Medicare & Medicaid Services Issues Biweekly Enrollment Snapshot

WASHINGTON, Feb. 3 -- The U.S. Department of Health and Human Services' Centers for Medicare & Medicaid Services issued the following fact sheet:

On January 31, 2017, Open Enrollment for 2017 coverage ended with more than 9.2 million plan selections in states that use the HealthCare.gov eligibility and enrollment platform. Those selections were made from a market that experienced a 25 percent increase over the previous year in the average premium for the benchmark second-lowest cost silver plan as well as a 28 percent decline in the number of issuers participating over the past year. [1]

This Open Enrollment Snapshot covers the period from January 15, 2017 through January 31, 2017.

This snapshot does not include plan selections from State-based Marketplaces. CMS will release a detailed final enrollment report in March, including final plan selection data from State-based Marketplaces.

Of the more than 9.2 million consumers who selected a plan through the HealthCare.gov platform, about 3 million are new consumers, which means 33 percent of all plan selections were from new consumers. In addition to the approximately 3 million new HealthCare.gov consumers, about 6.2 million were returning Marketplace consumers.

This year's plan selection totals take into account any consumer initiated or insurer initiated cancellations that occurred during Open Enrollment.

These snapshots provide point-in-time estimates of biweekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov. The final number of plan selections associated with enrollment activity during a reporting period may change as plan modifications or cancellations due to life changes like starting a new job or getting married occur. In addition, as in previous years, the biweekly snapshot does not report the number of consumers who have paid premiums to effectuate their enrollment.

A more detailed report that looks at plan selections across all states for the entire Open Enrollment period will be released in March.

Definitions and details on the data are included in the glossary.

Federal Marketplace Snapshot

Click here to view the table: (https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-02-03.html)

HealthCare.gov State-by-State Snapshot

The Snapshot provides cumulative individual plan selections for the 39 states using the HealthCare.gov platform.

Individual plan selections for the states using the HealthCare.gov platform include:

Click here to view the table: (https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-02-03.html)

HealthCare.gov Local Market Snapshot

The Weeks 12 through 14 snapshot includes a look at plan selection by Designated Market Areas (DMAs) which are local media markets. These data provide another level of detail to better understand total plan selections within local communities. Some DMAs include one or more counties in a state that is not using the HealthCare.gov platform for 2017. Plan selections for those DMAs only include data for the portion of the DMA that is using the HealthCare.gov platform, so the amounts reported in the snapshot do not represent plan selections for the entire DMA. However, in cases where a DMA includes portions of multiple states but all of those states use the HealthCare.gov platform, the reported amounts reflect the whole DMA.

Click here to view the table: (https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-02-03.html)

Glossary

Plan Selections: The cumulative metric represents the total number of people who have submitted an application and selected a plan, net of any cancellations from a consumer or cancellations from an insurer that have occurred to date. The biweekly metric represents the net change in the number of non-cancelled plan sections over the two-week period covered by the report.

To have their coverage effectuated, consumers generally need to pay their first month's health plan premium. This release does not report the number of effectuated enrollments.

New Consumers: A consumer is considered to be a new consumer if they did not have Marketplace coverage at the start of Open Enrollment on November 1st, 2016.

Renewing Consumers: A consumer is considered to be a renewing consumer if they had 2016 Marketplace coverage on November 1st, 2016 at the start of Open Enrollment and either actively selected the same plan or a new plan for 2017, were automatically re-enrolled into their plan, or were signed up for January 1 coverage through a suggested alternate plan.

Marketplace: Generally, references to the Health Insurance Marketplace in this report refer to 39 states that use the HealthCare.gov platform. The states using the HealthCare.gov platform are Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.

HealthCare.gov States: The 39 states with Marketplaces that use the HealthCare.gov platform for the 2017 benefit year, including those with Federally-facilitated Marketplaces, State Partnership Marketplaces, and State-based Marketplaces.

Consumers on Applications Submitted: This includes consumers who are requesting coverage on a completed and submitted application, including an application that is created through the automatic re-enrollment process, which occurs at the end of December, in a state that is using the HealthCare.gov platform. If determined eligible for Marketplace coverage, a new consumer still needs to pick a health plan (i.e., plan selection) and pay their premium to get covered (i.e., effectuated enrollment). Because families can submit a single application, this figure tallies the total number of people requesting coverage on a submitted application (rather than the total number of submitted applications).

Call Center Volume: The total number of calls received by the call center for the 39 states that use the HealthCare.gov platform over the course of the weeks covered by the snapshot or from the start of Open Enrollment. Calls with Spanish speaking representatives are not included.

Calls with Spanish Speaking Representative: The total number of calls received by the Federally-facilitated Marketplace call center where consumers chose to speak with a Spanish-speaking representative. These calls are not included within the Call Center Volume metric.

HealthCare.gov 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 a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual's browser settings and browsing habits, a visitor may be counted as a unique user more than once.

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 a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual's browser settings and browsing habits, a visitor may be counted as a unique user more than once. Users who window-shopped are also included in the total HealthCare.gov or CuidadoDeSalud.gov user total.

[1] U.S. Department of Health and Human Services, "Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace." ASPE Research Brief, ASPE, October 24, 2016, available at: https://aspe.hhs.gov/sites/default/files/pdf/212721/2017MarketplaceLandscapeBrief.pdf.

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