CMS Issues Reports on 2017 Marketplace Enrollment Trends

On June 12th, CMS released two reports on marketplace enrollment trends. The first report, “Effectuated Enrollment Analysis” offers a broad overview of 2017 marketplace enrollment. The second report, “Health Insurance Exchanges Trends Report” discusses exit survey data from consumers who cancelled or terminated their 2017 health plans.

These reports are intended to give policy makers a glimpse into trends thus far in 2017. This analysis follows a March report that found 12.2 million people selected or were automatically enrolled in Marketplace plans during the 2017 open enrollment period. 10.1 million (83%) of enrollees selected a plan that had premiums reduced by advanced payments of premium tax credits (APTC).

The Effectuated Enrollment Analysis highlights attrition rates for the first two and a half months of 2017. Of the 12.2 million who were enrolled in plans, 1.9 million did not pay their first month’s premium payment (10.3 million did). Some lawmakers have used this data to support the notion that the ACA is failing. They conclude that those who did not pay chose not to due to high premiums. Under the ACA consumers can fail to pay premiums for 90 days but still remain enrolled in a plan.

Although plan attrition is not uncommon, the initial attrition rates for 2017 appear to be considerably higher than those seen in previous years (15.5% for 2017 versus 8.6% for 2016).

A contributing factor could be that many insurers have chosen to leave marketplaces across the country. Major insurers such as Aetna, Humana, and UnitedHealth have all stopped offering plans on the exchanges either entirely or in select markets largely due to financial losses they were experiencing as well as the unpredictability of future policies. In addition, promises by the Republican Congress and President Trump to repeal the ACAs mandates may also have contributed to the higher attrition rates.

The Health Insurance Exchanges Trends Report sought to understand the forces behind the numbers. The investigation found:

  • Consumers with higher premiums were more likely to terminate or cancel coverage.
  • Consumers listed lack of affordability as one of the most common reasons for not paying for the first month’s coverage.
  • Disruptions in coverage options lead to fewer consumers retaining their coverage.
  • Consumers without financial assistance were more likely to terminate or cancel coverage

Additionally, the report found that people often left the market because they obtained a job with employer sponsored insurance or qualified for Medicare.

As always, ADVOCATE will keep you up to date on this and all issues impacting radiology as they become available.

Best regards,
Kirk Reinitz, CPA