Implementing health reform: An October through December enrollment report

From the Health Affairs Blog:

On January 13, 2014, the Department of Health and Human Services released a report on the Health Insurance Marketplace covering the first three months of open enrollment, October 1 through December 28, 2013. The data are reported cumulatively over the three month period rather than only for December, recognizing the fact that enrollment is a process that happens over a period of time and thus data reported separately on a monthly basis could be duplicative. Nevertheless the trends are very clear: the federal and many of the state exchanges are now in business, and enrollment is increasing at a rapid pace.

As of the end of December 2,153,421 Americans had enrolled in a qualified health plan: 956,991 had selected a plan through the state exchanges; 1,196,430 through the federal exchange. Three times as many enrollees selected a plan through the state exchanges in December (729,000) than had done so in October and November (227,000); five times as many selected a plan through the federal exchange in December (1,059,000) than had done so in October and November (137,000).

As of December 28, 2013, the exchanges had received a total of 4,348,224 applications, covering 7,716,824 individuals. Of these individuals, 5,130,798 were determined eligible for enrollment in an exchange-qualified health plan; 1,584,509 were determined or assessed eligible for Medicaid or CHIP. These numbers were dramatically increased from the 2.3 million determined eligible for exchange coverage and 803,077 eligible for Medicaid as of the end of November. A recent survey by the Commonwealth Fund found that 59 percent of adults who are potentially eligible for exchange coverage, but who had visited the exchange and not enrolled or had not yet visited the exchange, planned to enroll by March 31, 2014, the end of the open enrollment period. It is likely that many of the three million who have been determined eligible but not yet enrolled will yet do so.

The December report reveals new information on enrollees who qualified for premium tax credits. In October only 30 percent of enrollees who were determined eligible for exchange enrollment were determined eligible for financial assistance; by November the percentage had climbed to 50 percent. In the December report that number climbed only marginally, to 53 percent. The December report for the first time, however, tells us the proportion of individuals who actually enrolled in a plan who received financial assistance: 78 percent in the state-based exchanges, 80 percent in the federal exchange. This is close to the level of subsidy-eligible exchange enrollees projected by the Congressional Budget Office and suggests that the exchanges are actually reaching the uninsured — those who could not have previously afforded health insurance — as well as individuals who had individual coverage previously but really could not afford it.

To read the complete post, click here.

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