Report: Number of Insured Americans Continues to Rise under ACA

Report: Number of Insured Americans Continues to Rise under ACA

Yesterday, the U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) released the latest ACA open enrollment "snapshot," announcing that about 12.7 million plan selections had been added during the 2016 Open Enrollment period.

"Of the 12.7 million consumers enrolling in Marketplace coverage, over 9.6 million came through the HealthCare.gov platform and 3.1 million selected a plan through State-based Marketplaces," the report explained.

"It is also worth noting that nearly 400,000 people signed up for New York’s new Basic Health Program, along with about 33,000 people who signed up for Minnesota’s Basic Health Program, during this Open Enrollment. Basic Health Programs are state based programs supported by the Affordable Care Act that provide health insurance coverage to low income individuals who would generally otherwise be eligible for qualified health plans. In fact, about 300,000 of the New York Basic Health Program enrollees for 2016 are people who enrolled in Marketplace coverage for 2015 and were included in last year’s Marketplace total plan selections."

There are a number of caveats and considerations regarding this data. "The 12.7 million figure likely will come down a bit throughout the year, depending on how many people pay their monthly premiums or switch to other forms of health coverage, but the CMS already incorporated some plan cancellations into its calculation," writes Bob Herman for Modern Healthcare.

ACA Enrollment for 2016 “a Success,” Says HHS

U.S. Department of Health and Human Services Secretary Sylvia Burwell called the numbers “a success,” adding that the Health Insurance Marketplace “is changing people’s lives for the better.”

“Across the country, about 12.7 million Americans selected affordable, quality health plans for 2016 coverage, exceeding our goals,” Burwell added. “That includes over 4 million new consumers in the HealthCare.gov states who signed-up for coverage this year. The Marketplace is growing and getting stronger and the ACA has become a crucial part of healthcare in America.”

Not everyone shares Burwell's enthusiasm. Insurance executives and state officials "have publicly griped about the state of the exchanges" for months, Herman notes. Some larger insurers have even threatened to abandon the ACA's online marketplace because of "heavy losses," citing operational inefficiencies, "loose rules for special enrollments" and a risk pool that "skews toward older, higher-cost patients."

For its part, the HHS has been working to alleviate those concerns, citing "improvements we made to further automate transactions with insurers." All the same, many healthcare executives "believe it'll take at least another year or two before the individual marketplaces will have stable rates and broader enrollment," Herman writes.

In some areas, smaller, more regionally based insurance providers seem to be faring better, Herman notes. For instance, Connecticut-based ConnectiCare has actually grown its exchange membership to more than half of the state's total insured. The trends show that the ACA has empowered some Americans to shop around for better deals.

“Unlike the national players, we're focused solely on the state of Connecticut,” Michelle Zettergren, senior vice president of sales and marketing for ConnectiCare, told Herman. “We had a mature marketplace prior to ACA, and it continues to be a mature marketplace for us.”

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