Individual Health Sales Season (Mostly) Ends

The ordinary individual major medical insurance sales season ended Monday, sort of, in most of the United States.

HealthCare.gov closed for open enrollment period sales Jan. 15.

Most of the locally run “web-based supermarkets for health insurance” pulled up their welcome mats Jan. 15. Some locally run exchange programs, such as the exchange programs operated by Rhode Island and the District of Columbia, rolled down their open enrollment period shutters Monday.

But some of the highest-population states have fuzzed the final enrollment picture by extending their individual health enrollment periods even past Jan. 31.

In New York, for example, NY State of Health is keeping the open enrollment period lights on until at least March 31.

What It Means

Agents and brokers now have a better chance to sell “gap-filler” health insurance products, such as short-term health insurance, in most states.

They also have a better chance to attract consumers with special situations, such as moves to new communities, that qualify them to apply for coverage through special enrollment period applications. In some cases, however, carriers avoid paying commissions for special enrollment period signups, because of concerns that enrollees who come in through special enrollment period applications will have higher claim costs than other enrollees.

The Basics

The Affordable Care Act public exchange system gives people way to use income-based federal subsidies to pay for individual health coverage from private health insurers.

Health insurance regulators created the enrollment period calendar, or limits when people can buy individual health coverage without showing that they have a good reason to be shopping for health coverage, to shield health insurers from some of the effects of the ACA ban on medical underwriting. The idea is that enrollment period limits will push some young, healthy people to pay for coverage even when they feel great, to reduce the odds that they’ll be stuck with a broken leg and no way to buy health coverage at some other time of the year.

The Numbers

The Centers for Medicare and Medicaid Services reported recently that, as of Jan. 15, it had recorded a total of 14.5 million ACA exchange plan signups, or about 14% of the 169 million U.S. residents under age 65 who have private health coverage.

That was up 19% from the total for 2021 exchange plan coverage, and up 36% from the total for 2020, which was the last ACA exchange plan coverage year that was completely under the management of the administration of former President Donald Trump.

HealthCare.gov increased its plan signup count to 10.3 million, from 8.3 million as of Dec. 21, 2020, when the original open enrollment period for 2021 coverage ended.

The preliminary signup counts available from the locally run exchanges have increased 9.2%, to 4.2 million.

The 2021 and 2022 coverage year figures are not directly comparable because of the effects of extended special enrollment period rules on final 2021 coverage year signup counts, and because of the effect of the current enrollment period extensions on the 2022 coverage year totals.

The Broker Numbers

The ACA exchange system gets about half of its enrollees from traditional agents, traditional brokers and web brokers.

HealthSherpa, a company that helps agents and brokers with the ACA exchange plan signup process, says it has helped at least 3 million people get covered this year.

Their median gross premium was $733, and their median net premium payment, after federal premium subsidies were applied, was $21.

About 30% of the enrollees signed up for plans without having to pay for any cash for premiums out of pocket.

More Numbers

For a look at what has happened, so far, to signup counts in the three biggest ACA exchange markets, see the gallery above.

For data for all 50 states and the District of Columbia, see the chart below.

Affordable Care Act Public Exchange Signups

..
..
Individuals Signed Up for Coverage
..

Jurisdiction
Exchange Runner
2019
2020
2021
2022 (as of Jan. 15)
Signup Change, between 2021 and Jan. 15, 2022

