Health Insurance Marketplace: Summary Enrollment Report For the Initial Annual Open Enrollment Period. Overview of Enrollment-Related Activity to Date

05/01/2014

Selected a Marketplace Plan – Over 8 million persons selected a Marketplace plan during the initial open enrollment period (including additional SEP activity through 4-19-14), including nearly 2.6 million in SBMs and 5.4 million in the FFM (these numbers include those who have paid a premium and those who have not yet paid a premium, regardless of when their coverage begins).

The following are additional highlights of the data on the characteristics of Marketplace plan selections during the initial open enrollment period, including SEP activity through 4-19-14 (see Appendix A for national-level tables, and see the Addendum to the Marketplace Summary Enrollment Report for state-level tables).22

  • Marketplace Plan Selections by Gender – The gender distribution of Marketplace plan selections has remained constant. More than half of the people who have selected a Marketplace plan through the SBMs and FFM between 10-1-13 and 3-31-14 (including additional SEP activity through 4-19-14) are female (54 percent of the total for the Marketplace as a whole, excluding plan selections where gender is unknown), while the remaining 46 percent are male. The comparable proportions for the first five months of the initial open enrollment period were 55 percent and 45 percent, respectively.
    • SBMs: 53 percent female, 47 percent male (10-1-13 to 3-31-14, including SEP activity through 4-19-14).
    • FFM: 55 percent female, 45 percent male (10-1-13 to 3-31-14, including SEP activity through 4-19-14).

By comparison, males account for half (50 percent) of the total non-elderly population in the United States (ages 0 to 64).23

  • Marketplace Plan Selections by Metal Level – The proportion of Silver Marketplace plan selections has continued to increase. Silver plans account for nearly two-thirds (65 percent) of the Marketplace plan selections in the SBMs and FFM between 10-1-13 and 3-31-14, including additional SEP activity through 4-19-14 (compared with 63 percent during the first five months of the initial enrollment period).
    • SBMs: 58 percent Silver (10-1-13 to 3-31-14, including SEP activity through 4-19-14).
    • FFM: 69 percent Silver (10-1-13 to 3-31-14, including SEP activity through 4-19-14).

The metal level distribution of the remaining Marketplace plan selections (SBMs and FFM combined) are as follows: bronze (20 percent), gold (9 percent), platinum (5 percent), and catastrophic (2 percent).

  • Marketplace Plan Selections by Financial Assistance Status – The proportion of Marketplace plan selections with financial assistance (i.e., Marketplace plan selections by individuals who are eligible to receive financial assistance) has also continued to increase. More than eight out of ten (85 percent) of the people who selected a Marketplace plan through the SBMs and FFM between 10-1-13 and 3-31-14 (including additional SEP activity through 4-19-14) are eligible to receive Federal financial assistance in paying their premiums.24 The comparable proportion for the first five months of the initial open enrollment period was 83 percent.
    • SBMs: 82 percent in Marketplace plans with financial assistance (10-1-13 to 3-31-14, including SEP activity through 4-19-14).
    • FFM: 86 percent in Marketplace plans with financial assistance (10-1-13 to 3-31-14, including SEP activity through 4-19-14).

Tax credits for premium assistance may be available to individuals with family incomes between 100 and 400 percent of the Federal Poverty Level (138 to 400 percent of FPL in states taking the Federally-funded option to expand Medicaid). These percentages are consistent with previous estimates.25 It is also important to note that people who are not eligible for advance premium tax credits may have chosen to enroll in an Affordable Care Act-compliant, off-Marketplace plan instead; including them in the denominator would lower the percentages of people in Affordable Care Act-compliant plans in the individual market who are receiving premium assistance.

Additional Characteristics of FFM Marketplace Plan Selections – The following are highlights of data on additional characteristics of FFM Marketplace plan selections between 10-1-13 and 3-31-14 (including additional SEP activity through 4-19-14), based on cross-tabulations of the above mentioned metrics (see Appendix B for national-level tables, and see the Addendum to the Marketplace Summary Enrollment Report for state-level tables).

