Home Health HEALTH INSURANCE EXCHANGE FOR 2018 OPEN PERIOD OF THE CREDIT PERIOD.

HEALTH INSURANCE EXCHANGE FOR 2018 OPEN PERIOD OF THE CREDIT PERIOD.

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HEALTH INSURANCE EXCHANGE 2018 OPEN PERIOD
FINAL REPORT

This report summarizes the registration activities on individual exchanges[1] during the open registration period for 2018 Planning (2018 OEP) for all 50 states and the District of Columbia. About 11.8 million[2] consumers are selected or have been automatically re-registered[3] in exchange plans during the OEP for 2018. The Public Accompanying File (PUF) includes state-level details on consumer choice plans and demographics.[4] The methodology of this report and detailed metric definitions are included in the file for public use.

The final OEP report for 2018 includes data for 39 states that use the platform to participate in the HealthCare.gov competition, as well as for 12 public exchanges (SBEs) that use their own destination and registration platforms.[5] Demographics and plan information for consumers with a choice of plan submitted by all 50 states plus DC include: age, metal level, and whether the consumer has had a prepaid tax credit (APTC) or a cost reduction (CSR).

For the 39 states that use the HealthCare.gov platform, additional data are available, including gender, rurality, race, and ethnicity, family income as a percentage of federal poverty level (FPL), and average consumer premiums. with and without APTC. Data files with information on selecting a county-level plan and zip code are also available for HealthCare.gov states.Â

The main findings of this report include:

  • Approximately 11.8 million consumers were selected or automatically re-registered in the Exchange Plan in 50 states as well as DC.
  • Twenty-seven percent of consumers with the choice of plan were assigned to new consumers.
  • Sixty-three percent of consumers chose silver plans; 29 percent of consumers chose bronze plans, and 7 percent – gold.
  • Among consumers using HealthCare.gov, the average premium before applying for a tax credit was $ 621 during OEP 2018 and $ 476 during OEP 2017.

Consumers choosing plans on exchanges: 50 states plus DC

Approximately 11.8 million consumers are selected or automatically re-registered in the Exchange Plan during OEP 2018. This includes approximately 8.7 million consumers in 39 states using the HealthCare.gov platform, and approximately 3.0 million consumers in the SBE (see Figure 1).[6]

Figure 1: Choice of plans for the period of open registration 2014 – 2018[7]

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Table 1 summarizes the types of consumers who registered during OEP 2018 for all 50 states plus DC. Twenty-seven percent of consumers with the choice of plan were new to the exchanges, and 47 percent of consumers actively returned to choose the plan for 2018 on the exchanges.

Table 1: Summary of the OEP election plan for 2018 by type of enrollment

Room[8] % of the total
New consumers of 2018 3 223 034 27
Returning consumers are re-registering in 2018
    Active re-registration 5,467,967 47
    Automatic re-enrollment 2,865,774 24
    Unknown type of re-registration 193 407 2
The general choice of the plan for 2018 11,750 175 100

Table 2 summarizes the selected demographic characteristics and plan characteristics for consumers during OEP 2018; additional information is contained in the accompanying shared file. Nine percent of all Exchange consumers were under 18 years old. Nationally, 83 percent of consumers have had their premiums reduced by APTC.

Table 2: Demographic and planning characteristics of consumers with the choice of OEP plan for 2018

Age Room[9] % of the total[10]
From 0 to 17 1 003 825 9
18 to 34 3 073 716 26
35 to 54 4 231 303 36
55+ 3 359 538 29
Metal level
Catastrophic 98 389 1
Bronze 3 358 078 29
Silver 7 353 570 63
Gold 833 026 7
Platinum 110 893 1
Financial assistance [11]
With APTC 9,769,189 83
With the CSR 6 028 558 51

Consumers choose plans through the HealthCare.gov platform

More information is available to 8.7 million consumers in states that use HealthCare.gov. Table 3 shows selected demographics and plan characteristics among consumers who chose plans during the 2018 OEP. Fifty-four percent of HealthCare.gov consumers were women, and 18 percent of consumers lived in rural areas. Seventy percent of consumers reported that household income ranged from 100% to 250% FPL.[12]

Table 3: Demographic and planning characteristics of consumers with the choice of OEP plan for 2018 on HealthCare.gov

Gender Room % of the total[13]
Female 4,763,670 54
Male 3,979,972 46
Location
Rural 1,573,716 18
Non-village 7 169 926 82
Race
Asian 629 935 7
African American 598 440 7
White 4 309 822 49
Another race[14] 364 366 4
Unknown 2,841,079 32
Ethnicity
Hispanic / Latin American 1,033,699 12
Not Hispanic / Latin American 5,428,184 62
Unknown 2 281 759 26
Household income
100% – 250% FPL 6 142 502 70
251% – 400% FPL 1,614,363 18
Other family income[15] 986 777 11

Table 4 provides information on premiums for consumers in the states that used HealthCare.gov in 2018. The average premium before applying for a tax credit was $ 621 during OEP 2018 and $ 476 during OEP in 2017. Eighty-five percent of consumers who chose or were automatically re-registered in the 2018 plan through HealthCare.gov had APTC. Among consumers with APTC in 2018, the average tax credit covered about 86 percent of the total premium, bringing the average premium after APTC to $ 89 per month.

