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CMS’ final report shows 11.8 million consumers enroll in 2018 Exchange coverage nationwide

CMS’ final report shows 11.8 million consumers enroll in 2018 Exchange coverage nationwide
This marks agency’s most cost effective and successful open enrollment to date

The Centers for Medicare & Medicaid Services (CMS) today released the Final Enrollment Report for the 2018 Health Insurance Exchanges showing approximately 11.8 million consumers selected or were automatically re-enrolled in an Exchange plan in the 50 states, plus DC. This includes 8.7 million consumers in the 39 states using and 3 million consumers in State-based Exchanges. Compared to prior years, this year’s open enrollment was the agency’s most cost effective and successful experience for consumers to date. While the 2018 open enrollment period ran smoothly, Americans continue to experience skyrocketing premiums and limited choice.

“Our primary goal this year was to ensure that Americans who wanted coverage through the Exchange had a seamless experience,” said CMS Administrator Seema Verma. “We are pleased that consumer satisfaction was the highest it’s ever been during the 2018 open enrollment period. However, even with the success of this year’s open enrollment, the individual market continues to see premiums rise and choices diminish. Average individual market premiums have more than doubled since 2013 compared to health plans on the Exchange in 2018, and half of U.S. counties have had only one issuer to choose from this year.” 

The report shows that nearly three quarters of people who enrolled through the Exchanges actively shopped for a policy versus letting their policy automatically renew. Among all consumers with a plan selection, 27 percent were new enrollees and 47 percent actively returned to select a plan. These consumers were able to easily shop for and pick a plan with little interruption throughout the entire enrollment period. used only 22.5 hours of regular maintenance time, the lowest ever. Data from the Federal Health Insurance Exchange call center shows that the consumer satisfaction rate remained at an all-time high – averaging 90 percent. This is up from 85 percent last year.

This year’s open enrollment was also cost effective, with CMS spending less on outreach and advertising while enrollment stayed essentially the same. CMS adjusted the open enrollment marketing budget to a level that is consistent with advertising spending for Medicare and has proven to be effective. The agency spent $10 million on marketing and outreach, which is just over $1 per enrollee by funding only the most efficient tactics and increasing direct response outreach. In comparison, last year CMS spent $11 per enrollee, totaling approximately $100 million to enroll nearly the same number of individuals that were enrolled this year.

Moving into 2018, the report released today shows unsubsidized monthly premiums continue to rise for consumers, jumping from $476 last year to $621 this year, an increase of 30 percent.

Most consumers on the Exchanges relied on premium subsidies to purchase coverage through the Exchanges. The report shows that approximately 83 percent of consumers nationwide had their premiums reduced by tax credits.   The average tax credit for consumers covered about 86 percent of the total premium, resulting in an average premium after tax credits of $89 per month. Most consumers—63 percent—selected a silver plan. Twenty-nine percent of consumers selected bronze plans and 7 percent of consumers selected gold.

During this open enrollment, the share of individuals 55 years of age and older enrolled in increased from 27 percent last year to 29 percent this year, whereas the share of young adults between the ages of 18 and 34 decreased slightly. consumers who were not eligible for premium subsidies chose a plan on average that was 18 percent less expensive than those receiving subsidies. Through the Exchanges, the percent of bronze plan selections is up 6 percentage points and the percent of silver plan selections is down 9 percentage points compared to last year.

“Taken together these data suggest that more affordable healthcare options are needed. Especially for those forgotten women and men who are not eligible to have their premiums reduced by tax credits,” said Administrator Verma.

CMS recently published a proposed rule to expand the availability of short-term, limited-duration insurance to provide additional options to Americans who cannot afford to pay the costs of soaring healthcare premiums or do not have access to the healthcare choices that meet their needs under the law. Last year, the agency issued the Marketplace Stabilization Rule to lower premiums and increase consumer choice. These important steps will help stabilize the market to increase competition, choice, and access to lower-cost healthcare options for millions of Americans.

The report is available here: