inflation Reduction Act. Thanks to the Inflation Reduction Act, nearly 15 million Americans are saving an average of $800 a year on their health insurance premiums.
CMS will beef up its outreach strategy and scale up a pilot program that connected navigators to specific consumers who are not eligible for Medicaid but could enroll in an Affordable Care Act plan through healthcare.gov to help ensure people who lose benefits during the ‘unwinding’ maintain their coverage, according to a slide-deck from a recent webinar.
As part of the effort, healthcare.gov will send those consumers additional reminder letters about enrolling in ACA coverage, with the first batch slated to go out in mid-May, and the assisters will contact those customers shortly afterward.
HHS has estimated that about 2.7 million of the 15 million or so Medicaid beneficiaries expected to lose coverage during the redetermination may be eligible for subsidized coverage through the marketplaces.