Utah Health Policy Project Sustainable healthcare solutions for underserved Utahns

ACA Enrollment Update for Utah A Policy Memo for Utah Media

MEDIA 2/2016

Utah’s ACA sign-ups exceeded 175,000 in 2016

Sources: State-Level Data From from the ASPE January Health Insurance Marketplace Enrollment Report For The 2016 Open Enrollment Period; ; March 31, 2015 Effectuated Enrollment Snapshot; 15-06-02; http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-06-02.html HHS/CMS Health Insurance Marketplace; ASPE Issue Briefs: October 1, 2013 –April 19, 2014; November 15, 2014 – January 16, 2015; HHS News Release, “In Utah, 124,142 people are signed up for coverage through the Health Insurance Marketplaces,” 2/11/15 HHS News Release, “In Utah, 140,221 people are signed up for coverage through the Health Insurance Marketplaces,” 2/18/15 ASPE Issue Brief (3/10/15); http://aspe.hhs.gov/health/reports/2015/MarketPlaceEnrollment/Mar2015/ib_2015mar_enrollment.pdf Marketplace Plan Selection by Age in States Using the HealthCare.gov Platform, By State (1); 11-15-14 to 2-15-15 (including SEP activity through 2-22-15); Health Insurance Marketplace Open Enrollment Snapshot - Week 11; January 10, 2016 - January 16, 2016; Released: 1/20/16; Health Insurance Marketplace Open Enrollment Snapshot - Week 13 January 24, 2016-February 1, 2016; https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-02-04.html

175,637

-

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

200,000

Utah and Washington counties continue to lead ACA sign-ups in Utah

Sources: [OE2] Plan Selections by ZIP Code in the Health Insurance Marketplace (November 15, 2014 thru February 22, 2015) http://aspe.hhs.gov/health/reports/2015/MarketPlace-Enrollment/EnrollmentByZip/rpt_EnrollmentByZip_Apr2015.cfm [OE3] Plan Selections by ZIP Code in the Health Insurance Marketplace: (November 1, 2015 thru January 9, 2016) https://aspe.hhs.gov/basic-report/plan-selections-zip-code-health-insurance-marketplace-january-2016

County Open Enrollment #3 (1/9/16)

% change since Open Enrollment #2 (2/22/15)

Salt Lake 52,360 7.10% Utah 32,987 17.30% Davis 14,263 9.80%

Weber 9,753 5.20% Washington 10,437 12.40%

Cache 5,672 8.00% Tooele 2,086 4.40%

Box Elder 2,023 9.40% Iron 2,380 12.20%

Summit 3,034 13.30% Uintah 1,039 7.10%

Sanpete 1,272 7.40% Wasatch 2,118 5.70% Carbon 638 -2.60% Grand 904 -12.10%

In 2016, 13 of Utah’s top 20 ZIP codes for ACA enrollment were outside of Salt Lake

County

Source: 2016 Health Insurance Marketplace Plan Selections by ZIP Code; (Nov. 1, 2015 — Jan. 9, 2016); https://aspe.hhs.gov/basic-report/plan-selections-zip-code-health-insurance-marketplace-january-2016

RANK CITY SELECTIONS % INCREASE 1 Lehi (84043) 3,501 19% 2 South Jordan (84095) 3,346 12% 3 American Fork (84003) 2,948 17% 4 Pleasant Grove (84062) 2,931 20% 5 St. George (84790) 2,829 10% 6 St. George (84770) 2,742 11% 7 Draper (84020) 2,624 13% 8 Bountiful (84010) 2,455 5% 9 Spanish Fork (84660) 2,377 24%

10 West Valley City (84119) 2,368 3% 11 West Valley City (84120) 2,345 13% 12 Provo (84604) 2,289 22% 13 Herriman (84096) 2,276 20% 14 Clearfield (84015) 2,258 3% 15 Riverton (84065) 2,255 23% 16 Cottonwood Heights (84121) 2,254 6% 17 Orem (84058) 2,196 24% 18 Orem (84057) 2,193 16% 19 Ogden (84404) 2,189 1% 20 Layton (84041) 2,110 12%

Enrollment by Age

Utah children are enrolling in ACA insurance at 2.67x the national average

Utah

U.S.

24%

31% 16%

13%

16% Under 18

18-34

35-44

45-54

55-64

9%

26%

16% 21%

27% Under 18

18-34

35-44

45-54

55-64

Source: "State-Level Data From the ASPE January Health Insurance Marketplace Enrollment Report For The 2016 Open Enrollment Period; For the period: November 1, 2015 - December 26, 2015.“ https://aspe.hhs.gov/health-insurance-marketplaces-2016-open-enrollment-period-january-enrollment-report.

Premium subsidies make health insurance more affordable for many Utahns

Impact of subsidies on actual consumer costs

ACA enrollment by % poverty level

Source: Health Insurance Marketplaces 2016; Average Premiums After Advanced Premium Tax Credits in the 38 States Using the Healthcare.gov Eligibility and Enrollment Platform; Nov. 1-Dec. 26, 2015; Released 1/21/16

Source: "State-Level Data From the ASPE January Health Insurance Marketplace Enrollment Report For The 2016 Open Enrollment Period; For the period: November 1, 2015 - December 26, 2015.”

