Enrollment In Health Insurance Marketplaces Increases To 4.2 Million; Number Of Uninsured Dropping

Enrollment in the Patient Protection and Affordable Care Act (ACA)-created health insurance marketplaces has increased to 4.2 million as of February 2014, according to a recent report from the Department of Health and Human Services (HHS). Independent studies from Gallup-Healthways and McKinsey and Company also recently confirmed that the U.S. uninsured rate has dropped.

The HHS noted that as in January, the percent of young adults who selected a marketplace plan was 3 percentage points higher than it was from October through December (27 percent versus 24 percent). Based on enrollment patterns in other health care programs, it is expected that more people will sign up the March 31 deadline approaches.

“Over 4.2 million Americans have signed up for affordable plans through the Marketplace,” said HHS Secretary Kathleen Sebelius. “Now, during this final month of open enrollment our message to the American people is this: you still have time to get covered, but you’ll want to sign up today—the deadline is March 31st.”

Of the more than 4.2 million, the HHS found:

      • 55 percent are female and 45 percent are male;


      • 31 percent are age 34 and under;


      • 25 percent are between the ages of 18 and 34;


      • 63 percent selected a silver plan (up one percentage point over the prior reporting period), while 18 percent selected a bronze plan (down one point); and


    • 83 percent selected a plan and are eligible to receive financial assistance (up one point).

For more information, visit http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Mar2014/ib_2014mar_enrollment.pdf.

Numbers Of Uninsured Dropped

The U.S. uninsured rate continued to drop in the early part of 2014, continuing the reduction that began in the late part of 2013. In particular, the Gallup-Healthways Well-Being Index conducted a survey that found that so far in 2014 the uninsured rate is 15.9 percent, compared to a recorded rate of 17.1 percent in the fourth quarter of 2013. The poll was based on interviews with 28,000 Americans for the time period between Jan. 2, 2014, and Feb. 28, 2014. The uninsured rate has dropped the most substantially for black Americans and low-income individuals. The percentage of individuals who receive insurance benefits through employer-sponsored plans also has fallen in 2014. The changes in numbers of uninsured are at least partially due to the implementation of the ACA, noted Gallup-Healthways.

Uninsured group trends. While uninsured rates for almost every demographic has dropped in 2014, individuals with incomes under $36,000 have experienced the biggest reduction in uninsured rates at 2.8 percent, which was a reduction from 30.7 percent in the last quarter of 2013 to 27.9 percent by the end of February 2014. Similarly, the percentage of uninsured black Americans fell 2.6 percentage points from 20.9 to 18.3 in that same time period. Uninsured Hispanics continue to be the demographic with the highest percentage of uninsured individuals with 37.9 percent uninsured in the beginning of 2014, a 0.8 percentage drop since the end of 2013. Uninsured rates among certain age groups also showed notable decline with the 26- to 34- year old range dropping to 26.6 percent uninsured, down 1.6 percentage points, and the 35- to 64- year old range reduced from 18 to 16.3 percent. Uninsured rates have not declined for the 65-year old and older group, however, the poll explained this was most likely due to the fact most of these individuals were already covered by Medicare.

Sources of coverage. The survey also revealed a decline in insurance for individuals through employer-sponsored plans. Specifically, the data showed that the number of individuals who receive insurance coverage through a current or former employer fell to 43.4 percent, down 2.1 percentage points from 45.5 percent in the last quarter of 2013. Conversely, more individuals are paying for their own plans or are being covered through a family member’s plan that is paid for entirely through the individual or that family member, as that percentage grew from 17.2 percent to 18.1 percent in early 2014. The study also recorded increases in the number of individuals receiving coverage through Medicaid. This growth is most likely due to the expansion of Medicaid under the ACA.

For more information, visit http://www.healthways.com/solution/default.aspx?id=1125.

Uninsured Enrolling In Marketplace Plans

Enrollment in health insurance marketplaces continues to increase among the previously uninsured, according to a recent study by McKinsey & Company. Uninsured individuals represent the biggest percentage of enrollment growth over the past month into marketplaces, while a large portion of those who remain uninsured cite concerns over costs. McKinsey found that, as time ticks toward the enrollment deadline, the proportion of survey respondents who have not yet enrolled is decreasing.

Increased enrollment. Enrollment in health insurance marketplaces continued to increase since November 2013. Previously uninsured respondents accounted for 27 percent of respondents in February. These individuals consisted of insured individuals who switched plans and individuals who were uninsured. The 27 percent in February is up from 11 percent noted in earlier surveys.

The February survey interviewed 2,096 individuals eligible to enroll in qualified health plans (QHPs). Forty-eight percent of these individuals said that they enrolled in a 2014 individual product, which was up from 37 percent in January, 31 percent in December, and 19 percent in November. McKinsey noted that in total, 10 percent of all previously uninsured February respondents said that they had enrolled in a product, up from 3 percent in January.

Premiums. Perceived affordability challenges were the main reason for not enrolling, according to 50 percent of February survey respondents, both among previously insured and previously uninsured. McKinsey found that the majority (80 percent) of individuals expressing concern were eligible for subsidies. And of the number concerned about affordability, two thirds (66 percent) of those individuals were not aware of their subsidy eligibility status or subsidy amount.

Most individuals who enrolled in a health insurance marketplace plan have paid their premiums. Just under a quarter of enrolled individuals have not yet paid. The payment rate was higher among the previously insured (86 percent) than among the previously uninsured (53 percent). Some of this data may be slightly skewed, McKinsey noted, as consumers have 30 days from their effective date until their premium for coverage is due, and some respondents may not have reached their payment due date.

McKinsey’s most recent survey was conducted in February 2014 and included a national survey of consumers eligible to purchase individual health insurance coverage during the open enrollment period (on and off the marketplaces). This survey was the most recent in a series of four surveys completed by McKinsey since November 2013. For more information, visit http://www.mckinsey.com.

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