Nearly 4.7 million people signed up for an insurance plan through HealthCare.gov in the first six weeks of the Affordable Care Act’s open enrollment this year.
At the same time last year, a little more than 4 million people had signed up for a plan. But because this year’s open enrollment period is half as long as in previous years, the ACA exchanges have a lot of catching up to do to reach last year’s enrollment total of 9.2 million HealthCare.gov plan selections.
Experts tracking enrollment say that’s unlikely to happen, despite navigators predicting a surge in signups in the final days of the period as last-minute shoppers scramble to meet the deadline.
As of Dec. 9, open enrollment is nearly 90% complete. At the same point in the previous two years on a percentage basis, 7.3 million people had signed up for 2018 marketplace coverage, according to consultant firm Avalere Health.
In the sixth week of open enrollment ended Dec. 9, 1.1 million people signed up for a plan. Of those, a little more than a third are new customers, while the rest are returning customers. The data includes only signups through the federal health exchanges. It does not included enrollment in the 12 state-based exchanges or data for people who will be auto-enrolled in plans after the Dec. 15 deadline.
Customers this year faced an array of challenges in signing up for marketplace plans. In addition to the truncated sign-up period, the Trump administration slashed funds for Obamacare advertising and navigators, who help people sign up for health insurance on the exchanges.
At the same time, customers were confronted with mixed messages about the availability of financial assistance and the enforcement of the individual mandate, which may have deterred many would-be customers from picking a plan this year.
Also on Wednesday, the CMS said that of the 12.2 million people who selected a plan during open enrollment for 2017 marketplace coverage, an average of 10.1 million people had actually paid their premiums as of Sept. 15 of this year. The data includes enrollment in both the federal exchange and state-based exchanges.
Earlier this year, the CMS announced that 10.3 million paid their premiums and had an active policy as of mid-March.
The people who paid their premiums were more likely to receive federal premium tax credits to help offset the cost of coverage, the CMS said. Those tax credits are available for people with incomes up to 400% of the federal poverty level.
Of the 10.1 million people who paid their premiums as of mid-September, 8.6 million, or 84%, received a tax credit, and 5.8 million people, or 57%, received a cost-sharing reduction subsidy. CSRs lower out-of-pocket insurance costs, like copayments and deductibles, for people with incomes below 250% of the poverty level.
The average premium tax credit was worth $373 per month, but tax credits varied wildly by state, the CMS said. In Alaska, the average premium tax credit was $965 per month, while it was $177 in Massachusetts.
The size of the average premium tax credit for all states grew 29% compared with 2016.