enrollment in the ACA marketplace as a whole in the Open Enrollment Period for 2023 is on pace to finish about 13% higher than in OEP 2022, enrollment in the eighteen states that run state-based marketplaces (SBMs) is on course to come in about 3% below the OEP 2022 total.
This is WEIRD!
If you had asked me in October if I thought the Healthcare.gov states would have higher enrollment growth than State Based Marketplaces (SBM), I would not have been surprised if that was the case. I could tell you a story that SBM states all had expanded Medicaid so the pool of plausible enrollees is smaller. I could say that the wrap-around subsidies that SBM states have enacted mediate the effect of the enhanced ARPA/IRA subsidies a bit. I could say that the SBM states aren’t experiencing a substantial information infusion through increased advertising and navigator funding that has only turned back on in Healthcare.gov states as the SBM states had kept that constant(ish) over the Trump administration.
I could tell that story which could explain a general growth in enrollment with more growth in the Healthcare.gov states that are heavily exposed to zero premium silver plans.
But that is not the story that we actually see.
I don’t have a good initial story that explains why Healthcare.gov enrollment went up substantially but SBM enrollment is down a smidge.
Any good ideas?