Private Payers News

11.4M Consumers Selected ACA Health Insurance Exchange Plans in 2019

The number of consumers who selected or were automatically re-enrolled in ACA health insurance exchange plans remained steady in 2019.

11.4 million consumers selected ACA health insurance exchange plans in 2019

Source: Thinkstock

By Jessica Kent

- Approximately 11.4 million consumers either selected or were automatically re-enrolled in Affordable Care Act (ACA) health insurance exchange plans during the open enrollment period in 2019, according to CMS’s open enrollment report.

This number has stayed relatively steady since 2018, when CMS reported that 11.8 million members selected or automatically re-enrolled in these health plans.

CMS evaluated the 39 states that use the HealthCare.gov eligibility and enrollment platform, as well as the 12 state-based exchanges (SBEs) that use their own eligibility and enrollment platforms.

The report shows that the total number of consumers selecting health plans declined minimally since 2018, with about 300,000 fewer members selecting plans in 2019 than last year.

CMS noted that this decline was likely due to an increase in the number of individuals with access to employer-sponsored health plans, which would result in a lower demand for exchange coverage.

Additionally, the agency said the decline could be attributed to the roughly 100,000 people who were enrolled in the exchange in Virginia at the end of 2018, and who reported incomes that would make them eligible for the Virginia Medicaid expansion in 2019.

Of the 11.4 total enrollees, 8.4 million purchased coverage through the HealthCare.gov platform, a 1.5 percent decrease from 2018.  Three million consumers used state-based exchanges. 

Twenty-four percent of members were new to the exchanges, and 47 percent actively returned to select a 2019 plan. Thirty percent were automatic re-enrollees.

Of the 8.4 million members who enrolled through the HealthCare.gov platform, 18 percent were residents of a rural area. The number of consumers with reported household incomes between 100 percent and 250 percent of the federal poverty level increased slightly from 70 percent in 2018 to 71 percent in 2019.

Other demographic data, including age, gender, and race, also remained unchanged from 2018. Twenty-six percent of young adults ages 18 to 34 purchased health plans through HealthCare.gov in 2019, just as in 2018.

Between 2018 and 2019, the percentage of African-American consumers who selected health plans stayed at seven percent, while the percentage of whites increased from 49 percent in 2018 to 51 percent in 2019.

Similar to last year’s findings, silver-tier plans were the most popular, with 61 percent of members choosing this plan.  This represents a four percent decrease from 2018. Bronze plans also remained a common choice, with 30 percent of members selecting these plans, compared to 28 percent in 2018.

CMS also found that the average premium for consumers before applying tax credits decreased by one percent, from $621 in 2018 to $612 in 2019. After applying tax credits, premiums were $87 compared to $89 the previous year.

While this is a small reduction, CMS noted that the past two years have seen a sharp increase in premiums, rising 23 percent on average in 2017 and 31 percent in 2018.

In addition to the report, CMS is extending the non-enforcement policy to allow issuers to continue certain health plans that don’t meet all the mandates and restrictions in the ACA.

Often called “grandmothered” plans, these coverage options can be more affordable for people who choose to renew them. Extending grandmothered policies will help consumers maintain more affordable coverage than they would have through PPACA plans.

“Not extending the grandmothered plan policy would cancel plans that are meeting people’s needs today and, as a result, force people to decide between buying coverage they cannot afford on the individual market or going uninsured,” said CMS Administrator Seema Verma.

The report findings demonstrate the simplicity of the enrollment process, Verma said.

“Another year of stable enrollment through the Exchanges directly reflects the strong work CMS staff put into ensuring that Exchange consumers experience a seamless enrollment process free from unnecessary hurdles and IT glitches,” she concluded.

“It is no coincidence enrollment remained strong when the Exchange call center maintained a record high 90 percent satisfaction rate and no waiting rooms were needed in the final, busiest days of enrollment.”