CMS: Enrollment in individual health market has declined each year since 2016
The most recent data shows that average monthly enrollment across the individual market decreased by 3% between 2018 and 2019.
Average monthly enrollment in the individual health market has declined each year since its peak of 14.5 million in 2016, according to a new report from the Centers for Medicare & Medicaid Services.
Related: Expanding subsidies for the ACA marketplace: Yay or nay?
The report provides data on individual health insurance market enrollment trends for people who purchase health insurance with and without advanced premium tax credits. Among the key findings:
- From plan years 2016 to 2019, unsubsidized enrollment declined by 2.8 million people, representing a 45% drop nationally. At the state level, the percentage change in unsubsidized enrollment over this period ranged from a 4% drop in Rhode Island to a 90% drop in Iowa.
- The most recent year of enrollment data shows that average monthly enrollment across the individual market nationally decreased by 3% between 2018 and 2019.
- 80% of the decrease in enrollment between 2018 and 2019 occurred among people who did not receive APTC subsidies. Unsubsidized enrollment declined by 9%, compared to only a 1% decrease in subsidized enrollment, from 2018 to 2019.
“While premiums have stabilized, middle-class Americans can’t afford Obamacare’s expensive premiums,” said CMS Administrator Seema Verma in a statement.
Although unsubsidized enrollment continued to decline in 2019, the rate of decline was substantially lower than the 24% drop in 2018 and the 20A% drop in 2017. This lower rate of decline occurred as premium rates leveled off in 2019, after increasing by double digits in 2017 and 2018.
Looking at state-level enrollment trends between 2016 and 2019 also shows the link between enrollment and premium trends. States with larger declines in unsubsidized enrollment tended to experience a larger increase in average premiums.
Review of state-level data also shows that trends in declining enrollment began from 2015 to 2016 for 10 states. Declining enrollment occurred in 44 states from 2016 to 2017; 43 states from 2017 to 2018; and 39 states from 2018 to 2019.
Average monthly enrollment in the subsidized portion of the market grew substantially in comparison to the unsubsidized market. The subsidized portion of the market was 140% larger than the unsubsidized portion in 2019, up from 122% larger in 2018 and 61% in 2017.
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