2016 ACA Open Enrollment Comes to an End: CBO Estimates Rising Health Costs

2016 ACA Open Enrollment Comes to an End: CBO Estimates Rising Health Costs

On January 31st, the third open enrollment period ended for the Patient Protection and Affordable Care Act (ACA, P.L. 111-148).  Most Americans are now out of luck to purchase an Exchange plan (aka “Marketplace” plan) until the 2017 enrollment season. 

With just a few days remaining in the open enrollment period, CMS.gov reported that “(s)ince Open Enrollment for the Health Insurance Marketplace began on November 1, about 11.6 million people have signed up for or renewed a health plan (2.7 million through State-based Marketplaces through December 26 and over 8.9 million through HealthCare.gov or CuidadodeSalud.gov through January 23)…” With the official open enrollment closed in most jurisdictions, final numbers should be available later this month. 

2016 Open Enrollment

In November, we published a blog discussing some of the opportunities and challenges associated with this open enrollment season.  Clearly, the 2016 enrollment numbers will be lower than the 20 million additional covered lives projected by the CBO when the law was first enacted.

Interestingly, the Obama administration has been mum on whether there was any late surge in enrollment.  As reported by the Washington Post:

It was unclear whether the close of the three-month enrollment window drew any stampede of last-minute shoppers on HealthCare.gov, as was the case during the first two sign-up years. In each of those, federal health officials trumpeted a late surge of people choosing health plans as evidence of Americans' eagerness for coverage… (By) Sunday, the officials provided no figures about the final weekend's volume of traffic on the federal insurance website.

It should be noted that Medicaid and CHIP beneficiaries can continue to sign up through the federal Exchange system after the close of the open enrollment period.  In addition, individuals can sign up for coverage through a federal Exchange if they have a qualifying circumstance such as getting married, having a baby, or losing employment-based health insurance.  Of course, Americans also can purchase insurance coverage at any time through a non-Exchange plan. 

State Enrollment Totals

Enrollments in some state-based Exchange jurisdictions, like California, as well as some federal-based Exchanges like Florida appeared to be meeting expectations in terms of new enrollees.   

Covered California, a state-based Exchange, extended its open enrolment program after thousands of last minute applications were filed.  Anyone who has started the application by the deadline has one additional week to complete the application, which is now set for the end of the day on February 6, 2016.  Of course, critics wonder if this was just a ploy to get more lives to sign up.

State enrollments in Florida, a federal-based Exchange, could be positive as well:  “Jodi Ray of the University of South Florida's Covering Kids and Family program said appointments for help in signing up and walk-in requests were brisk over the weekend,” as reported in the Washington Post. 

Time will tell if this year’s projected estimates of additional covered lives are met.  Enrollment totals mid-way through the enrollment season are available through the Kaiser Family Foundation websiteThirty-four states use the federally affiliated Exchange, 13 use state-based Exchanges and four use a hybrid approach (i.e. state-based but using the HealthCare.gov platform).  Eventually, these statistics will be updated through the end of January 31, 2016.  We will provide an update once the final numbers are in.

CBO Estimates Increased Health Costs

Last week, the non-partisan Congressional Budget Office (CBO) estimated significant price increases in health insurance in large part due to the ACA.  CBO noted:

Spending on federal health care programs is growing rapidly, driven by both rising enrollment—stemming from the aging of the population and expansions of federal programs—and rising health care spending per enrollee. CBO prepares projections of federal health care spending under current law and analyzes proposals that would change federal health care policies.

According to media reports, taxpayers will have to shell out an estimated $18 billion more to subsidize the ACA this year, despite lower than expected enrollment in the health care Exchanges.  Key findings in the CBO Report include:

  • Subsidies for health insurance purchased through the Exchanges that were established under the ACA, as well as related spending, increased by $23 billion in 2015 to a total of $38 billion;
  • Subsidies that help people who meet income and other eligibility criteria to purchase health insurance through Exchanges to meet their cost-sharing requirements, along with related spending, are expected to increase by $18 billion in 2016, reaching a total of $56 billion; and
  • Tax subsidies to insurers participating in the Exchanges will likely cost taxpayers $4,308 per each of the 11 million subsidized enrollees. In 2010, the agency estimated that it would cost $2,810 to cover each of 21 million enrollees expected to sign up by 2016.

Final Analysis

The 2016 open-enrollment period is the first time the federal government has not extended the deadline for individuals to sign up.  In 2014, technology problems and other administrative issues compromised the debut of HealthCare.gov.  Even last year, the enrollment period was extended to optimize the enrollment figures. 

However, many experts don’t expect major changes in the enrollment figures from last year.  A recent article in the Huffington Post sums it up:

Year three of Obamacare enrollment promises to bring only incremental changes from year two, and little in the way of firm answers to lingering questions. The uninsured rate is about the same, the sign-up numbers are about the same, the polling numbers are about the same, and the worries about this new market are about the same.

The article does highlight that the ACA has “transformed the way low- and moderate-income people get covered.”


Stay Tuned

Stay tuned as we continued to report on emerging issues related to ACA enrollment and cost trends and other matters impacting Brokers.  

The views expressed in this post do not necessarily reflect the official policy, position, or opinions of BenefitMall. This update is provided for informational purposes. Please consult with a licensed accountant or attorney regarding any legal and tax matters discussed herein.


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