  • FFM Marketplace Plan Selections by Gender and Age
    • Young adults (ages 18-34) accounted for 29 percent of all males selecting Marketplace plans through the FFM, compared with 28 percent of all females selecting Marketplace plans through the FFM, and 28 percent of all FFM Marketplace plan selections as a whole.
    • Meanwhile, adding children ages 0 to 17 results in males between the ages of 0 and 34 accounting for over a third (36 percent) of all males selecting Marketplace plans through the FFM, compared with 33 percent for females, and 35 percent for all persons who selected a Marketplace plan through the FFM.
  • FFM Marketplace Plan Selections by Gender and Metal Level
    • Females were more likely to select Silver plans in the FFM (71 percent versus 67 percent for males).
    • Males were more likely to select Bronze plans in the FFM (19 percent versus 16 percent for females).
  • FFM Marketplace Plan Selections by Financial Assistance Status and Metal Level
    • Persons selecting a Marketplace plan who are eligible to receive financial assistance were more likely to select Silver plans in the FFM (76 percent versus 25 percent for persons selecting a Silver Marketplace plan without financial assistance).
    • Persons selecting a Marketplace plan without financial assistance were more likely to select Bronze plans in the FFM than other metal levels (33 percent versus 15 percent for persons selecting a Marketplace plan with financial assistance). They were also more likely to select gold, platinum and catastrophic plans than were persons who are eligible to receive financial assistance.
    • More than nine out of ten (95 percent) of the persons selecting a Silver plan in the FFM are eligible to receive Federal financial assistance in paying their premiums.
  • FFM Marketplace Plan Selections by Metal Level and Age
    • Among young adults (ages 18 to 34), 68 percent selected a Silver plan, while 17 percent selected a Bronze plan, 7 percent selected a Gold plan, 4 percent selected a Platinum plan, and 5 percent selected a Catastrophic plan.
    • One out of three (34 percent) of the 1.1 million persons who selected a standalone dental plan through the FFM are young adults (ages 18-34).26

Web Site and Call Center Volume – There were 98 million visits to the SBM and FFM websites,27 and 33 million calls to the SBM and FFM call centers between 10-1-13 and 3-31-14 (including additional SEP activity through 4-19-14).

Table 5

Cumulative Marketplace Enrollment-Related Information For the Initial Open Enrollment Period: 10-1-13 to 3-31-14 (Including SEP Activity through 4-19-14) (1) (based on data reported as of 4-29-14) Marketplace Total SBM Total FFM Total
Visits on the Marketplace websites (2) 98,333,355 31,109,693 67,223,662
Calls to the Marketplace call centers 33,303,050 9,592,887 23,710,163
Number of individuals who have selected a Marketplace plan 8,019,763 2,573,585 5,446,178

Males who have selected a Marketplace plan (3)

46%

47%

45%

18 to 34 year olds who have selected a Marketplace plan (3)

28%

28%

28%

Individuals who have selected a Silver Marketplace plan (3)

65%

58%

69%

Individuals who have selected a Marketplace plan with financial assistance (3)

85% 82% 86%

(1) 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. See Appendix F for methodological information. Visitors to the Marketplace websites is the sum of monthly data and has been unduplicated to the extent possible; however, we do not believe that all duplication has yet been removed.

(2) While all SBMs have provided updated data on call center activity, not all SBMs have provided updated data on website visits.

(3) Percentages shown in this table are based on the total number of plan selections for which the applicable data are available, excluding plan selections with unknown data for a given metric (e.g., age, gender, etc.)

Source: Centers for Medicare & Medicaid Services, as of 4-29-2014.


22 The percentages cited in this section are based on the total number of plan selections for which the applicable data are available, excluding plan selections with unknown data for a given metric (e.g., age, gender, metal level, etc.) Aggregate data on the total number of plan selections with available data for a given metric, and the corresponding number of plan selections with unknown data for a given metric can be found in Appendix Table A1.

23 ASPE analysis of the 2010-2012 Current Population Survey Annual Social and Economic Supplement (CPS ASEC, covering calendar years 2009-2011), adjusted using ASPE’s TRIM3 microsimulation to include only estimated nonelderly U.S. citizens and others lawfully present.

24 This includes people who qualify for an advance premium tax credit (APTC), with or without a cost-sharing reduction (CSR).

25 For example, the Congressional Budget Office (CBO) estimates for CY 2014 were as follows: 6 million subsidized / 7 million total in Marketplace = 86% with financial assistance. (Source: "Effects on Health Insurance and the Federal Budget for the Insurance Coverage Provisions in the Affordable Care Act—May 2013 Baseline," May 14, 2013, accessed at http://www.cbo.gov/system/files/cbofiles/attachments/43900-2014-0....)

26 It is important to note that the totals for standalone dental plans do not include individuals who are enrolled in Marketplace plans that provide integrated medical and dental coverage.

27 While all SBMs have provided updated data on call center activity, not all SBMs have provided updated data on website visits. In addition, duplication has been removed from the data on the cumulative number of website visitors to the extent possible; however, it is possible that not all duplication has been removed.

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