In the second of two recent updates on ACA exchange enrollment, the government’s Centers for Medicare & Medicaid Services (CMS) on August 13 said that 944,000 people enrolled in federal or state health insurance exchanges during a special enrollment period that ended June 30.  

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ACA Enrollment Update: What It Means for Legislation

Thu Aug 20, 2015

In the second of two recent updates on ACA exchange enrollment, the government’s Centers for Medicare & Medicaid Services (CMS) on August 13 said that 944,000 people enrolled in federal or state health insurance exchanges during a special enrollment period that ended June 30.

Special enrollments are permitted outside the regular Open Enrollment Period when certain events occur such as loss of employer coverage.

And in the June enrollment update CMS announced that 10.2 million people had selected plans through federal or state insurance exchanges and had paid for coverage as of March 31.

Of the 10.2 million, 7.5 million were enrolled through the 37 states that rely on the federal exchange (HealthCare.gov) and 2.7 million were enrolled through the remaining State-based exchanges.

The latest updates also confirm that government financial subsidies are vital to the success of the Affordable Care Act. Of the 10.2 million ACA enrollees nationwide, 85% or nearly 8.7 million, were receiving an Advanced Premium Tax Credit (APTC) subsidy “to make their insurance premium more affordable.” The average monthly subsidy was $272.

The health reform law entitles those with household income between 100% and 400% of the federal poverty level—between $23,850 and $95,400 in 2015 for a family of four—to financial aid, with the amount telescoping as income rises.

In addition to the insurance premium subsidy 57% or about 5.9 million exchange enrollees were also receiving “cost-sharing reductions” (CSR) to lower their out-of-pocket payments like deductibles and copays. This financial aid is available if a person’s household income is between 100% and 250% of the federal poverty level.

Premium tax credit subsidies and cost-sharing reductions vary from state to state. In Mississippi, Florida, North Carolina, Wisconsin, Louisiana and Georgia, for example, over 90% of those enrolled in ACA exchanges were eligible for government subsidies.

What do these numbers mean for the future of the Affordable Care Act? How might next year’s presidential election affect the law given that it makes health insurance more affordable for over 10 million people?

Opinion polls have been consistent since the ACA was enacted:  a majority of Americans have an unfavorable opinion of the law and few favor keeping the law as is. And there’s the dilemma: how to balance the public’s concerns with the law’s benefits?

Part 2 of this blog will examine implications of the impressive enrollment numbers for future legislation to amend the Affordable Care Act.