New Enrollment Data Shows Relative Stability in Federal Marketplace After Three Years of Major Declines, Putting a Spotlight on Covered California’s Growth in New Enrollment

SACRAMENTO, Calif. — New preliminary data from the Centers for Medicare and Medicaid Services indicates that the federal marketplace saw relatively stable enrollment during the open-enrollment period that closed Wednesday, following three years of very significant declines, particularly among new enrollees. Overall, enrollment in the federal marketplace has declined from 9.6 million in 2016 to 8.3 million in 2020, a drop of 14 percent. In addition, new enrollment has dropped from 4 million in 2016 to 2.1 million in 2020, a decrease of 49 percent.

“While things may appear to be holding steady in the federal marketplace, this is not a one-year story, as millions of people have been priced out of coverage by federal policies that have hurt enrollment,” said Covered California Executive Director Peter V. Lee. “The lack of marketing and outreach at the federal level means fewer healthy people have enrolled, driving up premiums and forcing unsubsidized people to either drop their coverage or sign up with junk plans.”

The federal marketplace, which handles Affordable Care Act enrollment in 38 states, wrapped up its open-enrollment period on Wednesday, which was extended by more than two days because of technical problems on www.healthcare.gov. Compared to last year, new enrollment increased by 2 percent, while the number of renewing consumers dropped 3 percent. Overall enrollment decreased by 2 percent compared to last year.

It is important to note that this data is not final and does not account for the fact that the federal marketplace no longer includes Nevada, which transferred to a state-based marketplace for 2020, and that Maine and Virginia expanded their Medicaid programs, meaning those eligible consumers would not need to purchase coverage on the federal marketplace.

However, the slight increase in year-to-year new enrollment contrasts with the steep losses the federal marketplace has seen recently.

“New enrollment is the lifeblood of any individual market because those consumers who are not signing up are more likely to be healthier, which means a sicker risk mix and higher premiums for everyone” Lee said. “In California, we have enacted new policies and our marketplace has shown stability in the face of multiple policies that are aimed at undercutting the Affordable Care Act.”

While Covered California is a little more than halfway through its open enrollment period, which runs through Jan. 31, the exchange recently reported that 230,000 new consumers had signed up for coverage through Dec. 16. The total is approximately 16 percent over last year’s total at the same time.

Lee noted that Covered California saw a 31 percent decline in new enrollments from 2016-2019. However, most of that came during the 2019 open enrollment period after Congress removed the individual mandate penalty. From 2016-2018 Covered California saw only a 9.2 percent decrease in new enrollment, compared to a drop of 38.9 percent in the federal marketplace.

“Policies matter and the decisions at the federal level have undercut the Affordable Care Act across the country,” Lee said. “California remains an example of what the Affordable Care Act can do – and is doing – when it is allowed to work.”

Last week, Covered California released two extensive reports which detailed how the state has used all the tools of the Affordable Care Act to benefit millions of Californians. The first report, “Covered California’s First Five Years: Improving Access, Affordability and Accountability,”highlights the key strategies undertaken by the state and Covered California to hold health insurance companies accountable, lower costs and build on the Affordable Care Act. The other report, “Covered California Holding Health Plans Accountable for Quality and Delivery System Reform,”summarizes how the 11 health insurance companies Covered California contracts with have met the contractual requirements imposed on them to foster better quality, healthier populations and lower costs, with particular attention to health equity and their efforts to promote changes in how health care is delivered.

In addition to the two reports, Covered California released a chart pack that illustrates many of the improvements made in the past five years.

“These reports are important because implementing the Affordable Care Act effectively is not about just one open-enrollment period or changes of one year to the next,” said Lee. “These reports detail the actions taken over five years and the impacts of those actions, demonstrating how California has put consumers first, saving individual Californians thousands of dollars and holding health insurance companies accountable. These results show the Affordable Care Act going strong and working well in California despite concerted national efforts to take us and the rest of the nation backward.” 

California Enacts New Policies to Encourage Enrollment

While the open-enrollment period in the federal marketplace is closed, Californians can still sign up for coverage. Those who enroll before the end of today will have their coverage start on Jan. 1. Covered California’s open-enrollment period runs through Jan. 31.

