The decrease in enrollment between 2016 and 2017 occurred largely among people who enrolled without Advance Payment Tax Credits (APTCs) with the average monthly non-APTC enrollment declining by 1.3 million (20 percent) compared to a decrease of only 223,000 (3 percent) APTC subsidized enrollees. Arizona’s enrollment losses tops in the nation.
The Centers for Medicare and Medicaid Services (CMS) reported that Arizona saw a 73 percent decline (highest in the nation) in non-APTC enrollment in ACA plans in 2017.
The report also included changes in Arizona’s APTC and non-APTC average monthly enrollment that showed the two populations enrollment totals neck in neck from 2014 through 2016 until a significant enrollment divide surfaces in 2017.
In 2017, average monthly premiums increased by 21 percent, compared to a 7 percent increase in 2016 and a 2 percent increase in 2015.
The four other states reporting significant declines in non-APTC enrollment were: Oklahoma (-60 percent), Minnesota (-53 percent), Tennessee (-49 percent), and Nebraska (-47 percent).
According to the CMS report, since 2014, the gap between subsidized ACA enrollees and non-subsidized has increased from 23 percent to 61 percent in 2017.
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The CMS provided the following highlights to its report.
- Average monthly enrollment in individual market plans decreased by 10 percent between 2016 and 2017 at the same time premiums increased by 21 percent.
- Most of the decrease in enrollment between 2016 and 2017 occurred among people who did not receive APTC subsidies. Non-APTC enrollment declined by 20 percent, compared to a 3 percent decline in APTC subsidized enrollment.
- Since 2014, average monthly enrollment in the APTC subsidized portion of the market has diverged considerably from the non-APTC market. The APTC subsidized portion of the market was 61 percent larger than the non-APTC portion in 2017, up from 23 percent larger in 2014.
- Reviewing state-level data shows that 10 states experienced declining individual market enrollment between 2015 and 2016. From 2016 to 2017, 44 states experienced declining enrollment.
- Declining enrollment between 2015 and 2016 was more widespread in the nonAPTC portion of state markets. Over that period, 23 states experienced a decline in non-APTC enrollment, with 10 states experiencing double-digit percentage declines.
- The decline in the non-APTC portion of state markets grew larger and more widespread between 2016 and 2017. Non-APTC enrollment declined in 43 states, with six states losing over 40 percent of their non-APTC enrollment.
CMS released two additional reports to provide an update on the current status of the federal and state-based health insurance exchanges and the individual health insurance markets.