Utah Enrollment Update

March 2016

Key Terms

Private insurance plans sold on healthcare.gov with monthly premiums subsidized for some people

ACA or Obamacare Insurance

Open Enrollment

Open Enrollment

Special Enrollment

2016

JANUARY 1 FEBRUARY 1 NOVEMBER 1

The new health insurance calendar

Next Open Enrollment: Nov. 1, 2016 -- Jan. 31, 2017

OCTOBER 31

Open Enrollment

Open Enrollment

Special Enrollment

2017

JANUARY 1 FEBRUARY 1 NOVEMBER 1 OCTOBER 31

Utah’s ACA sign-ups exceeded 175,000 in 2016

Sources: State-Level Data From from the ASPE January Health Insurance Marketplace Enrollment Report For The 2016 Open Enrollment Period; ; March 31, 2015 Effectuated Enrollment Snapshot; 15-06-02; http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-06-02.html HHS/CMS Health Insurance Marketplace; ASPE Issue Briefs: October 1, 2013 –April 19, 2014; November 15, 2014 – January 16, 2015; HHS News Release, “In Utah, 124,142 people are signed up for coverage through the Health Insurance Marketplaces,” 2/11/15 HHS News Release, “In Utah, 140,221 people are signed up for coverage through the Health Insurance Marketplaces,” 2/18/15 ASPE Issue Brief (3/10/15); http://aspe.hhs.gov/health/reports/2015/MarketPlaceEnrollment/Mar2015/ib_2015mar_enrollment.pdf Marketplace Plan Selection by Age in States Using the HealthCare.gov Platform, By State (1); 11-15-14 to 2-15-15 (including SEP activity through 2-22-15); Health Insurance Marketplace Open Enrollment Snapshot - Week 11; January 10, 2016 - January 16, 2016; Released: 1/20/16; Health Insurance Marketplace Open Enrollment Snapshot - Week 13 January 24, 2016-February 1, 2016; https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-02-04.html

175,637

-

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

200,000

Nationally, 20 million Americans have gained health insurance due to the ACA and Medicaid Expansion

Source: The Office of the Assistant Secretary for Planning and Evaluation’s (ASPE) analysis of the Gallup-Healthways Well-Being Index survey data through February 22, 2016.

16.7%

15.7%

16.3%

15.9%

16.7%

16.6%

15.7%

14.0%

12.5%

9.1%

10.2%

11.6%

11.9%

10.6% 10.7%

11.2%

10.6%

13.4%

13.2%

11.6%

10.3%

15.6%

13.3% 13.2%

8%

9%

10%

11%

12%

13%

14%

15%

16%

17%

18%

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015Q2

UT:Census/SAHIE

UT:DOH(BRFSS)

UT: Gallup-Healthways

Utah’s uninsured rate is decreasing… …but the most recent data indicates a slowdown

Census SAHIE: https://www.census.gov/library/publications/2015/demo/P60-253.html DOH (BRFSS): http://ibis.health.utah.gov/pdf/opha/publication/ins/InsHighlights_2014.pdf Gallup Healthways: http://www.gallup.com/poll/184514/uninsured-rates-continue-drop-states.aspx?utm_source=Well-Being&utm_medium=newsfeed&utm_campaign=tiles

Sources: [2014] https://https://insurance.utah.gov/health/Health%20Refrom/ACA_Rate_Individual_20131007_OnExchange.pdf [2015] Utah – On Exchange Rates (accurate as of 10/15/14) https://insurance.utah.gov/health/Health%20Refrom/2015IndividualOnExchange20141016.pdf [2016] www.hea;thcare.gov; See Plans and Premiums (October 2015)

Altius Health Plans Arches BridgeSpan Humana Molina Healthcare Select Health

6 plans

26 plans

34 plans

24 plans

1 plan

Humana (6) Molina Healthcare (3) Select Health (60) University of Utah (5)

2015: 101 Plans 2016: 74 Plans

Altius Health Plans Arches BridgeSpan Humana Molina Healthcare Select Health

2014: 91 Plans

Gold

Silver

Bronze

Catastrophic

Platinum

5 plans

19 plans

27 plans

21 plans

2 plans

5 plans

29 plans

40 plans

27 plans

0 plans

2014-16 Individual Marketplace Comparison Salt Lake County

0% 101% 400% 100%

Who is eligible for premium subsidies?