Alabama
HealthCare.gov
136,832
144,225
178,931
219,314
+22.6%

Alaska
HealthCare.gov
14,985
15,467
18,230
22,786
+25.0%

Arizona
HealthCare.gov
133,377
136,278
157,996
199,706
+26.4%

Arkansas
HealthCare.gov
56,139
58,392
67,403
88,226
+30.9%

California
Local
1,343,855
1,559,133
1,629,883
1,781,491
+9.3%

Colorado
Local
140,330
157,464
166,850
197,516
+18.4%

Connecticut
Local
94,904
98,498
98,960
112,633
+13.8%

Delaware
HealthCare.gov
19,285
23,099
25,936
32,113
+23.8%

District of Columbia
Local
15,961
17,133
15,952
15,926
-0.2%

Florida
HealthCare.gov
1,537,445
1,842,474
2,248,336
2,723,094
+21.1%

Georgia
HealthCare.gov
364,828
424,280
549,066
701,135
+27.7%

Hawaii
HealthCare.gov
16,580
18,526
20,033
22,327
+11.5%

Idaho
Local
84,986
67,710
67,388
73,359
+8.9%

Illinois
HealthCare.gov
258,472
261,401
277,642
323,427
+16.5%

Indiana
HealthCare.gov
128,024
129,117
130,406
156,926
+20.3%

Iowa
HealthCare.gov
46,238
52,801
59,482
72,240
+21.4%

Kansas
HealthCare.gov
76,642
77,520
90,852
107,784
+18.6%

Kentucky
Local
71,134
72,150
76,105
73,490
-3.4%

Louisiana
HealthCare.gov
76,784
76,701
82,316
99,626
+21.0%

Maine
Local
58,875
56,695
56,834
66,095
+16.3%

Maryland
Local
133,065
151,354
161,971
181,603
+12.1%

Massachusetts
Local
288,221
295,638
259,743
263,063
+1.3%

Michigan
HealthCare.gov
231,516
237,598
258,393
303,550
+17.5%

Minnesota
Local
98,818
106,665
106,647
121,322
+13.8%

Mississippi
HealthCare.gov
72,498
90,207
108,978
143,014
+31.2%

Missouri
HealthCare.gov
177,128
187,326
220,162
250,341
+13.7%

Montana
HealthCare.gov
39,098
40,356
43,794
51,134
+16.8%

Nebraska
HealthCare.gov
80,832
85,819
87,257
99,011
+13.5%

Nevada
Local
65,614
74,108
84,559
101,411
+19.9%

New Hampshire
HealthCare.gov
38,746
41,268
46,552
52,497
+12.8%

New Jersey
Local
209,237
217,374
270,573
311,692
+15.2%

New Mexico
Local
36,765
36,902
40,871
45,664
+11.7%

New York
Local
249,217
243,548
213,776
219,215
+2.5%

North Carolina
HealthCare.gov
422,685
461,322
548,420
670,223
+22.2%

North Dakota
HealthCare.gov
19,629
20,333
24,482
29,873
+22.0%

Ohio
HealthCare.gov
169,855
175,793
201,728
259,999
+28.9%

Oklahoma
HealthCare.gov
136,917
146,779
174,520
189,444
+8.6%

Oregon
HealthCare.gov
125,052
128,061
130,205
146,602
+12.6%

Pennsylvania
Local
297,296
292,331
328,366
374,776
+14.1%

Rhode Island
Local
33,079
32,925
32,403
31,343
-3.3%

South Carolina
HealthCare.gov
176,298
190,291
238,175
300,392
+26.1%

South Dakota
HealthCare.gov
26,388
28,531
33,504
41,339
+23.4%

Tennessee
HealthCare.gov
169,733
181,225
218,896
273,680
+25.0%

Texas
HealthCare.gov
885,754
1,026,498
1,406,841
1,840,947
+30.9%

Utah
HealthCare.gov
177,134
186,237
214,690
256,932
+19.7%

Vermont
Local
25,679
24,651
24,126
26,705
+10.7%

Virginia
HealthCare.gov
242,101
234,032
258,789
307,946
+19.0%

Washington
Local
192,680
197,532
210,535
239,566
+13.8%

West Virginia
HealthCare.gov
18,300
17,734
17,788
23,037
+29.5%

Wisconsin
HealthCare.gov
177,245
177,474
186,068
212,209
+14.0%

Wyoming
HealthCare.gov
21,962
23,112
27,980
34,762
+24.2%

TOTAL
..
9,714,218
10,642,088
12,199,393
14,492,506
..

MEDIAN
..
..
..
..
..
17.5%

Source: Centers for Medicare and Medicaid Services

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(Image: Igor Negovelov/AdobeStock)