Table 4: Average premium and average net premium after APTC for consumers with choice of OEP plan for 2018 at HealthCare.gov

Room Average
Premium
Average
APTC
Average premium
after APTC
All consumers 8,746,642 $ 621 $ 468 $ 153
Consumers with APTC 7 447 615 $ 639 $ 550 $ 89
Consumers without APTC 1,295,027 $ 522 NA NA

In the 2018 OEP, nine percent of consumers were under the age of 18, compared to 10 percent in 2017 (see Figure 2). Twenty-six percent of consumers were between the ages of 18 and 34 in 2018, compared to 27 percent in 2017. Twenty-nine percent of OEP consumers in 2018 were 55 years of age and older, while 27 percent of 2017 OEP consumers were 55 years of age or older.

Figure 2: Proportion of OpenCroll HealthCare.gov consumers by age

Figure 2: HealthCare.gov’s open consumer share by age

The state-level PUF can be found at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Marketplace-Products/2018_Open_Enrollment.html

[1] This report includes Qualified Health Plan (QHP) selections made on a separate exchange; public and county-level files also include data on dental plan selection.

[2] In addition to the overall plan selection in this report, there were 829,197 people in New York and Minnesota who signed up for coverage through the BHP. States have the ability to create a BHP to provide health care to low-income residents who might otherwise be eligible for Exchange coverage.

[3] As in previous years, consumers with coverage in late 2017 who did not make an active choice tended to automatically switch to 2018. When Exchange plans for 2018 were available to consumers from their issuer in 2017, they were automatically transferred to the same plan as in 2017, or another plan from the same issuer; depending on the exchange, they may also be automatically recalculated into a proposed alternative plan from another issuer.

[4] State-level PUF can be found here: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Marketplace-Products/2018_Open_Enrollment.html. For 39 states that use the platform to participate in and register with HealthCare.gov, public files with information on selecting county-level plans and zip codes are also available.

[5] Data for SBEs that use their own eligibility and registration platforms are retrieved from the information systems of the respective states and have not been validated by CMS, so metric calculations for these states may differ. The 12 SBEs that use their own eligibility and registration platforms are California, Colorado, Connecticut, DC, Idaho, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont and Washington.

[6] Figures for states HealthCare.gov and SBEs are not 11.8 million due to rounding, for more information see PUF at the state level.

[7] Data for OEP 2014 were from 1.10.2013 to 19.04.2014; OEP 2015 was from 15.11.2014 to 22.02.2015; OEP 2016 was from 1.11.2015 to 1.02.2016 (31.01.2016 for some states); OEP 2017 was from 11/1/2016 to 01/31/2017; for HealthCare.gov it is claimed that the OEP for 2018 was from 11.01.2017 to 15.12.2017 with data submitted before 23.12.2017 (date data differ for SBE; see PUF methodology for details). Selecting an Exchange platform plan for each OEP reflects the status of the Exchange platform state at the time of that OEP. Care should be taken when comparing election plans across different OEPs, as some states have shifted platforms between the years, and Medicaid’s expansion may affect enrollment figures from year to year. In addition, the rate at which issuers submitted plan cancellations could vary from year to year, and care should be taken when interpreting this data as it does not reflect plan execution.

[8] The registration type does not sum up the total amount due to administrative errors in handling a limited number of cancellations / termination plans in Vermont. Please contact PUF State Level for more information.

[9] Some SBEs were unable to verify the age of entrants and metal level characteristics, so these figures are not 11,750,175; more information is available in PUF definitions.

[10] The reported figures reflect the percentage of the total (11,750,175), so the totals may not be 100%.

[11] Financial aid figures were updated in April 2018 and August 2018 to reflect changes presented by Washington and California, respectively. Please see the state-level PUF for more information.

[12]Â For a family of four in 2018, a household income of 100% to 250% FPL typically corresponds to an annual family income of $ 24,600 to $ 61,500.

[13] Total amounts may not be 100% due to rounding.

[14] Other races include multiracial, Native American / Alaska Native and Hawaiian / Pacific Islanders.

[15] Other household incomes include choice of plans for which consumers did not request financial assistance, incomes below 100% FPL, incomes above 400% FPL, and unknown income. Please see the shared file for more information.

[16] Note that these findings cannot be generalized to the entire consumer group who opted for an ACA-compliant plan without APTC, as many consumers in this group purchase plans on the exchange; the premiums in this document are not representative of individual off-exchange plans.

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