by Leslie Small
Now that the open enrollment period has ended for the 38 states
that use HealthCare.gov to enroll people in Affordable Care Act (ACA)
marketplace plans, the preliminary sign-up numbers offer relatively reassuring
news for the insurers that operate in the individual market.
From Nov. 1 to Dec. 17, 8.3 million people chose or were
automatically re-enrolled in health plans on the federal exchange, CMS said on
Dec. 20. That's down just slightly compared with 2019, when total
HealthCare.gov enrollment was 8.5 million.
Deep Banerjee, a health care sector analyst at Standard &
Poor's, tells AIS Health that the preliminary 2020 enrollment figures from
HealthCare.gov didn't come as a surprise.
One major reason is that the exchanges have become a heavily
subsidized market, and for those receiving subsidies, "it's highly likely
they'll sign up every year," he says.
"On the other side, this is kind of the positive [effect]
of continuous economic growth in the country — if less people are unemployed,
which means they are getting their insurance from the group side, [they’re]
less likely to sign up on the individual market," Banerjee adds.
For insurers, the fact that ACA exchange enrollment has
plateaued "is not necessarily positive," he says, given that carriers
would like the market to be growing. However, "flat is definitely better
than declining," Banerjee points out.
Cynthia Cox, vice president at the Kaiser Family Foundation and
director for its program on the ACA, says "the Trump administration has
had a mix of policies — some that were harmful and some that were helpful for
the market." In general, moves that some worried would have a large
negative impact, such as the repeal of the individual mandate penalty, do not
appear to have led to a huge decline in enrollment, she notes.
"People being priced out who don't get a subsidy is still a
concern, but generally speaking, the market has been pretty stable for the last
couple of years, and it looks like it will continue to be going forward for at
least another year," she adds.
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