Income as % of the Federal Poverty Level (FPL)

NO YES 53,000 Utahns

in the Gap

Sliding-scale subsidies make insurance more affordable

Source: http://www.coloradohealthinsurancebrokers.com/wp-content/uploads/2013/08/2015-2016-FPL-Chart-1024x314.jpg

For 2016, a family of four can earn $97,000 a year and receive a premium subsidy

If your income/family size is on this chart, you qualify for a subsidy

The Hernandez Family Income: $26,000 Residence: Salt Lake City, Utah Ages: Dad : 33 Mom: 29 Kids: 11, 7

Annual income: $26,000

% of poverty level: 109%

Monthly premium: $458

Subsidy pays: $410 per month

The Hernandez’s pay: $48 per month

Benchmark Silver Plan

Primary doctor: $5 Specialist doctor: $15 Emergency room care: $150 Generic drugs: $6

Plan Details

2016 rate change: + $4/month

Deductible: $1000 Out-of-pocket maximum: $1,500 Source: https://www.healthcare.gov/see-plans/; Image source: Moodboard

Annual income: $44,000

% of poverty level: 222%

Monthly premium: $537

Subsidy pays: $274 per month

The Shumways pay: $262 per month

Benchmark Silver Plan

Primary doctor: $35 Specialist doctor: $60 Emergency room care: $500 Generic drugs: $10

Plan Details

Deductible: $2,300 Out-of-pocket maximum: $10,900

2016 rate change: +$1/month

The Shumways Income: $44,000 Residence: American Fork, UT Ages: Dad : 24 Mom: 23 Kid: Newborn

Source: https://www.healthcare.gov/see-plans/

Mr. and Mrs. Smith Income: $42,000 Residence: Santa Clara, Utah Ages: 60, 62

Annual income: $42,000

% of poverty level: 267%

Monthly premium: $1,188

Subsidy pays: $865 per month

The Smiths pay: $323 per month

Benchmark Silver Plan

Primary doctor: $35 Specialist doctor: $60 Emergency room care: $600 Generic drugs: $10

Plan Details

Deductible: $2,500 Out-of-pocket maximum: $13,700

2016 rate change: + $13/month

Source: https://www.healthcare.gov/see-plans/; Image source: Moodboard

The Simonsen Family Income: $135,000 Residence: Alpine, Utah Ages: Dad : 35 Mom: 44 Kids: 11, 7

Annual income: $135,000

% of poverty level: 555%

Monthly premium: $757

Subsidy pays: $0 per month

The Simonsen’s pay: $757 per month

Benchmark Silver Plan

Primary doctor: $35 Specialist doctor: $60 Emergency room care: $600 Generic drugs: $10

Plan Details

Deductible: $2,500 Out-of-pocket maximum: $13,700 Source: https://www.healthcare.gov/see-plans/; Image source: Moodboard

Annual income: $21,000

% of poverty level: 89%

Expected contribution: 100%

Monthly premium (for 2): $482

The Smith’s pay: $482

Subsidy pays $0

The Smith Family Income: $21,000 Residence: Orem, Utah Ages: Dad : 35 Mom: 33 Child: 7 Child: 11

No Subsidy

The Smith’s healthcare costs would be 27% of their total income

Who lives in the Coverage Gap?

Source: https://www.healthcare.gov/see-plans/; Image source: Fotozalc

In 2016, 13 of Utah’s top 20 ZIP codes for ACA enrollment were outside of Salt Lake

County

Source: 2016 Health Insurance Marketplace Plan Selections by ZIP Code; (Nov. 1, 2015 — Jan. 9, 2016); https://aspe.hhs.gov/basic-report/plan-selections-zip-code-health-insurance-marketplace-january-2016

RANK CITY SELECTIONS % INCREASE 1 Lehi (84043) 3,501 19% 2 South Jordan (84095) 3,346 12% 3 American Fork (84003) 2,948 17% 4 Pleasant Grove (84062) 2,931 20% 5 St. George (84790) 2,829 10% 6 St. George (84770) 2,742 11% 7 Draper (84020) 2,624 13% 8 Bountiful (84010) 2,455 5% 9 Spanish Fork (84660) 2,377 24%

