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THE AFFORDABLE CARE ACT’S MARKETPLACES Results From The First Three Months
Sara R. Collins, Ph.D.Vice President, Health Care Coverage and Access The Commonwealth Fund
SABEW: The Business of Health CareNew York, NY
January 22, 2014
Exhibit 1. Trends in Cumulative Number of Individuals Who Have Selected a Marketplace Plan Through the
Federally-facilitated Marketplace (FFM), October 1 to December 28, 2013
Source: Health Insurance Marketplace: January Enrollment Report, For the Period: October 1, 2013 – December 28, 2013, ASPE Issue Brief, U.S. Department of Health and Human Services, January 13, 2014, http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf.
THE COMMONWEALTH
FUND
Exhibit 2. More than 2 Million People Have Selected or Enrolled in Marketplace Plans, as of Dec. 28, 2013
Eligible for marketplace plansHHS Report (12/28)
Selected a marketplace plan*HHS Report (12/28)
Eligible for Medicaid/CHIP
HHS Report (12/28)
State-run marketplaces
1,794,708 956,991 833,389
Federally facilitated marketplaces
3,345,090 1,196,430 751,120
Total in all marketplaces
5,139,798 2,153,421 1,584,509
CBO 2014 enrollment projection
7,000,000 7,000,000 9,000,000
Percent of CBO 2014 enrollment projection
73.4% 30.8% 17.6%
*People who have selected a marketplace plan may or may not have paid their premiums, and thus finalized their enrollment. Source: Health Insurance Marketplace: January Enrollment Report, For the Period: October 1, 2013 – December 28, 2013, ASPE Issue Brief, U.S. Department of Health and Human Services, January 13, 2014, http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf; and state websites.
TX
FL
NMGA
AZ
CA
WY
NV
AK
OK
MSLA
MTWA
OR ID SD
ND
MNWI
MI
AR
OH
AL
PA
NY
ME
MA
NHVT
HI
UTCO
KS
NEIA
MO
IL IN
KY
WVVA
NC
SC
DCMD
DE
NJ
CTRI
TN
Percent of three month enrollment target reached by 12/28/2013
<50%
50%-<75%
75%-<100%
100%+
Exhibit 3. Ten States Have Reached or Exceeded Their Three Month Marketplace Enrollment Target as of Dec. 28, 2013
Source: Memo from Marilyn Tavenner, CMS Administrator, Projected Monthly Enrollment Targets for Health Insurance Marketplaces in 2014, September 5, 2013, http://waysandmeans.house.gov/uploadedfiles/enrolltargets_09052013_.pdf; Health Insurance Marketplace: January Enrollment Report, For the Period: October 1, 2013 – December 28, 2013, ASPE Issue Brief, U.S. Department of Health and Human Services, January 13, 2014, http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf
Exhibit 4. Trends in Cumulative Number of Young Adults Who Have Selected a Marketplace Plan Through the
Federally-facilitated Marketplace (FFM), October 1 to December 28, 2013
Source: Health Insurance Marketplace: January Enrollment Report, For the Period: October 1, 2013 – December 28, 2013, ASPE Issue Brief, U.S. Department of Health and Human Services, January 13, 2014, http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf.
50–6428%
19–3441%
35–4931%
Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace
Exhibit 5. Distribution of Marketplace Visitors and Marketplace Enrollees by Age
Note: Segments may not sum to 100 percent because of rounding.Source: The Commonwealth Fund Affordable Care Act Tracking Survey, Dec. 2013 and Health Insurance Marketplace: January Enrollment Report, For the Period: October 1, 2013 – December 28, 2013, ASPE Issue Brief, U.S. Department of Health and Human Services, January 13, 2014, http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf.
18-3424%
35-4415%
45-5422%
55-6433%
<186%
Adults who selected a marketplace plan
50–6428%
19–3441%
35–4931%
Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace
Exhibit 6. More than Three-Fourths of Visitors Report Being in Excellent, Very Good, or Good Health
Don’t know or refused
1%
Health status
Note: Segments may not sum to 100 percent because of rounding.Source: The Commonwealth Fund Affordable Care Act Tracking Survey, Dec. 2013.
Excellent17%
Very good37%
Good23%
Fair17%
Poor6%
Exhibit 7. By Dec. 2013, More Adults Who Visited the Marketplaces Found It Easy to Compare Plan Benefits and Premiums
How easy or difficult was it to compare the … of different insurance plans?
Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace
Dec. 2013
Oct. 2013
Dec. 2013
Oct. 2013
Dec. 2013
Oct. 2013
26
20
18
25
19
25
27
31
23
27
32
33
22
14
30
21
24
19
16
19
21
16
20
11
Note: Bars may not sum to 100 percent because of “don’t know” responses or refusal to respond; segments may not sum to subtotals because of rounding.* Potential out-of-pocket costs from deductibles and copayments. Source: The Commonwealth Fund Affordable Care Act Tracking Surveys, Oct. 2013 and Dec. 2013.
3058
3752
3451
Percent
Benefits covered
Premium costs
Potential out-of-pocket costs*
Somewhat easy Very easySomewhat difficultVery difficult or impossible
4351
5142
3854
Exhibit 8. Adults Who Visited the Marketplaces Continued to Report Difficulties Finding a Plan with the Type of Coverage They Needed
Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace
Note: Bars may not sum to 100 percent because of “don’t know” responses or refusal to respond; segments may not sum to subtotals because of rounding.* Potential out-of-pocket costs from deductibles and copayments. Source: The Commonwealth Fund Affordable Care Act Tracking Surveys, Oct. 2013 and Dec. 2013.
How easy or difficult was it to find…?
Dec. 2013
Oct. 2013
Dec. 2013
Oct. 2013
19
21
27
19
39
40
33
38
20
14
19
16
17
16
17
21 38
30
56
61
Percent
A plan with the type of coverage you need
A plan you could afford
Somewhat easy Very easySomewhat difficultVery difficult or impossible
60 36
3758
Exhibit 9. Marketplace Plan Selection by Metal Level and Financial Assistance Status, October 1 to December 28, 2013
Percent of individuals who selected a plan
Source: Health Insurance Marketplace: January Enrollment Report, For the Period: October 1, 2013 – December 28, 2013, ASPE Issue Brief, U.S. Department of Health and Human Services, January 13, 2014, http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf.
Metal Level Financial Assistance0
20
40
60
80
100
1
20
79
60
2113
7 Yes No
PlatinumGoldSilverBronzeCatastrophic
Exhibit 10. A Majority of Adults Who Have Visited the Marketplaces Rate Their Experience as Fair or Poor
Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace
Excellent or good Fair or poor Don't know or refused0
25
50
75
100
27% 70% 3%29% 69% 2%
Oct. 2013 Dec. 2013
Overall, how would you describe your experience in trying to get health insurance through the marketplace in your state?
Source: The Commonwealth Fund Affordable Care Act Tracking Surveys, Oct. 2013 and Dec. 2013.
Percent
Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace
Once39%
More than once59%
Adults ages 19–64 who are uninsured or have individual coverage and went
to marketplace more than once
How many times did you visit the marketplace—did you visit once, or more than once?
Exhibit 11. A Majority of Adults Who Visited the Marketplaces Went More Than Once; Three of 10 Said Their Experience Improved Over the Course of Their Visits
Improved29% Stayed
about the same52%
Got worse18%
Source: The Commonwealth Fund Affordable Care Act Tracking Survey, Dec. 2013.
From your first visit to your last visit, did your experience in trying to get
health insurance through the marketplace in your state…?
Don’t know or refused
2%
Exhibit 12. A Majority of Adults Potentially Eligible for Coverage Who Have Not Yet Enrolled Say They Are Likely to Shop for Coverage by March 31, 2014
Adults ages 19–64 who are uninsured or have individual coverage* and who have not gone to marketplace, or went to marketplace but did not apply or did not enroll
The enrollment period for health insurance in the marketplaces ends on March 31, 2014. How likely are you to go to/go back to the marketplace by March 31, 2014, to enroll in a health
plan or find out if you are eligible for financial help to pay for your plan or for Medicaid?
Fair or poor
Excellent, very good, or good
50–64
35–49
19–34
Total
10
8
9
7
10
8
18
33
31
27
30
28
25
22
16
26
25
23
42
33
39
35
33
36
Percent
Somewhat likely Very likelySomewhat unlikelyVery unlikely
Notes: Bars may not sum to 100 percent because of “don’t know” responses or refusal to respond; segments may not sum to subtotals because of rounding.* Respondents with individual market coverage who said they had received an offer from their insurance carrier to renew their plan for 2014 and said they planned to keep their policies were excluded from this analysis. Source: The Commonwealth Fund Affordable Care Act Tracking Survey, Dec. 2013.
Age
Health Status
37
39
32
40
41
28 67
55
55
61
58
59
Acknowledgements
David BlumenthalPresident
Michelle DotyVice President
Survey Research and Evaluation
Tracy GarberSenior Policy Associate
Health Care Coverage and Access
Petra RasmussenSenior Research Associate
Health Care Coverage and Access