Health Reform WK-EDGE Over 10 million effectuated exchange enrollment, HHS expects more enrollees
Wednesday, November 2, 2016

Over 10 million effectuated exchange enrollment, HHS expects more enrollees

By Bryant Storm, J.D.

An average of 10.6 million consumers effectuated marketplace enrollment for the first half of 2016. Effectuated enrollment means those consumers paid their premiums and had an active policy through one of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) health Insurance marketplaces. The first half enrollment statistics were announced alongside HHS Secretary Sylvia M. Burwell’s announcement that she expects 13.8 million individuals to sign up for coverage through the ACA’s marketplaces during the upcoming open enrollment. The expected 13.8 million enrollees would eclipse 2016 enrollment levels by 1.1 million individuals.

2016 enrollment. Out of the approximately 10.4 million consumers with effectuated marketplace enrollments from January 1 through June 30, 2016—the first half of the enrollment year—about 84 percent, or 8.8 million consumers, were receiving advanced premium tax credits (APTC). Additionally, 56 percent of consumers, or nearly 5.9 million individuals, benefitted from cost-sharing reductions (CSRs).

Data matching. From April 1, 2016, to June 30, 2016, about 113,000 consumers had exchange enrollment terminated due to unresolved citizenship or immigration status data-matching issues. Unresolved annual household income data-matching issues also led to the adjustment of 2016 APTC and/or CSRs for 425,000 households. The figures represent improvements over previous data-matching issues from the second quarter of 2015. Specifically, the new figures represent a 63 percent decrease in the number of consumers whose marketplace coverage ended because of an unresolved citizenship or immigration data-matching issue and a 42 percent decrease in households who had their APTC and/or their CSRs adjusted due to income data-matching issues.

IndustryNews: NewsStory NewsFeed AccessNews CostSharingNews HealthInsuranceExchangeNews PremiumTaxNews

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