National Healthcare Exchange Enrollment Expands

National Healthcare ExchangeEnrollment on the national healthcare exchanges continue to expand according to a Feb. 2014 study of those eligible to purchase on a government-sponsored exchange by the consulting firm McKinsey & Co.  The most recent growth in enrollments is coming primarily from those identifying as “previously uninsured” although they continue to lag far behind those previously insured in enrollments.  McKinsey has conducted this survey on a monthly basis since November 2013 in order to assess enrollment trends over time.  Here are some of the more interesting findings:

  • 82% of those previously insured have enrolled on an exchange with most (56%) having renewed their previous plan
  • 10% of those identifying as previously uninsured had enrolled by February with the majority (56%) having “not shopped.”
  • Overall, 52% of respondents reported that they had not enrolled in a product with 22% of those stating that they intended to at some point
  • Of those respondents who selected a new product for 2014 (insured who switched and previously uninsured who enrolled), 77% reported having paid their first premium
  • Payments varied by prior status - 86% of the previously insured reported making their first payment vs. 53% of the previously uninsured
  • The percentage of respondents who reported not having enrolled was highest among those previously uninsured with 56% stating they had not shopped and 34% saying that they had shopped but not enrolled.  That compares with 7% and 11% in those same categories for those previously insured
  • For those shopping but not enrolling, concerns about affordability was the concern 50% of the time with technical challenges at 27% (down from January) and plan selection at 12%
  • Of those respondents who cited affordability concerns as impeding their enrollment, 82% were previously uninsured.  Although many were eligible for subsidies (approx 82%), most (66%) didn’t know that they were eligible, didn’t know for how much or didn’t think the subsidy would be adequate

In summary, although enrollment continues to tick up, of the people who were uninsured prior to passage of the ACA, most remain that way and most of the individuals enrolling in the exchanges were previously insured. Concerns about affordability continue to impact people’s decision to enroll in healthplans.

Source: Individual market enrollment, Updated View.  McKinsey Center for US Health System Reform, March 2014

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