Details are being released regarding the number of individuals that signed up for medical coverage under the Affordable Care Act (ACA) Marketplace. The numbers show that there is an overall reduction of 3.7% in 2018 over 2017. This a combination of a slight increase (0.2%) in the state-based marketplace offset by a reduction at Healthcare.gov. There were 15 states that showed an increase over 2017 with the majority of these being state-based services.
This is a larger enrollment than many expected because funding for outreach informing those potentially in need of the program was dramatically reduced and the enrollment period was cut in half. There were also a few political factors including the government’s termination of the cost-sharing provision and uncertainty whether the law would be in effect at all.
Outreach, as outlined in the ACA, was provide through Navigator programs. These programs helped inform and guide potential enrollees in the 34 states using Healthcare.gov about enrollment periods and what they specifically had to do to comply with the ACA. In august of last year, the Center for Medicare and Medicaid Services significantly reduced their spending on Navigator. Because it was so close to the actual enrollment period, many thought that it would have a major impact on enrollment in general.
The elimination of the cost-sharing provision for insurers prior to the open enrollment period led to an increase in the premiums that many would have to pay. It also increased the premium subsidies for some of those enrolled that qualified leading to reductions in what they had to pay.
In Illinois, 334, 979 enrolled this year down 6% from the 356,403 that enrolled in 2017.
There are still many changes on the horizon with regards to the ACA and its components. While Congress did not fully repeal and replace the ACA, they did remove the individual mandate as part of the most recent tax bill. The full impact of this will be realized over the next few months and years.
We will continue to monitor progress in the provisions of the ACA and how it will impact your business. Please contact us if you would like to discuss how this changing environment will impact your business and what steps you can take to make sure that you are compliant while still saving as much on the expense side as possible.
Sources for this blog include: