During the second open enrollment period (OE2), nearly 8.8 million consumers enrolled in health coverage in 37 states using HealthCare.gov (and another 2.8 million enrolled through a state-based marketplace). We’ve mapped where these HealthCare.gov enrollees live, but what else can we learn about who’s enrolling?
The Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the Department of Health and Human Services released their final enrollment report for OE2 in March. It includes enrollment tallies as well as other important data about the marketplace-enrolled population: demographics, financial help received, and plans selected (by metal tier). We’ve taken a close look at the data packed in this 73-page report, and summarized some of the key points below.
HealthCare.gov Enrollee Demographics
- Age: Almost all enrollees are non-elderly adults 18-64 years old with 18-to-34-year-olds making up the largest share of enrollees (28 percent of the enrollee population), followed closely by 55-to-64-year-olds (25 percent), 45-to-54-year-olds (22 percent), and 35-to-44-year-olds (17 percent). Just 9 percent of enrollees are younger than 18 or older than 64. This is not surprising, given that many of those younger than 18 are eligible for Medicaid or the Children’s Health Insurance Program, and most of those age 65 and older are eligible for Medicare.
- Gender: There are slightly more female enrollees (54 percent) than male enrollees (46 percent).
- Race/ethnicity: Most enrollees who chose to report their race/ethnicity were white (65 percent), followed by African American (14 percent), Latino (11 percent), and Asian (8 percent). Note: When applying for coverage on HealthCare.gov, applicants are asked an optional question about their race/ethnicity. The data here do not include the more than one-third of OE2 enrollees who did not provide their race/ethnicity.
- Income: We know that financial help is a top motivator for many uninsured consumers to get covered, and that generally, the lower a consumer’s income is, the more financial help the marketplace will provide. In addition to tax credits on a sliding scale to lower a consumer’s monthly premium, consumers with income below 250 percent of the federal poverty level (FPL) qualify for cost-sharing reductions, which allow them to enroll in special plans that have lower cost-sharing (lower deductibles, co-insurance, and co-payment amounts).
Given that more financial help is available for those with lower incomes, it makes sense that marketplace enrollees are heavily concentrated at the lower end of the income spectrum. More than 40 percent of HealthCare.gov enrollees have income below 150 percent FPL (about $18,000 for an individual or $36,000 for a family of four) and two out of three enrollees (68 percent) have income below 200 percent FPL (about $23,000 for an individual or $48,000 for a family of four). Only 16 percent of enrollees have income between 250 and 400 percent FPL, and 2 percent have income above 400 percent FPL. Note: These data do not include the 6 percent of consumers who did not apply for financial help and thus did not report income to the marketplace.
Figure 1. HealthCare.gov enrollee demographics, 2015
Financial Help and Enrollment Behavior of HealthCare.gov Enrollees
- Financial help: Almost all enrollees (87 percent) received financial help to purchase a plan on the marketplace. Of those who received financial help, most (69 percent) got both tax credits and cost-sharing reductions.
- Metal level: The vast majority (69 percent) of consumers selected Silver plans, and a sizeable minority selected Bronze plans (21 percent). Many fewer selected the higher premium Gold and Platinum plans (9 percent) or catastrophic plans (1 percent).
- New or renewal status: About half of enrollees (53 percent) were new to HealthCare.gov in OE2, and half enrolled last year and were re-enrolling for 2015. Out of those re-enrolling, about half (53 percent) actively renewed their coverage and the rest were automatically re-enrolled.
Figure 2. HealthCare.gov enrollees’ financial help and enrollment behavior, 2015
Stay tuned for more analysis of who has enrolled in coming blog posts, and in the meantime check out our maps on where HealthCare.gov enrollees live!