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Small Business Employee Benefits and HR Blog

Current Marketplace Enrollment Exceeds CBO's Estimate

predictionWhen the Affordable Care Act (ACA) was enacted, it introduced the individual shared responsibility. This is the provision of the ACA that requires Americans to be enrolled in a health insurance plan or pay a fee at the end of the tax year. Yesterday, Centers for Medicare and Medicaid Services Administrator, Marilyn Tavenner, released the first ACA enrollment update since May. While the Congressional Budget Office had a more modest estimate of Marketplace enrollees for 2014, Tavenner’s update proved otherwise.

Marketplace Enrollment in 2014

The CBO originally predicted that 6 million Americans would be covered by the health insurance Marketplace in 2014. After open enrollment ended in March, the official enrollment count was 8,019,763 in April. These enrollees had selected individual health insurance policies, but not all had paid the premiums.

Tavenner announced yesterday that 7.3 million Americans are currently enrolled in Marketplace health insurance plans, meaning they had paid their premiums and retained their coverage through August 15th. Critics of the Affordable Care Act point to the fact that this number suggests that at least 700,000 enrollees had let their coverage go. The enrollees were dropped from their coverage because of a failure to pay premiums. Tavenner suggests that some of these enrollees may have ended coverage due to obtaining insurance elsewhere.

While the critics point to the nine percent drop in enrollment since April, Tavenner counters that its “really a strong number.” Additionally, she expects the total enrollment number to remain stable until the next open enrollment on November 15th.

The number was obtained by the health insurance companies, who reported the number of Marketplace enrollees to the Obama administration each month. The figure includes the 8 million who initially enrolled during open enrollment for 2014, minus those who failed to pay their premiums. It also includes those consumers who enrolled during a special enrollment period. Back in July, CMS reported that 1 million consumers had either gained or changed coverage during special enrollment periods.

Marketplace Enrollment in 2015

The CBO estimates over twice as many enrollees as they predicted last year. They projected that 13 million consumers will enroll in Marketplace coverage in 2015. Additionally, while last year’s enrollments were spread over a six month period of time, this year’s open enrollment will only run from November 15th to February 15th. This influx of new enrollees in a significantly shorter period of time has some critics of the ACA nervous that the considerable volume increase will cause similar technical glitches to last year’s open enrollment.

March (the last month of open enrollment) was the busiest month of open enrollment last year. This year, however, consumers who currently have Marketplace coverage will only have until December 15th to make changes to their current enrollment information. If no changes are made, these enrollees’ policies will automatically renew for 2015. This may make the first month of open enrollment busier than the last.