The first deadline for Open Enrollment passed late last week. People who signed up for coverage on Healthcare.gov by the end of day on December 15th will, as long as they make their initial payment, have coverage starting on January 1, 2024. People in every state except IDAHO have several more weeks to sign up for coverage that starts on February 1, 2024.
The Centers for Medicare and Medicaid Services (CMS) released their early tally for Healthcare.gov enrollment:
The Biden-Harris Administration announced today that the Affordable Care Act (ACA) Marketplace enrollment continues at a record-breaking pace. As of December 15, 2023, for HealthCare.gov states and December 9, 2023, for State-based Marketplaces, preliminary data projects that over 19 million consumers will enroll in 2024 coverage through the ACA Marketplaces — over 7 million more than when President Biden took office. This includes 15.3 million individuals who have selected a health plan using the HealthCare.gov platform. [my emphasis]
Nineteen million is an undercount. States that operate their own marketplace only reported through December 9th. The last week of January 1st initiation likely has 25% to 33% of total enrollment action for the entire Open Enrollment Period.
I had given several press interviews about my expectations for this OEP relative to last year. My expectations were that this year would look a lot like last year when just over 16 million people signed up through the entire OEP period. I would not have been surprised by 17 million, and 17.5 would be a nice reach goal.
I got that wrong.
I had assumed that the subsidies were constant, market entry and exit were not too dissimilar, advertising and navigator support are similar year over year, federal messaging and support for enrollment is similar. The big change was Medicaid redetermination. I had assumed that past transitions from Medicaid to ACA were low and even doubling the conversion rate would still not be a material event.
I’m not sure exactly where I’m wrong but those were my assumptions to get me to a wrong answer.
Old School
We’ll expect better next time.
Barbara
There may be states that actually tried to help people being terminated from Medicaid transition to the ACA. Also, if my client base is representative, many providers and health plans were proactively reaching out to individuals perceived to be at risk from termination to assist them with either retaining their Medicaid eligibility or moving to an ACA plan. Institutional support like this can really make a difference, especially in states that are gleefully taking a meat axe to Medicaid beneficiaries with no effort to help them find alternatives.
NoraLenderbee
Count us in that 19 million. We just signed up for a silver plan through the California exchange. I am astonished by the cost, even with subsidies.
Chris
Just posted this downstairs, but reposting it here since it’s a new thread and this is, in fact, a health care question though on a very different topic:
Has anyone here ever used air-dr.com (a service that claims to put you in touch with doctors in other countries when you’re traveling)? I’m currently traveling and finding myself in need of a doctor, can’t find anything online that suggests the site is a scam, but I was somewhat weirded out by the fact that all the doctors’ names are incomplete (one name and initial), that I can’t find them anywhere else online (though that’s explainable by the fact that the alphabet isn’t even the same here), and that the website won’t tell me where the appointment is at until I actually book it (the anodyne name of the place being “clinic C,” which isn’t enough to find an actual institution on).
Alternatively, if anyone’s ever happened to be in need of a doctor in Athens, Greece recently and has someone they can recommend, I’d be thrilled with that too. But that seemed like a much longer shot.
Miss Bianca
Just signed up for my second year with Anthem, second year with $0 monthly fee. Thank you, Connect for Health Colorado!
Central Planning
@Chris:
If you can find a thread where Bruce K in ATH-GR recently posted, you might just be in luck. Or, maybe ask one of the front pagers to send a note to Bruce to see if he would be willing to connect with you.
mvr
They interviewed the Secretary of Heath and Human Services (I’m old so I keep wanting to write Health, Education and Welfare) Becerra on NPR about this last night. He was saying that they had put more resources into navigators this year.
FWIW . . .
WV Blondie
We’re still waiting for my husband’s Medicaid eligibility review to conclude. I’m presuming if they shoot him down, he can get insurance through the ACA even though the deadline has passed.
David Anderson
@WV Blondie: He can enroll no questions asked on the ACA through January 15th.
Lobo
Is this a good “get it wrong” or a bad “get it wrong.” ;)
Bruce K in ATH-GR
@Chris: For what it’s worth, if you can see this, I’ve seen an internist by the name of Nikolaos Papadopoulos, with an office just west of the American Embassy. His contact info is at: nipapmed.wixsite.com/nipapmed
Marcopolo
Personal anecdotal point: I have friends who were on Medicaid last year, who while doing their 2024 renewal paperwork discovered on 12/13 they would be bumped off for too much income. A bit of a mad scramble to for them to get ACA signed up through the portal. Pretty sure they did not get the best deal (cause they wanted to keep their providers and only one insurer worked for that) but at least they’ll continue to have health insurance.
Dave, perhaps when all the dust clears down the road you can let us know the final +/- overall coverage numbers (from folks getting kicked off their state’s Medicaid rolls (the minus) and new sign ups via the ACA (the plus). Guess I’m expecting the number of uninsured folks to rise but only a little.
Marcopolo
@NoraLenderbee: Astonished good or bad? With subsidies I’m only paying ~$175/month (think $1200 deductible) but I’m towards the low end income wise. I’ve had my insurance through the ACA since it first began. Best experience was the entire year and few months I had no payments because the insurance company earned too much. That was awesome, though the first month I thought I’d somehow screwed up the payments on my end.
David Anderson
@Marcopolo: Happily surprised….
Now back to data cleaning for my dissertation.