Date

Press release

CMS Issues the 2019 Exchange Open Enrollment Period Final Report

CMS Issues the 2019 Exchange Open Enrollment Period Final Report
Agency also extends the policy allowing issuers to continue “grandmothered” plans

The Centers for Medicare & Medicaid Services (CMS) today released the Health Insurance Exchanges 2019 Open Enrollment Report. With the Trump Administration’s focus on making healthcare more affordable, the report confirms another successful open enrollment period coinciding with a stabilization of premiums after years of substantial increases.  Specifically, the report shows plan selections in Exchange plans in the 50 states and D.C. remained steady at 11.4 million. This represents a minimal decline of around 300,000 plan selections from the same time last year. Also, as outlined in the report, average total premiums for plans selected through HealthCare.gov dropped by 1.5 percent from the prior year, the first decline since the Exchanges began operations in 2014. 

In addition to this report, as part of the Administration’s commitment to ensure access to affordable coverage options, CMS is also issuing guidance extending for one additional year, the non-enforcement policy to allow issuers to continue certain health plans, often referred to as “grandmothered” plans, which do not meet all the many mandates and restrictions in the Patient Protection and Affordable Care Act (PPACA). These plans can be more affordable for people who choose to renew coverage with them.  Extending these grandmothered policies will allow consumers to maintain more affordable coverage than they would have access to through PPACA plans.

“Not extending the grandmothered plan policy would cancel plans that are meeting people’s needs today and, as a result, force people to decide between buying coverage they cannot afford on the individual market or going uninsured,” said CMS Administrator Seema Verma. “By extending the grandmothered plan policy, we are following through on our commitment to protect those left behind by Obamacare.”

While the overall number of plan selections decreased from the previous year, this decrease in plan selections could likely be attributed to a lower demand for Exchange coverage. The strong economy and growing employment likely increased the number of people with access to employer-sponsored coverage and, in turn, reduced demand for subsidized health coverage offered on the Exchanges. Another factor that reduced demand for Exchange coverage, were the roughly 100,000 people who were enrolled in the Exchange in Virginia at the end of 2018 and reported incomes that would make them eligible for the new Virginia Medicaid expansion in 2019. 

Demographic data provided in the report also demonstrate stability on the Exchanges. The percent of young adults aged 18-34 who selected a plan through HealthCare.gov remained unchanged from the prior year at 26 percent. The demographic proportions by gender, race, income, and rural and non-rural also remained largely unchanged.

“Another year of stable enrollment through the Exchanges directly reflects the strong work CMS staff put into ensuring that Exchange consumers experience a seamless enrollment process free from unnecessary hurdles and IT glitches,” said Administrator Verma. “It is no coincidence enrollment remained strong when the Exchange call center maintained a record high 90 percent satisfaction rate and no waiting rooms were needed in the final, busiest days of enrollment.”  

The report also shows the average monthly premiums for plans purchased through HealthCare.gov before taking advantage of advanced payments of the premium tax credits available to eligible consumers was $612, down from $621 for the previous open enrollment period (OEP). After these advanced payments are applied, the average premium was $87 compared to $89 for the prior OEP. 

This decline in premiums, however, follows a 23 percent average premium increase in 2017 and another 31 percent increase in 2018. Such large premium increases in previous years made premiums substantially less affordable for people who do not qualify for subsidies. This small decline in premiums in 2019 moves in the right direction, but, for unsubsidized people, premiums remain considerably higher than before the PPACA’s main requirements were implemented in 2014.

Recognizing individual health insurance premiums are no longer affordable for a great many Americans, the Trump Administration is committed to expanding more affordable coverage options to this group of people left behind by the PPACA, which spurred recent actions to expand access to association health plans and short-term health plans, as well as the extension of the grandmothered plan policy issued in guidance today.

To view the OEP Final Report, click here: https://www.cms.gov/newsroom/fact-sheets/health-insurance-exchanges-2019-open-enrollment-report

To view the guidance on ‘Grandmothered’ plans, click here: https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/Limited-Non-Enforcement-Policy-Extension-Through-CY2020.pdf

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