Special Enrollment Period Boosts ACA Enrollment by 200k Enrollees

The Affordable Care Act’s federal marketplace has gained 200,000 new enrollees since the beginning of the special enrollment period, the Biden administration announced.

“These numbers are an encouraging sign—but we can’t slow down until every American has the security and peace of mind that quality, affordable health coverage provides,” President Joe Biden said in the announcement.

The president urged Americans to enroll on the Affordable Care Act marketplace.

“There is plenty of time left to sign up, and I encourage everyone who needs health insurance to go to HealthCare.gov before May 15. If you already have coverage, you can help family members and friends who are uninsured get themselves covered,” President Biden said.

The statement appealed to the pandemic’s impact as the primary reason for focusing on higher access to healthcare, pointing out that almost 30 million Americans have contracted this disease.

In tandem with the special enrollment periods, the administration advocated for its American Rescue Plan, which was still under consideration in the Senate when this statement was released.

“Getting more Americans covered is an important part of the equation—but we also need to lower health costs,” President Biden said.

Recent research affirmed that cost could still be a major deterrent for individuals seeking healthcare coverage on the Affordable Care Act marketplace.

Although 8.9 million individuals are eligible for subsidies on the Affordable Care Act marketplace, many Americans may turn down even the $0 premium bronze plan due to the high deductible. What one saves on premiums could easily bleed out in deductible out-of-pocket healthcare spending, eligible individuals may reason.

A separate study published in Health Affairs found that, while the Affordable Care Act marketplace brought down healthcare spending for lower-income enrollees, middle-income enrollees did not benefit as much from subsidies and continued to face high healthcare spending.

Out-of-pocket healthcare spending for middle-income enrollees dropped only $38 after the Affordable Care Act went into effect—as opposed to $109 for lower-income individuals—and catastrophic healthcare spending diminished by less than one percent after the law’s implementation.

The American Rescue Plan’s proposed solution to this was to increase premium tax credits and diminish costs for the elderly with incomes of over 400 percent of the federal poverty level, among other strategies that aimed to lower costs.

The new administration opened the special enrollment period on the federal health insurance marketplace on February 15. Individuals will have three months to enroll on an Affordable Care Act health plan until May 15. State-based marketplaces are also permitted to open special enrollment periods and a couple of states have done so, such as Washington and Colorado.

Although special enrollment period enrollees tend to accrue higher costs, large payer organizations were receptive to the special enrollment period when it was announced.

“If anything, we have seen several of the big carriers embrace this, because it is going to function more like a broad open enrollment period than it is like a narrow, technical, special enrollment period,” Joel Ario, managing director at Manatt Health, told HealthPayerIntelligence.

The results of the most recent federal health insurance marketplace open enrollment may bode well for this special enrollment period. Enrollment was fairly consistent with previous years’ gains.

During open enrollment for 2021, 8.2 million Americans enrolled on the federal health insurance marketplace.

New Jersey and Pennsylvania's enrollment numbers were not included in the open enrollment 2021 metrics since they transitioned to state-based marketplaces in 2020. If these states were discounted from the open enrollment 2020 numbers, then 2021 enrollment on the federal health insurance marketplace increased by seven percent compared to the previous year.

The level of interest in state health insurance marketplace’s special enrollment periods throughout 2020 may also be positive forecasters for the 2021 federal health insurance marketplace special enrollment period.

California witnessed a 250 percent higher signup rate for its 2020 coronavirus-related special enrollment period compared to a 2019 special enrollment period around the same timeframe. Connecticut saw a 70 percent increase over the previous year’s special enrollment period and the District of Columbia saw a 66 percent increase.