April 29, 2014 – May 5, 2014

Final Enrollment Numbers Released: On May 1, the U.S. Department of Health and Human Services (HHS) released official enrollment numbers for the initial open enrollment period for both the health insurance marketplaces and Medicaid and the Children’s Health Insurance Program (CHIP). In total, nearly 13 million Americans enrolled in Marketplace coverage, Medicaid, or CHIP between October 1, 2013 and April 15, 2014.

  • Marketplaces: 3.8 million Americans selected marketplace plans during March and the subsequent grace period, bringing the final cumulative total to 8 million enrollees – including 5.4 million enrollees in federally facilitated marketplaces (FFMs) and 2.6 million in state-based marketplaces (SBMs). Almost as many people enrolled during March/April as enrolled during the first five months of open enrollment. For the first time, the marketplace enrollment report also includes information on FFM enrollees’ race/ethnicity.
  • Medicaid/CHIP: 4.8 million more Americans enrolled in Medicaid or CHIP between October 1, 2013 and March 31, 2014 compared with enrollment in the months prior to open enrollment. States that expanded Medicaid increased Medicaid/CHIP enrollment by 4.2 million, or 12.9 percent. States that did not expand Medicaid increased Medicaid/CHIP enrollment by 640,000, an increase of 2.6 percent.

New FFM Special Enrollment Periods (SEPs) andHardship Exemptions: On May 2, HHS announced three new “exceptional circumstances” that qualify individuals for SEPs and two new hardship exemptions from the individual shared responsibility fee.

  • SEP for COBRA enrollees: Individuals currently enrolled in COBRA coverage can receive an SEP to cancel their COBRA coverage and enroll in the FFMs by July 1. This SEP stems from COBRA notices that did not provide adequate notice about marketplace coverage options and will not apply to consumers moving forward who receive revised notices. To gain access to the SEP, consumers need to call the call center and indicate they are calling about COBRA benefits and the opportunity to enroll in the marketplace.
  • Other new SEPs: HHS created new SEPs in FFM states for consumers with individual market plans that are renewing outside of open enrollment and individuals who are beginning or concluding their service in AmeriCorps, VISTA, or NCCC programs. The first SEP is available to consumers through HealthCare.gov or the call center, but for the latter, consumers must use the call center.
  • New hardship exemptions: HHS also announced two new hardship exemptions: 1) All individuals who obtained minimum essential coverage effective on May 1, 2014 will not have to pay a fee for not having coverage from January through April; and 2) Individuals in AmeriCorps, VISTA, or NCCC programs who had certain types of limited-benefit coverage through these programs during their service are eligible for a hardship exemption for the entire year.

Confirmation Hearing for HHS Secretary this Week: On May 8, the U.S. Senate Committee on Health, Education, Labor, and Pensions is scheduled to hold a hearing on the nomination of Sylvia Burwell to be the next secretary of HHS. The Senate Finance Committee will also hold a nomination hearing, although the timing has not been announced.

Update on SBM Deadlines: Most SBMs ended their grace period on April 15 for consumers who had difficulty enrolling during open enrollment. A few states had other dates: April 30 was the last day to complete enrollment in Oregon and Washington, DC, and consumers in Nevada have until the end of May to finish enrolling. Minnesota also announced this week that they are offering retroactive coverage and financial help to consumers who tried but were unable to enroll during open enrollment, and financial help to eligible consumers who enrolled in off-exchange coverage; consumers must apply to MNsure by May 15 to secure either option. HHS extended the option to offer retroactive coverage and financial help to all SBMs in February.

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