The federal platform, Healthcare.gov released their final open enrollment numbers late last week.
Approximately 8.3 million people selected or were automatically re-enrolled in plans using the HealthCare.gov platform during the 2020 open enrollment period. …
Charles Gaba has a good summary of the meaning behind these numbers:
As a result, HC.gov ends the 2020 Open Enrollment Period down just 1.5% from last year…and it’s actually just 0.5% when you take into account Nevada splitting off onto their own state-based exchange.
It’s also worth noting that in the end, renewing enrollees dropped by 2.2% year over year (139,000 people), but new enrollees actually increased by 0.7% (14,000 people).
I was wrong.
I had thought that enrollment would decline due to pricing pressures. I expected declines in ACA enrollment for two mechanical reasons. First, Nevada transitioned off of Healthcare.gov to their own, state based marketplace for the 2020 open enrollment period. Secondly, several more states have expanded Medicaid or are in their second open enrollment period where on-marketplace enrollment declines are still expected.
I had thought pricing would matter more as the spreads compressed:
In 2019, the median premium spread between the benchmark and the least expensive bronze plan was $164 for a single 40-year-old. In 2020, this difference decreased to $148. For the same 40-year-old, the median premium spread from the least expensive silver plan to the benchmark decreased from $27 in 2019 to $14 in 2020.
The reduced silver spread, while small in dollars, may have a profound impact. At incomes up to 200 percent of poverty, the value of CSR—a free added benefit—exceeds the value of most bronze and gold plan discounts generated by silver loading. …Those discounts appear to have boosted enrollment, offsetting negative factors such as repeal of the individual mandate penalty and reduced federal spending on advertising and outreach. While enrollment at 200–400 percent of poverty has increased slightly from 2017 to 2019 (less than 1 percent), enrollment at 100–200 percent of poverty has fallen 10 percent in the same period.
I’m curious as to what is going on in the market as I thought the pricing environment was slightly worse in 2020 than it was in 2019 and the number of advertised outs was higher. I’m not sure what is going on.
donnah
David, I know nothing about the ACA lingo, but my husband and I are facing a crisis with our coverage. Last year our youngest son was still covered under our plan, but he turns 27 in March and we lost his exemption. Our rates jumped from $450/mo to an incredible $1400/mo. We just can’t afford that. It’s practically double our house payment. My husband has spoken with both the insurance company and the Healthcare.gov people with no help.
Any advice for us?
David Anderson
e-mail me directly and we’ll strategize
donnah
@David Anderson: Thanks! Can I contact you after he gets home from work this evening?
David Anderson
@donnah: sounds like a start of a plan, so yes!
WaterGirl
@donnah: That is beyond distressing. I hope David can help you get something figured out.
Adam Lang
Jesus @donnah. I don’t know anywhere near the amount that David does, so all I can do is offer my condolences.
As for the story, possibly this is just a reflection of the fact that the approval rating for the ACA is up about ten percent since two years ago?
weavrmom
@donnah So sorry to hear of your situation. The same happened to my family before the ACA, when our COBRA payments jumped to more than our mortgage. I hope you are able to find a workable solution for your family!
More generally: as for why so many are enrolling in ACA, I think the terror of being uninsured in modern America is underestimated. It’s playing Russian roulette with bankruptcy every day. I will go to great lengths to avoid that happening ever again. As for the lower unenrollment in the 100-200% group, guessing that they may have trouble making those payments, which here in CA go up steeply. It’s a group that is stressed and pressed, for sure. otoh, I have no professional or informed opinion, so enjoy reading these posts, which are often above my head.
David Anderson
Plausible!
donnah
Thanks, everyone, for your kind thoughts. It’s scary to be without coverage. I hope we can figure something out with David’s help.
Fingers crossed!
Geo Wilcox
I’ll tell you what is going on. My pal in TX had her BCBS private plan go up to $700 per month. She thumbed her nose at the ACA when it first rolled out, libertarian moron that she is, saying nothing was better than her plan. Fast forward several years and now she sings a very different tune. She chose a silver Ambetter plan and pays less than $200 per month, every preventative thing is free, and if she does them all she gets a free VISA card.
I told her ages ago to check it out but she is one of those idiots who thinks getting help is bad, esp if it is from the government. She despises trump so I love her but she can be pretty shortsighted and stupid.
Christine
@David Anderson:
What is ACA?
At age 60 I enrolled in HEALTHCARE.GOV
Got a Bronze plan $150.00 2018, that went the next year for a silver to $300.00, found insurance minimal cover at work for 2020, I couldn’t afford $300.00 and I assumed it would double again to $600.00. Nothing is being done to help people, I live in NJ the ones who gain are ILLEGALS and GOV MURPHY.
CD
rekoob
As a self-employed 58-year-old, I’ve opted for an HSA-qualified plan (not enough hyphens? Keep reading). I blew through the out-of-pockets in 2019, but believe I’ll be okay in 2020 (here’s hoping). I believe agonizing about healthcare expenditures every November-December is an incredible waste of time, and I hope we can all think about a better way to deal with it soon. My monthly premium went up about 8%, which for central Virginia and my age-related claims seems about right, since the “level premium” option would have had far fewer overall benefits. I hope CIGNA is getting some excellent hookers and blow with my increase.