Heading into the new year, California lawmakers put two new policies in place for 2020 that were designed to encourage enrollment and lower costs. 

First, they restored the individual mandate penalty that was part of the Affordable Care Act from 2014 to 2018, meaning consumers who do not get covered could face a penalty when they file their 2020 taxes in the spring of 2021.

For those facing a penalty, a family of four would pay at least $2,000, and potentially more, for not having health insurance throughout 2020.

Covered California is working with the Franchise Tax Board, which will administer the penalty, to alert Californians about the new law and reduce the number of uninsured people in our state.

The second new policy for 2020 is new financial help for eligible Californians that will lower the cost of their coverage. Last week, Covered California announced that nearly 540,000 people who had already signed up for coverage in 2020 will be receiving the new subsidies. 

On average, consumers between 200 and 400 percent of the federal poverty level will receive $21 per household, per month on top of their federal tax credits. Meanwhile, for the first time in the nation, people who earn between 400 and 600 percent of the federal poverty level will be receiving an average of $460 per month, per household.

Californians Can Still Enroll

While the open enrollment period in the federal marketplace is closed, Californians can still sign up for coverage. Those who enroll before the end of Friday, Dec. 20 will have their coverage start on Jan. 1. Covered California’s open enrollment period runs through Jan. 31.

Consumers can easily find out if they are eligible for financial help and see which plans are available in their area by entering their ZIP code, household income and the ages of those who need coverage into Covered California’s Shop and Compare Tool.

Those interested in learning more about their coverage options can:

• Visit www.CoveredCA.com.
• Get free and confidential in-person assistance, in a variety of languages, from a certified enroller.
• Have a certified enroller call them and help them for free.
• Call Covered California at (800) 300-1506.

Open Enrollment in Other States

Nationally, several states announced open-enrollment extensions this week. California is now one of 10 marketplaces, representing about 28 percent of the nation’s population, that will continue to allow people to sign up for health care coverage to take effect in 2020.

The following state marketplaces remain open for residents to enroll in coverage for 2020 (listed in order of enrollment cutoff):

1. Nevada:Nevada Health Link is allowing consumers who have started an application until Dec. 20 to enroll and get Jan. 1 coverage. Contact Janel Davis at j-davis@exchange.nv.gov or (775) 687-9934 for more information.
2. Minnesota: MNsure will enroll consumers through Dec. 23. Contact Marie Harmon at Marie.Harmon@state.mn.us for more information.
3. Washington:Washington Healtplanfinder extended its open-enrollment period through Dec. 30. Contact Shawna Bruce at shawna.bruce@wahbexchange.org for more information.
4.  Rhode Island:HealthSourceRI will be accepting applications through Dec. 31. Contact Robin Dionne at robin.dionne@exchange.ri.gov or (401) 383-5542, ext. 5542, for more information.
5. Colorado:Connect for Health Colorado extended its deadline for Jan. 1 coverage until tonight. The exchange’s open-enrollment period runs through Jan. 15. Contact Monica Caballeros at mcaballeros@c4hco.com or (720) 496-2574.
6. Connecticut:Access Health CT extended its open-enrollment period through Jan. 15. Contact Kathleen Tallarita at Kathleen.Tallarita@ct.gov or (860) 757-5339 for more information.
7. Massachusetts:Massachusetts Health Connector will be accepting applications through Jan. 23. Contact Jason Lefferts at (617) 933-3141 for more information.
8. New York:New York State of Health’s open-enrollment period runs through Jan. 31. The exchange can be contacted at press@health.ny.gov or (518) 474-7354, Ext. 1.
9. The District of Columbia:DC Health Link extended its deadline for Jan. 1 coverage until tonight. The exchange’s open-enrollment period runs through Jan. 31. Contact Linda Wharton-Boyd at Linda.Wharton-Boyd@dc.gov or (202) 741-5201.

About Covered California

Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the legislature. For more information about Covered California, please visit www.CoveredCA.com.