Charles Gaba
A
thread 1/27
🎉 BREAKING: Happy 14th Anniversary to the #ACA !

Data Wonks Rejoice: Let's dig into the official 2024 Open Enrollment Period Public Use Files!

https://acasignups.net/24/...
09:10 AM - Mar 22, 2024
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Charles Gaba
A
thread 2/27
(It's Part 2 since CMS hasn't sent the formal press release out yet...)

Let's dig in!

Final, TOTAL 2024 #ACA Open Enrollment Period plan selections: 21,446,150 people!

That's up 31.1% over last year! 6.4% of the U.S. population is now enrolled in ACA exchange plans.
09:20 AM - Mar 22, 2024
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Charles Gaba
A
thread 3/27
Overall BHP enollment (MN/NY only) is up 6.9% y/y; when combined w/QHP enrollees, that's 22.76 million enrollees nationally!

Federal exchange state enrollment is up 38%; state-based exchange enrollment is up 13% y/y.
09:26 AM - Mar 22, 2024
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Charles Gaba
A
thread 4/27
Medicaid expansion state enrollment up 23%; NON-expansion state enrollment up 40%

WEST VIRGINIA up a stunning 80%

LA, OH, IN, TN, MS, AR all up 50% or more

TEXAS up 45%, adding over 1 million people this year!

Over 4.2M Floridians now enrolled...18.6% of the total population!
09:33 AM - Mar 22, 2024
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Charles Gaba
A
thread 5/27
In addition to Texas, 11 other states added 100K or more enrollees this year: FL, GA, NC, TN, SC, OH, AL, AZ, IN, MS & MO

MAINE is the only state to have a net enrollment *drop* (802 fewer, down 1.3%)...but even that was due to a "mini-expansion" of Medicaid to young adults.
09:35 AM - Mar 22, 2024
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Charles Gaba
A
thread 6/27
NEXT UP: New enrollment vs. Renewing enrollees...

https://acasignups.net/24/...
09:51 AM - Mar 22, 2024
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Charles Gaba
A
thread 7/27
Nationally, 24% of all #ACA exchange enrollees were NEW this year (up from 23% last year). The other 76% are 2023 enrollees who actively or passively re-enrolled.

Lowest % of new enrollees: NY (13%)
Highest % of new enrollees: WV (34%)
09:54 AM - Mar 22, 2024
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Charles Gaba
A
thread 8/27
There continues to be a huge divide between the states hosted by HCgov and those operating their own ACA exchanges when it comes to renewals: 70% of HCgov renewals were ACTIVE (ie, the enrollees actively did so), but only 28% of state-based exchange enrollees did so. Huh.
09:57 AM - Mar 22, 2024
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Charles Gaba
A
thread 9/27
NEXT UP: PREMIUMS, APTC SUBSIDIES & CSR ASSISTANCE!

https://acasignups.net/24/...
09:58 AM - Mar 22, 2024
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Charles Gaba
A
thread 10/27
--NATIONALLY, average full-price #ACA premiums are $605/mo per enrollee this year...exactly the same as last year!

(2024 premiums were projected to be 6% higher, but that assumes a static enrollment pool who remain in the same policies each year, which of course never happens)
10:04 AM - Mar 22, 2024
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Charles Gaba
A
thread 11/27
LOWEST avg. premiums: NEW HAMPSHIRE ($453/mo)

HIGHEST avg. premiums: WEST VIRGINIA ($1,119/mo, which is actually *down* $55/mo y/y)

92% of enrollees are receiving financial aid (which will plummet if the upgraded subsidies of the #IRA are allowed to expire at the end of 2025)
10:08 AM - Mar 22, 2024
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Charles Gaba
A
thread 12/27
Lowest APTC (premium tax credit) uptake: DC (because residents earning up to 210% FPL are eligible for Medicaid there)

Highest APTC uptake: Mississippi, where OVER 98% OF #ACA ENROLLEES receive financial aid.

Reminder: House Republicans are AGAIN planning on gutting the ACA.
10:13 AM - Mar 22, 2024
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Charles Gaba
A
thread 13/27
In addition to 92% of enrollees receiving help w/premiums, 50% also receive COST SHARING REDUCTION help (ie, reduced deductibles, co-pays & coinsurance).

This ranges from 2.6% in DC (again, special case) to over 71% in (again) MISSISSIPPI...