1%

33%

25%

21%

18% Under 100%

100% to 150%

150% to 200%

200% to 250%

250% to 400%

$189

$87

Consumer

Cost Subsidy

Amount

No subsidy

Received subsidy

Subsidy Status

85% of Utahns enrolling on healthcare.gov received a premium subsidy

No subsidy

Received subsidy

Utah

U.S.

Source: Health Insurance Marketplaces 2016; Average Premiums After Advanced Premium Tax Credits in the 38 States Using the Healthcare.gov Eligibility and Enrollment Platform; Nov. 1-Dec. 26, 2015; Released 1/21/16

85%

15%

83%

17%

Half of existing ACA consumers switched health plans in 2016

Origin of all consumers

Plan selection by re-enrolled consumers

Source: "State-Level Data From the ASPE January Health Insurance Marketplace Enrollment Report For The 2016 Open Enrollment Period; For the period: November 1, 2015 - December 26, 2015.”

Source: "State-Level Data From the ASPE January Health Insurance Marketplace Enrollment Report For The 2016 Open Enrollment Period; For the period: November 1, 2015 - December 26, 2015.”

70%

30%

51%

49%

Newly enrolled

Re-enrolled

Switched plan

Same plan

Sources: [2014] https://https://insurance.utah.gov/health/Health%20Refrom/ACA_Rate_Individual_20131007_OnExchange.pdf [2015] Utah – On Exchange Rates (accurate as of 10/15/14) https://insurance.utah.gov/health/Health%20Refrom/2015IndividualOnExchange20141016.pdf [2016] www.hea;thcare.gov; See Plans and Premiums (October 2015)

Altius Health Plans Arches BridgeSpan Humana Molina Healthcare Select Health

6 plans

26 plans

34 plans

24 plans

1 plan

Humana (6) Molina Healthcare (3) Select Health (60) University of Utah (5)

2015: 101 Plans 2016: 74 Plans

Altius Health Plans Arches BridgeSpan Humana Molina Healthcare Select Health

2014: 91 Plans

Gold

Silver

Bronze

Catastrophic

Platinum

5 plans

19 plans

27 plans

21 plans

2 plans

5 plans

29 plans

40 plans

27 plans

0 plans

2014-16 Individual Marketplace Comparison Salt Lake County

What are the penalties for remaining uninsured in 2016?

[Chart] Kaiser Family Foundation

$285 $975 $2,085 Max per family

$95/adult, $47.50/child

$325/adult $162.50/child

$695/adult $347.50/child

We Are Here

The Hernandez Family Income: $26,000 Residence: Salt Lake City, Utah Ages: Dad : 33 Mom: 29 Kids: 11, 7

Annual income: $26,000

% of poverty level: 109%

Monthly premium: $458

Subsidy pays: $410 per month

The Hernandez’s pay: $48 per month

Benchmark Silver Plan

Primary doctor: $5 Specialist doctor: $15 Emergency room care: $150 Generic drugs: $6

Plan Details

2016 rate change: + $4/month

Deductible: $1000 Out-of-pocket maximum: $1,500 Source: https://www.healthcare.gov/see-plans/; Image source: Moodboard

Annual income: $44,000

% of poverty level: 222%

Monthly premium: $537

Subsidy pays: $274 per month

The Shumways pay: $262 per month

Benchmark Silver Plan

Primary doctor: $35 Specialist doctor: $60 Emergency room care: $500 Generic drugs: $10

Plan Details

Deductible: $2,300 Out-of-pocket maximum: $10,900

2016 rate change: +$1/month

The Shumways Income: $44,000 Residence: American Fork, UT Ages: Dad : 24 Mom: 23 Kid: Newborn

Source: https://www.healthcare.gov/see-plans/

Mr. and Mrs. Smith Income: $42,000 Residence: Santa Clara, Utah Ages: 60, 62

Annual income: $42,000

% of poverty level: 267%

Monthly premium: $1,188

Subsidy pays: $865 per month

The Smiths pay: $323 per month

Benchmark Silver Plan

Primary doctor: $35 Specialist doctor: $60 Emergency room care: $600 Generic drugs: $10

Plan Details

Deductible: $2,500 Out-of-pocket maximum: $13,700

2016 rate change: + $13/month

Source: https://www.healthcare.gov/see-plans/; Image source: Moodboard

Annual income: $21,000

% of poverty level: 89%

Expected contribution: 100%

Monthly premium (for 2): $482

The Smith’s pay: $482

Subsidy pays $0

The Smith Family Income: $21,000 Residence: Orem, Utah Ages: Dad : 35 Mom: 33 Child: 7 Child: 11

No Subsidy

The Smith’s healthcare costs would be 27% of their total income

Who lives in the Coverage Gap?

Source: https://www.healthcare.gov/see-plans/; Image source: TVZ Design

Open Enrollment

Open Enrollment

Special Enrollment

2016

JANUARY 1 FEBRUARY 1 NOVEMBER 1

Open Enrollment ended January 31st

Next Open Enrollment: Nov. 1, 2016 -- Jan. 31, 2017

OCTOBER 31

Open Enrollment

Open Enrollment

Special Enrollment

2017

JANUARY 1 FEBRUARY 1 NOVEMBER 1 OCTOBER 31

After January 31st, you can’t sign up for health insurance unless you have one of these “qualifying life events…”

www.takecareutah.org | call 2-1-1

TCU’s trained counselors are ready to help you understand your new options to find affordable

health care coverage today

Where can Utahns find help applying for health insurance?