Health Insurance Marketplaces in 2014: Behind the Numbers

July 11, 2014

With the first open enrollment period for health insurance marketplaces now completed, an estimated 8 million people have enrolled in new private health insurance plans, with millions more newly enrolled in Medicaid. This briefing will look behind the enrollment numbers to take a detailed look at the demographics of marketplace enrollees, initial consumer experiences with health plans and lessons for next year’s open enrollment period.

What have we learned from the first open enrollment experience and what will it mean for 2015? How did the enrollment experience vary from state to state? How many previously uninsured Americans accessed coverage through the Marketplaces? What do people think of their new coverage? Has access to affordable coverage and care improved? Are ACA’s procedures and safeguards for preventing inaccuracies in the enrollment and premium subsidy process working effectively? A panel of experts addressed these and related questions.

Arnold Epstein, deputy assistant secretary, Office of Health Policy, ASPE, provided a federal perspective on enrollment in the new health insurance marketplaces.

Linda Sheppard, special counsel and director of Health Policy and Analysis for the Kansas Insurance Department, discussed factors affecting the enrollment experience in their federally facilitated marketplace.

Richard Onizuka, chief executive officer, Washington Health Benefit Exchange, offered lessons learned on Medicaid and private coverage enrollment through a state-based marketplace.

Timothy Jost, professor, Washington and Lee University School of Law, and consumer representative to the National Association of Insurance Commissioners (NAIC) talked about implementation from a broad consumer perspective across a variety of states.

Ed Howard of the Alliance and Sara Collins of Commonwealth co-moderated.

Contact: Deanna Okrent (202)789-2300

Follow the briefing on Twitter: #ACAmarketplace

The event was sponsored by the nonpartisan Alliance for Health Reform and The Commonwealth Fund.
If you were unable to attend the briefing, here are some key takeaways:

*85 percent of those that chose a plan on the marketplace got enrollment assistance, Arnold Epstein stated. Within metal type (bronze, silver, gold), 42 percent selected the lowest premium plan, which indicated that monthly premium cost was a large driver in plan selection. 92 percent of individuals who chose silver plans were eligible for tax credits and paid, on average, premiums of $69 per month.

*The rate of uninsurance among young adults declined by 60 percent after the marketplace opened for enrollment, and 59 percent of adults enrolling were previously uninsured, Sara Collins said. Young adults, Latinos and those with low to moderate incomes are making the greatest gains in coverage. Most importantly, she added, 62 percent of individuals who enrolled on the marketplace said they would not have access to care without it.

*In Kansas, 57,000 individuals enrolled on the marketplace and 28,000 were added to Medicaid or CHIP, Linda Sheppard stated. However, if Kansas expanded Medicaid another 315,000 people would be eligible for coverage.

*Washington State’s new Medicaid enrollment exceeded state target for 2018 by 29 percent, Richard Onizuka said. The number of uninsured patients at Harborview Medical Center, the safety net hospital in Seattle, dropped from 12 percent to 2 percent, he continued. There is expected to be an 8 percent premium hike for 2015, but one plan will see lower rates.

*Both Washington and Kansas are adding new plans to their marketplace in 2015. Kansas will go from offering 72 plans in 2014 to offering over 250 for 2015. Washington added four new carriers for 2015 and will offer 100 plans, compared to 38 in 2014.


Full Transcript (Adobe Acrobat PDF)

Speaker Presentations

Sara Collins Presentation (Adobe Acrobat PDF)
Arnold Epstein Presentation (Adobe Acrobat PDF)
Linda Sheppard Presentation (Adobe Acrobat PDF)
Richard Onizuka Presentation (Adobe Acrobat PDF)
Timothy Jost Presentation (Adobe Acrobat PDF)

Event Details

Agenda (Adobe Acrobat PDF)
Speaker Biographies (Adobe Acrobat PDF)

Event Resources