October 13 – October 19, 2015

HHS Projects 10 Million Will Be Enrolled in Marketplace Coverage at the End of 2016: On October 15, the Department of Health and Human Services (HHS) released its marketplace enrollment estimate for 2016, projecting that 9.4 to 11.4 million Americans would be enrolled at the end of 2016 and setting a target of 10 million enrollees. At the same time, HHS acknowledged the challenge of projecting enrollment, particularly in the early years of a program when numerous factors can affect enrollment. According to an HHS study of the remaining uninsured released in tandem with the enrollment estimates, 8 in 10 uninsured Americans could qualify for tax credits to lower the cost of marketplace premiums, and nearly half could also receive cost-sharing assistance with out-of-pocket costs. Separate enrollment projections from the Congressional Budget Office, estimating 20 million enrollees in 2016, anticipated a significant shift from job-based and off-marketplace non-group coverage to marketplace coverage, which HHS says has not occurred.

New Analysis of Medicaid Enrollment Growth Under the Affordable Care Act: From October 1, 2014, to September 30, 2015 (fiscal year 2015), Medicaid enrollment increased by 13.8 percent, according to a new Kaiser Family Foundation (KFF) analysis. In fiscal year 2014, Medicaid enrollment increased by 8.3 percent, and KFF projects that Medicaid enrollment will grow by 4.0 percent during the upcoming fiscal year. Since October 2013, 30 states and the District of Columbia have expanded Medicaid under the Affordable Care Act.

Nonprofit Issuers in Three States No Longer Offering 2016 Coverage: In Colorado, Tennessee, and Oregon, nonprofit issuers created under the Affordable Care Act’s CO-OP program will not offer marketplace coverage in 2016 due to financial concerns. The Tennessee and Oregon plans withdrew voluntarily while Colorado’s co-op, the Colorado HealthOP, was shut down by the state’s Division of Insurance and attempted to appeal the decision. Starting on November 1 during open enrollment, consumers enrolled in those co-op plans will be able to sign up for new 2016 coverage.

State Updates:

  • California: Pregnant women in California who qualify for the Medi-Cal Access Program will now be able to enroll in the program through the state marketplace’s enrollment portal. This technology was implemented in an effort to improve the consumer experience.
  • Kentucky: On October 15, the HHS Office of the Inspector General published an audit evaluating Kynect’s eligibility-determination systems, finding that they were “generally effective” and identifying ways to improve the marketplace’s processes. The report includes a response from Kynect concurring with the audit’s findings and recommendations and describing steps the marketplace has taken to improve the verification of eligibility.
  • Pennsylvania: On October 15, the Pennsylvania Insurance Department announced approved premiums for 2016 on the marketplace. Premiums for 12 of the 19 issuers offering health plans will increase by less than 10 percent, and six plans will have increases over 20 percent.
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