Health Insurance Report™ helps you track and analyze legal, legislative, and regulatory developments affecting the health-insurance industry throughout implementation of the Affordable Care Act...
By Sara Hansard
Sept. 8 — About 9.9 million people got health insurance coverage through the marketplaces set up by the Affordable Care Act as of June 30, a decline from earlier in the year though still higher than the Obama administration’s target.
About 84 percent got government subsidies to buy the coverage, getting an average of $270 a month, according to data released by the Centers for Medicare & Medicaid Services Sept. 8. Enrollment had been 10.2 million at the end of March.
The administration has set a year-end goal of insuring at least 9.1 million people via policies bought in the insurance marketplaces. People fall off the rolls when they stop paying for the insurance. Sometimes that means they’re getting coverage elsewhere, for instance because they’ve married or gotten a job that offers health benefits.
“Millions of Americans are benefiting from the peace of mind that comes with having quality coverage at a price they can afford,” Sylvia Burwell, secretary of the Department of Health and Human Services, said in a statement.
At the end of June there were 7.2 million consumers with effectuated enrollments, meaning they had paid monthly premiums for the plans, through the 37 federally facilitated marketplaces run by HealthCare.gov, including state partnership marketplaces and supported state-based marketplaces, and 2.7 million consumers enrolled through the remaining state-based marketplaces, the CMS said.
Nine of the 10 states with the highest rate of consumers receiving financial assistance had not expanded Medicaid programs under the ACA as of June 30— all except Arkansas, according to the fact sheet released by the CMS. Residents in the states that didn't expand with household incomes from 100 percent to 133 percent of the federal poverty level can qualify for coverage through the marketplace with advance premium tax credits (APTCs), it said. APTC eligibility ranges from 100 percent to 400 percent of the federal poverty level.
Of the 9.9 million consumers with enrolled in marketplace plans at the end of June, 68 percent were in silver plans that have average actuarial values of 70 percent, 21 percent were in bronze plans with average actuarial values of 60 percent, 7 percent were in gold plans with an average actuarial value of 80 percent, 3 percent were in platinum plans with an average actuarial value of 90 percent and 1 percent were enrolled in catastrophic plans that are primarily reserved for people under the age of 30 and people who can't afford other plans, the CMS said in the fact sheet.
From April 1 to June 30, enrollment through the federally facilitated marketplaces was terminated for about 306,000 consumers with citizenship or immigration status data matching issues who failed to produce sufficient documentation of their citizenship or immigration status, the CMS said. During the same time period about 734,000 households with annual household income inconsistencies had their APTC or cost-sharing reductions for 2015 coverage adjusted, it said.
Overall as of June 30 “the Marketplace has ended 2015 coverage for approximately 423,000 consumers with 2015 coverage who failed to produce sufficient documentation on their citizenship or immigration status and has adjusted APTC and/or CSRs for about 967,000 households,” the CMS said.
The CMS releases marketplace state-by-state effectuated enrollment snapshots on a quarterly basis detailing how many consumers are enrolled, how many are benefiting from the advance premium tax credits and cost-sharing reductions, and the distribution of enrollment by qualified health plan metal level, which is the actuarial value of the plans.
To contact the reporter on this story: Sara Hansard in Washington at firstname.lastname@example.org
To contact the editor responsible for this story: Janey Cohen at email@example.com
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to firstname.lastname@example.org.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to email@example.com.
Put me on standing order
Notify me when new releases are available (no standing order will be created)