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March 11, 2016 12:00 AM

Vast majority of ACA enrollees still receiving subsidies

Bob Herman
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    Nearly 12.7 million Americans selected or re-enrolled in health coverage on the Affordable Care Act's state and federal marketplaces, according to new HHS data (PDF) released Friday. The data confirm the initial estimates after open enrollment closed Jan. 31.

    Most people qualified for financial assistance to help pay down the costs of coverage, a key pillar of President Barack Obama's healthcare reform law.

    The federal government also said that as of Dec. 31, the ACA's marketplaces had 8.8 million paying members. The Obama administration expects that of the 12.7 million current exchange enrollees, there will be 10 million consumers routinely paying their monthly premiums by the end of this year.

    Indeed, the 12.7 million people with exchange coverage will winnow down throughout the year as people drop coverage or gain insurance through other means, such as a job or Medicaid. But a drop likely won't be too steep since the CMS has already factored in many plan cancellations.

    HHS parsed out different data points in its latest release, showing that, for example, 39% of the 12.7 million ACA enrollees were new to the marketplaces. Approximately 28% were between the ages of 18 and 34, the highly coveted group of young adults and millennials who, because they are often healthier than their elders, help offset the costs of older, sicker people.

    Most enrollees have low or moderate incomes, a recurring theme in the third year of the ACA's exchanges. Nearly 83%, or 10.5 million of the 12.7 million exchange members, received the law's premium subsidies, according to HHS.

    The percentage of people who received premium and cost-sharing subsidies varied greatly among states. People who make between 100% and 400% of the federal poverty level are eligible for the premium subsidies to lower monthly payments. Those who earn between 100% and 250% of poverty and selected a silver-level plan receive the cost-sharing subsidies, which reduce out-of-pocket costs like deductibles and copays.

    Not surprisingly, states with high levels of poverty had more people who qualified for subsidies. In Mississippi, almost 96% of paying enrollees received the premium tax credits as of Dec. 31. That number dropped only slightly, to 90%, when accounting for people who had coverage as of Feb. 1. More than 3 out of 4 Mississippi residents also received cost-sharing subsidies as of Dec. 31.

    Only 9% of people living in the high-cost Washington, D.C. area received premium subsidies as of Dec. 31.

    Democratic presidential candidate Hillary Clinton has touted the ACA's insurance gains. But Vermont Sen. Bernie Sanders, who also is vying for the Democratic nomination, said recently that although more Americans have health insurance, their coverage isn't that comprehensive because of “outrageously high” deductibles and premiums.

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