Lower premiums and more participation by insurers. That's what the Centers for Medicare & Medicaid Services announced as it released its look ahead to the upcoming open enrollment season for coverage that begins in 2021.
The average premium for the second lowest cost silver plan (also called the benchmark plan) dropped by 2% for the 2021 coverage year and, when looking at states that are using HealthCare.gov in both 2020 and 2021, 22 more issuers will offer coverage in 2021, for a total of 181 issuers delivering more choice and competition for consumers.
Three years of declining average benchmark plan premiums combine to deliver an 8% premium reduction across HealthCare.gov since the 2018 coverage year. Looking at the coming year, four states will see double-digit decreases in the average benchmark plan premiums for 27 year olds, including Iowa, Maine, New Hampshire and Wyoming. For two of these states - Maine and New Hampshire - CMS has used its authority to approve State Innovation Waivers under Section 1332 of the Patient Protection and Affordable Care Act to establish state-based reinsurance programs, contributing to the decline in premiums.
Issuer participation will also increase for the third year in row. As more issuers offer coverage, the percentage of HealthCare.gov enrollees with access to only one issuer is decreasing from 29% in 2018 to 4% in 2021, and more than three quarters of HealthCare.gov enrollees will have access to at least three issuers in 2021. To show this improvement from a geographic perspective, CMS also released the 2021 Issuer Participation County Map for states with Exchanges that use HealthCare.gov as well as State-based Exchanges showing greater consumer choice. The map covers the entire country and shows the portion of counties with only a single issuer dropped from 50% in 2018 to 24% in 2020 and will drop further to 9% in 2021. For 2021, there will be 288 counties nationwide with a single issuer offering plans through the Exchange, down over 80% from a high of 1,582 counties with a single health insurance issuer offering plans through the Exchange in 2018.
While today’s report shows efforts to stabilize the market are working, average premiums are still significantly higher than when the Affordable Care Act was first implemented and affordability remains a significant challenge for people who do not qualify for a premium tax credit and must pay the entire premium themselves. The average benchmark plan premium for a typical family of four has increased from $794 in 2014 - the first year the ACA’s main requirements were introduced - to $1,486 in 2021. As premiums increase, a recent report by CMS on enrollment among people with and without subsidies documents how unsubsidized enrollment continues to decline, suggesting middle income Americans continue to struggle to afford coverage
Consumers will be able to start enrolling in plans for the 2021 plan year beginning on November 1, 2020, which marks the beginning of the annual Open Enrollment Period for the individual market Exchanges. The Health Insurance Exchange 2021 Open Enrollment Period is November 1, 2020 to December 15, 2020, with coverage beginning on January 1, 2021.
To view the 2021 Health Insurance Exchange Premium Landscape Issue Brief, visit: https://www.cms.gov/CCIIO/Resources/Data-Resources/Downloads/2021QHPPremiumsChoiceReport.pdf
To see the 2021 Issuer Participation County Map; visit: https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/Downloads/10-16-2020-County-Coverage-Map.pdf
To view the Scheduled Maintenance Windows, visit: https://marketplace.cms.gov/technical-assistance-resources/2021-open-enrollment-healthcaregov-maintenance-windows.pdf
To view the Trends in Subsidized and Unsubsidized Enrollment; visit: https://www.cms.gov/newsroom/press-releases/unsubsidized-enrollment-individual-market-dropped-45-percent-2016-2019-0