HealthCare.gov Gets Off to a Fast Start

HealthCare.gov looks as if it got off to a fast start this year.

The web-based supermarket for health insurance took in an average of 116,909 health insurance applications per day during the first seven days of the open enrollment period for 2021 coverage, according to the first weekly enrollment snapshot sent out by HealthCare.gov managers.

Figures for the first week of the latest open enrollment period may be hard to compare with figures for the first week of the open enrollment period for 2020 coverage: Last year, the first snapshot report of the open enrollment period gave data on a “week” that was just two days long.

But, so far this year, the daily application count has been 32% higher than the average daily application count recorded for the first week in the open enrollment period for 2020 coverage.

The average number of applications is up just 1.2% for consumers who are new to HealthCare.gov, but it’s up 44% for consumers who are renewing their coverage.

Resources

• A copy of the first CMS HealthCare.gov 2021 open enrollment period snapshot report is available here.
• An individual major medical open enrollment period preview article is available here.

The HealthCare.gov numbers are up even though two states, New Jersey and Pennsylvania, have shifted to using their own, locally run exchange programs. New Jersey and Pennsylvania accounted for about 7% of HealthCare.gov’s 2020 application volume, according to HealthCare.gov data.

HealthCare.gov is now providing Affordable Care Act exchange intake and account administration services for 36 states.

In addition to New Jersey and Pennsylvania, the list of jurisdictions with locally run ACA exchange programs includes California, Colorado, Connecticut, Idaho, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Vermont, Washington state and the District of Columbia.

Open Enrollment Period Basics

The Democrats who wrote the Affordable Care Act hoped to make the commercial health insurance market by using subsidies and the ACA exchange system to make it easier for people to get covered.

Originally, ACA drafters hoped that states would all run their own exchange programs.

The U.S. Department of Health and Human Services set up HealthCare.gov to provide exchange services for states that were unwilling or unable to set up exchange programs. It put its Centers for Medicare and Medicaid Services arm in charge of running ACA commercial health insurance rules and programs, including HealthCare.gov.

In states that use HealthCare.gov, the open enrollment period for 2021 coverage started Nov. 1 and is set to run until Dec. 15.

Insurance regulators, exchange program managers and health insurers designed the open enrollment period system, or limits on when people can get individual and family coverage, to try to push younger, healthy people to pay for coverage even when they feel healthy, instead of waiting until they’re in the hospital to pay premiums

To buy coverage outside of the open enrollment period, consumers must show they qualify for a special enrollment period, due to unusual circumstances, such as marriage, a move to a new community, or the loss of employer-sponsored coverage.

The theory is that consumers who understand the rules will buy coverage during the open enrollment period and pay to keep the coverage in force, to avoid the risk of being stuck with big health problems and no access to health coverage outside of the open enrollment period.

This year, most states with their own, locally run exchange programs eased the open enrollment period calendar in response to the COVID-19 pandemic.

HealthCare.gov states are stuck with the original enrollment period calendar timeline.

Web Brokers

HealthCare.gov managers say the enrollment snapshot figures for the first week of the enrollment period for 2021 coverage include applications flowing in through web brokers that use the HealthCare.gov enhanced direct enrollment (EDE) system.

The EDE system gives a web broker the ability to enroll a consumer on what looks like the web broker’s own site, without handing the consumer off to HealthCar.gov.

HealthCare.gov managers have not broken out EDE application volume separately in the first snapshot period of the new open enrollment period.

About  year ago, HealthCare.gov managers said about half of the exchange program’s applicants were coming in through agents and brokers.

Health Sherpa, a web broker that serves retail agents and brokers, said on its website that it’s now running ads from health insurers on its website because carriers are eager to reach retail producers.

“Most projections indicate that OE2021 will be an explosive growth year for the ACA,” according to Health Sherpa.

— Read ACA Exchange System Keeps Growing in Its Core States, on ThinkAdvisor.

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