Avalere Health
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Insights

Sep 19, 2014

Exchange Enrollment Down to 7.3M

Published

Sep 19, 2014

On Sept. 18, the Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner told Congress that there are currently 7.3 million people enrolled in health insurance plans on the exchanges.

This figure is the first official enrollment update since the May 1 Assistant Secretary for Planning and Evaluation (ASPE) report, which announced that 8 million individuals had selected an exchange plan through mid-April. Since then, sustained enrollment has dropped by about 700,000 individuals, including some people who failed to pay their premiums.

In the spring, health insurance issuers participating in the exchanges estimated that roughly 15 percent of enrollees would not pay their premiums. As it stands, enrollment since ASPE’s May announcement has decreased by only 9 percent thus far. Tavenner announced that the total number of enrollees in the exchanges has remained consistent over the summer. Accordingly, CMS expects the enrollment figure to change only slightly in the coming months, as some people move into the exchanges via special enrollment periods (SEPs) and others time out of grace periods.  

Despite the drop in coverage, exchange enrollment of 7.3 million is likely sufficient to sustain plan interest in the market, particularly with enrollment expected to increase again when open enrollment begins in November. Plans and providers remain concerned about the medical costs associated with enrollees who fail to pay premiums, so they will be anxious for more information about how many enrollees failed to effectuate coverage versus those who paid their first month’s premium but subsequently dropped out of coverage.

With the second open enrollment period fast approaching, the Administration may use this relatively high retention rate as fuel for its exchange awareness campaign. Additionally, while enrollment may fluctuate slightly in the coming months, CMS and exchange issuers will likely use this and any future enrollment announcement to prepare for the mid-December auto redeterminations and renewals.  

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