Dive Brief:
- HHS projects a total of 13.8 million individuals will sign up for health plans through the ACA marketplaces by the end of open enrollment for 2017, Secretary Sylvia M. Burwell announced Wednesday.
- That number supposes there will be an increase of 1.1 million people purchasing coverage on top of the 12.7 million existing customers, which would be about the same percentage of growth that was seen for 2016.
- HHS further projected that due to attrition and non-payment, the average number of people actually covered under ACA plans during any given month in 2017 will be 11.4 million people, which it noted is also an increase of 1.1 million people from 2016.
Dive Insight:
The administration has been gunning for strong ACA enrollment leading into 2017, not just for the sake of getting more people covered, but also for the sake of stabilizing the current risk pool by attracting more young and healthy hold-outs. Based on its estimates of how many of the remaining uninsured are eligible for financial assistance, the HHS is optimistic it will get them.
The agency noted of the 10.7 million uninsured Americans who qualify for marketplace coverage, about 85% have incomes that likely qualify them for assistance, and about 60% appear to also qualify for cost-sharing reductions on top of tax credits. It added 40% of the eligible uninsured are in the desired demographic of 18-34 years old.
Officials estimate another 5.1 million people who currently purchase off-marketplace plans will come over to the marketplace, noting that about 2.5 million of these people are estimated to be eligible for assistance. The HHS announcement did not detail why it projects those who are non-eligible for assistance might be draw to move over.
Another question that may remain to be seen is whether any significant number of current enrollees will be turned off by the market volatility that will force an estimated 1.4 million to 2.5 million of them to select new plans to stay enrolled, because their 2016 choices will no longer be available.
The issues with changing plans include often having to change provider networks, finding providers who are taking new patients, and often having to change prescription medications, a recent study noted, all of which can cause negative interruptions to healthcare and provider/patient relationships. Furthermore, a growing number of consumers are expected to have only one choice serving their region, which may or may not prove a good fit for their needs or preferences.