10 West Valley City (84119) 2,368 3% 11 West Valley City (84120) 2,345 13% 12 Provo (84604) 2,289 22% 13 Herriman (84096) 2,276 20% 14 Clearfield (84015) 2,258 3% 15 Riverton (84065) 2,255 23% 16 Cottonwood Heights (84121) 2,254 6% 17 Orem (84058) 2,196 24% 18 Orem (84057) 2,193 16% 19 Ogden (84404) 2,189 1% 20 Layton (84041) 2,110 12%

County Open Enrollment #3

(1/9/16) % Change since Open Enrollment #2

(2/22/15) County Population

(2014)

Salt Lake

52,360 7.1%

1,091,742

Utah

32,987 17.3%

560,974

Davis

14,263 9.8%

329,692

Weber

9,753 5.2%

240,475

Washington

10,437 12.4%

151,948

Cache

5,672 8.0%

118,343

Tooele

2,086 4.4%

61,598

Box Elder

2,023 9.4%

51,518

Iron

2,380 12.2%

47,269

Summit

3,034 13.3%

39,105

Uintah

1,039 7.1%

36,867

Sanpete

1,272 7.4%

28,477

Wasatch

2,118 5.7%

27,714

Carbon

638 -2.6%

20,660

Grand

904 -12.1%

9,429

Utah and Washington counties continue to lead ACA sign-ups in Utah

Sources: [OE2] Plan Selections by ZIP Code in the Health Insurance Marketplace (November 15, 2014 thru February 22, 2015) http://aspe.hhs.gov/health/reports/2015/MarketPlace-Enrollment/EnrollmentByZip/rpt_EnrollmentByZip_Apr2015.cfm [OE3] Plan Selections by ZIP Code in the Health Insurance Marketplace: (November 1, 2015 thru January 9, 2016) https://aspe.hhs.gov/basic-report/plan-selections-zip-code-health-insurance-marketplace-january-2016

Enrollment by Age

Utah children are enrolling in ACA insurance at 2.67x the national average

Utah

U.S.

24%

31% 16%

13%

16% Under 18

18-34

35-44

45-54

55-64

9%

26%

16% 21%

27% Under 18

18-34

35-44

45-54

55-64

Source: "State-Level Data From the ASPE January Health Insurance Marketplace Enrollment Report For The 2016 Open Enrollment Period; For the period: November 1, 2015 - December 26, 2015.“ https://aspe.hhs.gov/health-insurance-marketplaces-2016-open-enrollment-period-january-enrollment-report.

Premium subsidies make health insurance more affordable

Impact of subsidies on actual consumer costs

ACA enrollment by % poverty level

Source: Reduction in Average Monthly Premiums from Advance Premium Tax Credits in States Using the HealthCare.gov Platform (1) 11-15-14 to 2-15-15 (including SEP activity through 2-22-15)

Consumer

Cost

$248

Source: "State-Level Data From the ASPE January Health Insurance Marketplace Enrollment Report For The 2016 Open Enrollment Period; For the period: November 1, 2015 - December 26, 2015.”

1%

33%

25%

21%

18% Under 100%

100% to 150%

150% to 200%

200% to 250%

250% to 400%

Half of existing ACA consumers switched health plans in 2016

Origin of all consumers

Plan selection by re-enrolled consumers

Source: "State-Level Data From the ASPE January Health Insurance Marketplace Enrollment Report For The 2016 Open Enrollment Period; For the period: November 1, 2015 - December 26, 2015.”

Source: "State-Level Data From the ASPE January Health Insurance Marketplace Enrollment Report For The 2016 Open Enrollment Period; For the period: November 1, 2015 - December 26, 2015.”

70%

30%

51%

49%

Newly enrolled

Re-enrolled

Switched plan

Same plan

RyLee Curtis

Utah Health Policy Project 801.433.2299 x8 rylee@healthpolicyproject.org

Jason Stevenson

Utah Health Policy Project 801.433.2299 x7 stevenson@healthpolicyproject.org

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