Health Insurance Exchange enrollment continues to decline

CMS recently released its annual report of Health Insurance Exchange open enrollment, which revealed that open enrollment is down from 12.2 million in 2017 to 11.8 million for 2018.

Health Insurance Exchange enrollment began at 8 million in 2014 (the first year of the program) and saw a dramatic jump to 11.7 million in 2015. Enrollment peaked in 2016 at 12.7 million but has been on the decline since. The data includes enrollment through HealthCare.gov as well as 12 State-Based Exchanges (SBE) that use their own eligibility and enrollment platforms.

Year over year, the number of enrollments through Healthcare.gov exceed SBE enrollments, with 8.7 million Healthcare.gov enrollments and 3 million SBE enrollments in 2018. The number of SBE enrollees remained steady at 3 million from 2017 to 2018, with the overall enrollment decline attributed to a decrease in Healthcare.gov enrollments, which dropped from 9.2 million in 2017 to 8.7 million in 2018.

More than one quarter (27%) of overall enrollments in 2018 were attributed to new consumers, compared to 31% in 2017. Returning consumers, which includes active re-enrollees, automatic re-enrollees, and unknown re-enrollment types, made up 69% of enrollees in 2017 and increased to 73% of enrollees in 2018.

Again in 2018, most enrollees (82%) are from non-rural areas. Enrollees typically fall within the 100%–250% household income as a percent of the federal poverty level range with 70% reporting this range in 2018.