QHPs

Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7

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.

Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7

Next up: Age brackets, gender, racial/ethnic groups and urban/rural communities. I'm also throwing in the stand-alone Dental Plan table here for the heck of it since I don't know where else to include it.

I don't have a ton to say about any of these, really. It's always interesting to me to see that 1.7% of ACA exchange enrollees are 65 or older. Not sure why they aren't on Medicare but I'm sure there are logical reasons.

Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7

Next up: Premiums, Advance Premium Tax Credits (APTC) and Cost Sharing Reduction (CSR) assistance.

Nationally, the average unsubsidized premiums for 2023 exchange-based Open Enrollment Period enrollees is $605/month, exactly the same as 2023.

Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7

Now it's time to move on to the actual demographic breakout of the 2024 Open Enrollment Period (OEP) Qualified Health Plan (QHP) enrollees.

First up is breaking out new enrollees vs. existing enrollees who either actively re-enroll in an exchange plan for another year or who passively allow themselves to be automatically renewed into their current plan (or to be "mapped" to a similar plan if the current one is no longer available).

Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7

Moments ago the Centers for Medicare & Medicaid Services (CMS) posted the official 2024 ACA Open Enrollment Period Public Use Files. Let's dig in!

The table below has the data for both Qualified Health Plans (QHPs) in all 50 states + DC as well as Basic Health Plan (BHP) enrollment in Minnesota and New York only, compared to the 2023 OEP.

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.

There's still likely up to perhaps ~25,000 or so Qualified Health Plan (QHP) enrollments to be added to the 2024 Open Enrollment Period (OEP) tally from the states which haven't reported their final, post-1/16 enrollments (in fact, CA & NY technically haven't ended theirs yet, but I decided to throw this together today for the hell of it.

The table below charts the first eleven 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 (Oregon is scheduled to launch theirs this summer, I believe).

No further analysis or comment here; I just think this is a pretty cool graphic which demonstrates visually how the ACA has grown over time to become firmly embedded into the U.S. healthcare landscape. Source: CMS Marketplace Open Enrollment Period Public Use Files for 2014 - 2023; CMS Final National Snapshot for 2024.

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.

via the Centers for Medicare & Medicaid Services:

The Centers for Medicare & Medicaid Services (CMS) reports that 21.3 million consumers have signed up for 2024 individual market health insurance coverage through the Marketplaces since the start of the 2024 Marketplace Open Enrollment Period (OEP) on November 1. This includes 16.4 million Marketplace plan selections in the 32 states using the HealthCare.gov platform for the 2024 plan year through the end of the OEP on January 16, 2024 (Week 11+), and 4.9 million plan selections in the 18 states and the District of Columbia with State-based Marketplaces (SBMs) that are using their own eligibility and enrollment platforms, through January 13, 2024 (Week 11) or the end of their OEP[1].  Total nationwide plan selections include 5 million consumers (24% of total) who are new to the Marketplaces for 2024, and 16.3 million consumers (76% of total) who have active 2023 coverage and returned to their respective Marketplaces to renew or select a new plan for 2024. 

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