...and 80% in MASSACHUSETTS (???)
10:17 AM - Mar 22, 2024
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Charles Gaba
A
thread 14/27
80% getting CSR in Massachusetts makes no sense (it was 57% last year) unless I'm missing something. They did upgrade their ConnectorCare program this year, which includes additional CSR help, but that's *state* funding, not federal...it shouldn't be listed as CSR by CMS...
10:20 AM - Mar 22, 2024
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Charles Gaba
A
thread 15/27
NEXT UP: AGE, GENDER, RACE/ETHNICITY & URBAN/RURAL STATUS:

https://acasignups.net/24/...
10:25 AM - Mar 22, 2024
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Charles Gaba
A
thread 16/27
1.7% of ACA enrollees are 65+.

Lowest % under 18: AL & NY (3.3% each)

Highest % under 18: Utah (28.4%)

Lowest % under 35: Hawaii (25.4%)

Highest % under 35: Utah (58.4%)

50% of enrollees have an unknown racial category so that's not very helpful.

DENTAL plans up 12% y/y
10:32 AM - Mar 22, 2024
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Charles Gaba
A
thread 17/27
NEXT UP: METAL LEVELS!

https://acasignups.net/24/...
10:37 AM - Mar 22, 2024
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Charles Gaba
A
thread 18/27
--Catastrophic plans aren't available in 10 states and Platinum plans aren't available in 34 of them...and even where available they make up less than 1% of all enrollment combined, which is why you almost never hear healthcare wonks talk about them.
10:41 AM - Mar 22, 2024
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Charles Gaba
A
thread 19/27
BRONZE: 31.2% of enrollees
SILVER: 54.4%
GOLD: 13.5%...which I'm happy to see is *up* from 11.9% last year.

Highest Gold uptake: NEW MEXICO (71.8%)
Lowest Gold uptake: MISSISSIPPI (1.1%)
10:44 AM - Mar 22, 2024
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Charles Gaba
A
thread 20/27
STILL WORKING ON PART 7...check back soon...

In the meantime, if you'd like to support my work at ACA Signups, you can do so here, thank you!

https://www.paypal.com/don...
11:00 AM - Mar 22, 2024
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Charles Gaba
A
thread 21/27
📣 UPDATE: 2 1/2 hours AFTER I posted my deep dive analysis of the 2024 #ACA Open Enrollment Period data, HHSGov / CMSGov sent out the actual press release about it!
#ACAHereToStay

https://acasignups.net/24/...
12:12 PM - Mar 22, 2024
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Charles Gaba
A
thread 22/27
📣 UPDATE: I've finally added Part 7: Enrollment by HOUSEHOLD INCOME BRACKETS!

https://acasignups.net/24/...
09:14 PM - Mar 22, 2024
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Charles Gaba
A
thread 23/27
--Over 1/3 of all #ACA exchange enrollees earn less than 138% FPL. Some of these are recent *documented* immigrants who aren't eligible for Medicaid but *are* eligible for ACA enrollment/subsidies)...

...but most of them are U.S. citizens who live in NON-MEDICAID EXPANSION STATES.
09:18 PM - Mar 22, 2024
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Charles Gaba
A
thread 24/27
In fact, if all 10 of the remaining states were to finally expand Medicaid under the #ACA all at once, nearly 6 MILLION current exchange enrollees would be transferred over to Medicaid instead...including over 4.2 million in Florida & Texas alone!
09:20 PM - Mar 22, 2024
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Charles Gaba
A
thread 25/27
~13 million ACA enrollees earn between 100 - 200% FPL. Pretty much *all* of them (w/rare exceptions) SHOULD be enrolled in SILVER CSR plans, but at least a few million aren't.

If you're in this income range & don't choose Silver CSR, you're likely leaving money on the table!
09:25 PM - Mar 22, 2024
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Charles Gaba
A
thread 26/27
Another 7.1 million #ACA enrollees (another 1/3 of the total) earn more than 200% FPL. Of these, around 1.5 million earn more than 400% FPL. And another ~850K have unknown incomes.
09:28 PM - Mar 22, 2024
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Charles Gaba
A
thread 27/27
Oh yeah...I'll be writing up a more formal post about this soon as well, but here's the breakout of how much different ACA enrollee income groups are saving on premiums thanks to the subsidy upgrade of the #IRA .

It's set to expire at the end of 2025.

If that happens...ouch.
09:35 PM - Mar 22, 2024
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