CMS Cites Cost Effectiveness of 2018 Obamacare Open Enrollment

The Centers for Medicare and Medicaid Services (CMS) has released its final report on the 2018 open enrollment period for Affordable Care Act (ACA, or Obamacare) policies, touting the cost effectiveness of the new approach.

obamacare-enrollment-reaches-3.6-millionIn 2017, CMS spent $100 million in advertising and promotion for open enrollment, coming out to $11 per enrollee; in 2018, it spent $10 million, or just $1 per enrollee. The agency said it adjusted its budget this year to match that of Medicare promotion.

An estimated 11.8 million consumers enrolled in Affordable Care Act plans for 2018, compared to 12.2 million in 2017 and 12.7 million in 2016, when the numbers were at an all-time high.

Here are the details from the report:

The 2018 OEP Final Report includes data for the 39 states that use the HealthCare.gov eligibility and enrollment platform, as well as for the 12 State-Based Exchanges (SBEs) that use their own eligibility and enrollment platforms. Demographic and plan information for consumers with a plan selection provided by all 50 states plus DC include: age, metal level, and whether the consumer had advance payments of the premium tax credit (APTC) or cost sharing reductions (CSR).

For the 39 states that use the HealthCare.gov platform, additional data are available, including gender, rural location, self-reported race and ethnicity, household income as a percent of the federal poverty level (FPL), and the average premiums among consumers with and without APTC. Data files with information on plan selections at the county and zip code levels are also available for HealthCare.gov states.

Key findings from this report include:

  • Approximately 11.8 million consumers selected or were automatically re-enrolled in an Exchange plan in the 50 states, plus DC.
  • Twenty-seven percent of consumers with a plan selection were classified as new consumers.
  • Sixty-three percent of consumers selected silver plans; 29 percent of consumers selected bronze plans and 7 percent of consumers selected gold.
  • Among consumers using HealthCare.gov, the average premium before application of the tax credit was $621 during the 2018 OEP and $476 during the 2017 OEP.

NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
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