In the next week or so, Health and Human Service should release its report on ACA's annual effectuated enrollment. These data will tell us how many of the 20M marketplace signups went through with paying their premiums. The report also provides detailed information about sign-ups by state, premiums and average APTC and CSR payments.
In the meantime, our model relies on 2022 APTC payments and premiums. As of February 29, we estimate that 18.5M people have enrolled in ACA Marketplace plans, an all time high. Marketplace enrollment gains are of particular interest in Florida and Texas. These two states have declined to expand Medicaid under the Affordable Care Act and continue to be under pressure from the White House to do so.
Unlike in years past when ACA Marketplace enrollment was meager due to policy limitations, Medicaid enrollment holds less allure for providers. The argument of "its better than nothing" does not hold up when commercial enrollment via Marketplace plans is robust. Marketplace PMPM is better than Medicaid and a lot less fraught with politics so carriers have some reason to agree with providers.
Of course, political pressure and market economics are two different things.
Emily Evans
Managing Director – Health Policy
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