This is the time of year we receive updates on open enrollment numbers for the individual market. To our knowledge, New York is the only state marketplace that remains open. According to an article in the New York Times on January 26th, Record Numbers Sign Up for Health Insurance via Affordable Care Act, (link here) 21.3 million people enrolled in individual plans during the open enrollment season. This is an important milestone since it marks ten years of Affordable Care Act plans being offered to individuals. 

There are several points the article makes but I’d like to first emphasize a point the article neglects to make. Early on the article describes a woman choosing a plan in Wisconsin with a navigator who helped her sort through “roughly 110 plans.” I then researched how many insurers offered products on the Wisconsin exchange to find that fourteen do. That is more than California at eleven and on par with Texas and Florida, states which also have much larger populations than Wisconsin. 

Having to choose among 110 plans is madness. We believe that Marketplace Executives and their Boards of Directors, State Insurance Departments, and the federal government should reverse course and find a way to limit the number of coverage options. The endless addition of complexity and cost makes no public policy sense and doesn’t add value. 

We see the same problem with Medicare with too many supplement options and often too many supplement carriers, and Medicare Advantage and Medicare drug plan products. And to help people sort through their 25 or 30 Advantage Plan or drug plan choices, a star rating system has been added to create yet another layer of bureaucracy. We’d like to applaud the state of Massachusetts which historically offered two Medicare supplement options and that’s enough.

Nevertheless, since we have to work in the real world, let me summarize the article’s contents.

1) Some of the bulge in enrollment is due to the requirement that states renew Medicaid eligibility which was suspended during the official public health pandemic emergency. As a result, many have lost their Medicaid eligibility and turned to the Marketplace.

2) Enrollment is tremendously helped by funding navigators which was done under the Obama administration, cut by the Trump administration, and then funded more generously again under the Biden administration. 

3) The Affordable Care Act expanded subsidies under the current administration have helped low-income people in states that have chosen to not expand Medicaid like Texas, Georgia, and Florida. 

We at Healthcare Navigation have little influence on healthcare policy but wish we did! Thanks for reading.