2018 Affordable Care Act Enrollment Shows Marketplace Stabilizing
The Centers for Medicare and Medicaid Services (CMS) plan to release a more detailed 2018 enrollment report in March for the recent open enrollment under the Affordable Care Act, including final plan selection data from the 11 state-based exchanges that do not use the HealthCare.gov platform.
Until then, we have new information from the National Academy for State Heath Policy (NASHP). The data from NASHP, looking at returns from all 50 states and the District of Columbia, shows that a total of 11.8 million people signed up for healthcare coverage for 2018, a reduction of 3.7% from last year.
State healthcare exchanges operating independently of Healthcare.gov, along with state healthcare exchanges that partially use the federal platform, saw a slight increase of 0.2% in enrollment for 2018 compared to 2017, according to NASHP. The non-profit, non-partisan agency said that by comparison, the 34 states that rely entirely on Healthcare.gov saw sign-ups drop by 5.3%.
“For the first time we now have the full national picture of how the individual marketplaces did this year and it is a picture of remarkable stability,” said Trish Riley, Executive Director of NASHP in a press release. “Despite all the uncertainty and challenges we have seen, particularly for consumers living in states supported by state-based marketplaces, we see millions of Americans continuing to benefit from the coverage they get in the individual market.”
Based on this updated enrollment information, the five states with the most enrollees are:
Florida 1,715,227
California 1,521,524
Texas 1,126,838
North Carolina 519,803
Georgia 480,912
Open enrollment to obtain insurance on Healthcare.gov involving the 39 states who fully or partially use the federal platform starting on January 2018 ended on December 15 with more than 8.7 million Americans signing up for coverage, according CMS. Enrollment for 11 states and the District of Columbia had deadlines past December 15, with some deadlines set for January 31. More than 3 million people enrolled to receive healthcare insurance through these state exchanges, according to NASHP.
It will be interesting to see how the CMS final report in March compares to the information provided by NASHP.
The response to the 2018 open enrollment demonstrates that Americans still see value in obtaining health insurance, despite the ACA’s flaws and a significantly shorter enrollment period for many states, as well as increasing premiums of plans on government marketplace exchanges, and continued efforts by the Republican controlled Congress and White House to undermine the law. It will be interesting to see if that changes when the individual mandate provision of the ACA is essentially repealed when the tax penalty is reduced to $0 for any American who does not obtain health insurance as part of the new tax reform legislation approved by Congress.
Until then, expect the IRS to move forward with its efforts to enforce compliance with the ACA for the individual mandate. There is no change with respect to the employer mandate. The IRS has been and will continue to enforce it.
In regards to the employer mandate, the IRS has started sending IRS Letter 226J tax penalty notices containing ACA penalty assessments for ACA information filings for the 2015 tax year. Some of these IRS Letter 226J notices contained penalties in the millions of dollars. More are expected to be issued in 2018, including for 2016 tax year filings.
For an infographic on how to respond to Letter 226J penalty notices, click here.
To learn more about ACA compliance in 2021, click here.
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