As expected, an enrollment surge occurred in March as the close of the open enrollment period approached for the Marketplace. This is consistent with the experience of private employers, the Federal Employees Health Benefits Program (FEHBP), and Medicare Part D.8
Table 2 shows that approximately 0.9 million (12 percent) of the more than 8 million total Marketplace plan selections during the initial open enrollment period (including SEP activity through 4-19-14) were selected after 3-31-14.9
|Cumulative Number of Marketplace Plan Selections by Plan Selection Date 10-1-2013 to 3-31-2014, Including SEP Activity Through 4-19-14 (based on data reported as of 4-29-14)||Total Number of Individuals Who Have Selected a Marketplace Plan During The Initial Open Enrollment Period
(Including SEP Activity Through 4-19-14)
|By Plan Selection Date|
|Number Who Selected a Marketplace Plan By
|Number Who Selected a Marketplace Plan Between
4-1-14 and 4-19-14
Notes: Represents cumulative data on the number of unique individuals who have been determined eligible to enroll in a Marketplace plan through the SBMs and FFM, and have selected a plan (with or without the first premium payment having been received by the issuer). Special Enrollment Period (SEP) activity includes plan selections that were made between 4-1-14 and 4-19-14 by those who qualified for an SEP because they were “in line” on 3-31-14, as well as those who experienced a qualifying life event or a complex situation related to applying for coverage in the Marketplace. Source: Centers for Medicare & Medicaid Services, as of 4-29-2014.
As discussed earlier, the total number of Marketplace plan selections at the end of the initial open enrollment period was over 8 million (including SEP activity through 4-19-14). We note that the Congressional Budget Office (CBO) Marketplace enrollment projection of 6 million for 2014 is estimated based on average enrollment for the calendar year (full-year equivalents from CMS enrollment data will not be available until sometime in 2015).10 It is important to note that the Marketplace plan selection data as of the end of the open enrollment period do not represent effectuated enrollment (e.g., those who have paid their premium), and does not include the additional persons who will experience a qualifying life event (also known as a change in life circumstances, such as having a baby, getting married, getting divorced, or losing other coverage) that enables them to qualify for an SEP and enroll in Marketplace coverage for 2014 through the end of the year.11
8 For additional information, please refer to the March Marketplace Enrollment Report, which can be accessed at http://www.aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Mar201... and Appendix C of the November Marketplace Enrollment Report, which can be accessed at http://www.aspe.hhs.gov/health/reports/2013/MarketPlaceEnrollment/rpt_en....
9 The Department estimates that most of these persons qualified for an SEP because they were “in-line” on 3-31-14. As discussed earlier, this number may also include persons who qualified for an SEP due to a change in life circumstances, or a complex situation related to applying for coverage in the Marketplace. The data are not disaggregated based on the reason that a given individual qualified for an SEP.
10 CBO recently revised its initial CY 2014 Marketplace enrollment projection (to 6 million in the February 2014 baseline from 7 million in earlier baselines). CBO estimates represent averages over the calendar year (i.e., a full-year equivalent or total life years), rather than an estimate for a point in time.), rather than an estimate for a point in time. CBO’s “Budget and Economic Outlook: Fiscal Years 2014 to 2024,” released Feb. 4, 2014, accessed at http://www.cbo.gov/system/files/cbofiles/attachments/45010-Outloo....
11 There are nine types of life events that would potentially allow an individual to qualify for an SEP through the Marketplace.: 1) a change in marital status (marriage, divorce); 2) a change in dependents (birth, adoption, or undertaking placement of a child); 3) permanently moving to a state whose health plan options differ from their current choices; 4) gaining new status as a citizen or lawfully present individual in the USA; 5) experiencing a change in income; 6) experiencing an enrollment error on behalf of the Marketplace; 7) losing minimum essential health coverage due to job loss, divorce, loss of Medicaid or CHIP eligibility, expiration of COBRA coverage, or decertification of a health plan; 8) being already enrolled in a Marketplace plan, but experiencing a change in income or household status, affecting tax credit or cost-sharing reduction eligibility; and 9) aging off of their parent’s healthcare plan at 26 years of age. Additionally, there are several types of other complicated cases that may qualify for an SEP, relating to: exceptional circumstances, misinformation or misrepresentation, an enrollment error, system errors related to immigration status, display errors on HealthCare.gov, Medicaid/Marketplace transfers, error messages, unresolved casework, victims of domestic abuse, and other system errors.