Centers for Medicare & Medicaid Services: 2021 Marketplace Special Enrollment Period Report

BALTIMORE, Maryland, May 7 -- The U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services issued the following fact sheet entitled "2021 Marketplace Special Enrollment Period Report":

The Centers for Medicare & Medicaid Services (CMS) reports that 940,000 Americans have signed up for health insurance through HealthCare.gov since February 15, the start of the 2021 Marketplace Special Enrollment Period (SEP) opportunity, through April 30, with approximately 469,000 consumers signing up for health insurance in the month of April./1

The number of new plan selections from the start of the SEP opportunity on February 15 through April 30 represents a substantial increase in enrollment from the same period in 2020 and 2019, when 391,000 and 266,000 consumers signed up for Marketplace coverage, respectively./2 In previous years, SEPs were available primarily only for qualifying life events, whereas this year the Biden-Harris Administration opened a SEP to all Americans in response to the COVID-19 Public Health Emergency.

Under the American Rescue Plan (ARP), most consumers are now eligible for more generous advance payments of premium tax credits (APTC), which further reduce monthly premiums. Since HealthCare.gov implemented the expanded APTC amounts on April 1, approximately 1.9 million consumers have returned to the Marketplace and reduced their monthly premiums after APTC by over 40 percent, from $100 to $57, on average.

The ARP also makes it more affordable for new consumers to purchase and use Marketplace coverage. For new consumers selecting plans during the SEP, the average monthly premium after APTC fell over 25 percent, from $117 for those enrolling from February 15 through March 31 to $86 for those enrolling from April 1 through April 30. The ARP also helped to lower out of pocket costs for new consumers. The median deductible for new consumers during the SEP fell by nearly 90 percent, from $450 prior to April 1 to $50.

Definitions and details on the data are included in the glossary at the end of the report.

See table here: https://www.cms.gov/newsroom/fact-sheets/2021-marketplace-special-enrollment-period-report-1

Glossary

New Plan Selections: The number of unique consumers who didn't have an active enrollment as of February 14, and made a plan selection on or after February 15, that is active as of the end of the reporting period. An active plan selection is one that is non-cancelled with an end date of December 31. While this plan selection metric is net of cancellations and terminations that occur during the reporting period, it doesn't represent effectuated enrollments because reconciliation activity may continue in later periods.

HealthCare.gov States: This report refers to the 36 Marketplace states that use the HealthCare.gov platform for the 2021 coverage year. The 36 states for 2021 include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.

New Consumers Requesting Coverage on an Application Submitted on or after February 15: The number of unique consumers who submitted an application and are requesting coverage on or after February 15, and didn't have an active enrollment as of February 14. If determined eligible for Marketplace coverage, a consumer still needs to pick a health plan (i.e., plan selection) and pay their premium to have coverage (i.e., effectuate enrollment).

Marketplace Eligible: The number of unique new consumers requesting coverage on an application submitted on or after February 15 who are determined eligible to enroll in a Marketplace health plan, regardless of whether they applied for or are eligible for financial assistance.

Medicaid/CHIP Eligible: The number of unique new consumers requesting coverage on an application submitted on or after February 15 who are assessed or determined eligible for enrollment in Medicaid or the Children's Health Insurance Program (CHIP)./3

Call Center Volume: The total number of calls received by the Marketplace call center, which supports HealthCare.gov, over the course of the reporting period. Calls with Spanish-speaking representatives aren't included.

Calls with Spanish-Speaking Representative: The total number of calls received by the Marketplace call center, which supports HealthCare.gov, where consumers chose to speak with a Spanish-speaking representative over the course of the reporting period. These calls aren't included in the Call Center Volume metric.

HealthCare.gov Users or CuidadoDeSalud.gov Users: These user metrics total how many unique users viewed or interacted with HealthCare.gov or CuidadoDeSalud.gov, respectively, over the course of the reporting period.

Window Shopping HealthCare.gov Users or CuidadoDeSalud.gov Users: These user metrics total how many unique users interacted with the window-shopping tool at HealthCare.gov or CuidadoDeSalud.gov, respectively, over the course of the reporting period. Users who window-shopped are also included in the HealthCare.gov or CuidadoDeSalud.gov user total.

Footnotes:

(1) Cumulative plan selections from February 15 through April 30 reflect new plan selections net of terminations and cancellations during that period and count consumers that were not actively enrolled as of February 14. The April 1-30, 2021 total only reflects plan selection activity since April 1 and counts consumers that were not actively enrolled as of March 31. The comparable figure for March 1-31, 2021 was 343,000.

(2) New Jersey and Pennsylvania transitioned to State-based Marketplaces in 2020, and Nevada transitioned to a State-based Marketplace in 2019. Plan selections from these three states aren't included in this report.

(3) Individuals are generally identified in this report as eligible for either a QHP or Medicaid/CHIP, but there are cases where a consumer is considered eligible for both types of coverage or neither. As a result, the eligibility breakouts do not sum to the total number of consumers requesting coverage on applications submitted.