In March, the U.S. Department of Health and Human Services (HHS) released the final report for the 2016 open enrollment period for the Health Insurance Marketplaces, established by the Affordable Care Act (ACA). This year enrollment in the Marketplace continued to grow with 1.3 million Texans selecting health plans in the Marketplace, 48 percent of whom where new consumers. The HHS report also provides information on the cost of insurance and the availability of subsidies. During open enrollment for the 2016 plan year in Texas:
- 84 percent of people who selected a plan were eligible for financial assistance
- The average monthly premium before credit was $344.
- Average monthly premium after the tax credit was $87–a 75 percent reduction in premium cost!
Source: U.S. Dept of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation
So how are we doing? Enrollment is on target with goals from the U.S. Department of Health and Human Services announced prior to open enrollment and not too far from recent projections from Congressional Budget Office (CBO), but they are lower than CBO projections from last March.
Researchers at the Kaiser Family Foundation released a report outlining possible reasons why enrollment in the Marketplace is lower than initially projected by the CBO such as:
- There was not a significant decline in employer sponsored coverage after the ACA as many people expected
- People who are not eligible for subsidies on the Marketplace often choose to purchase plans directly from the insurer, and
- Affordability remains a challenge especially for those with income below 138 percent of the federal poverty level who should have been eligible for Medicaid if states like Texas had chosen to expand coverage.
Finally, it’s important to remember that this report provides only a snapshot of the number of people who chose a plan during open enrollment in the Marketplace. As 2016 goes on, some people may drop their coverage, for example if they get a job that offer coverage. Also, individuals can newly enroll in coverage during a “special enrollment period” if they experience a qualifying life event like having a baby or getting married. HHS provides quarterly reports which reflect gains and losses that occur throughout the year.