- Analysts expect up to a 13 percent drop in open enrollment on the ACA marketplace exchange in 2018, according to Standard and Poor’s Global (S&P Global).
Only 10.1 million to 11.4 million individuals are expected in enroll in 2018, say projections based on changes in re-enrollment, new enrollment, and market perception of available plans.
Previously, open enrollment totals exhibited an upward trend. In 2014, 8 million enrolled in ACA coverage; in 2015 the figure jumped to 11.7 million. During 2016, 12.7 million individuals took advantage of exchange plans, but the number dropped slightly to 12.2 million in 2017.
Full-year effectuated enrollment (OEE), or the number of individuals who pay premiums and pay coverage year-long, trended in a similar direction.
OEE in 2014 totaled 6.3 million individuals followed by 8.8 million in 2015, 9.1 million in 2016, and 9 million in 2017.
For 2018, S&P Global predicts that OEE could remain at 9 million individuals or decrease by eight percent from the previous year.
S&P Global believes that previous trends in the earlier stages of enrollment help explain some of the expected decreases in ACA plan enrollment.
In 2015, 50 percent of open enrollment individuals, or roughly five million people, were newly enrolled in the ACA. That number steadily declined as the number of yearly new enrollees dropped to 39 percent in 2016 (4.3 million), and 31 percent in 2017 (3.7 million).
These findings suggest that the ACA market is leveling off. Individuals who either need or want ACA health plans already have them, which limits the growth of new enrollee numbers.
S&P Global also suggests that consumers who used the plans on a temporary basis have voluntarily phased themselves out of the market. The team believes that individuals who don’t receive premium tax credits for ACA plans have also opted-out of coverage.
Current policy decisions are expected to raise consumer premiums, the analysis added. Payers are expected to break even financially - a prediction that has been volunteered by other recent industry examinations.
Increased enrollment would help payers that operate in this market, and stabilize the individual risk pool, but current projections and previous data is showing that increases in enrollment are not likely to happen in the short term.