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exchange-map1Data released by the Department of Health and Human Services earlier this month confirm what everyone has been assuming for the last few weeks:

The number of people who have completed the process of signing up for insurance through federal or state-based Marketplaces has fallen far short of officials’ hopes. Yet enrollment figures are considerably better than some had feared given the tumultuous launch of healthcare.gov.

Between October 1 and November 2:

  • More than 846,000 applications were completed via the Marketplace, for coverage of 1.5 million individuals.
  • Of the 1.5 million people who applied for coverage, 1.1 million (72 percent) were eligible for Marketplace plan enrollment.
  • Of the 1.1 million people who were found to be eligible for Marketplace coverage, just one in every ten (106,185) have selected a plan.
  • Nearly 400,000 people were found to be eligible for Medicaid or CHIP.

The data also reveal significant differences between states who have established their own Marketplaces and those relying on the federally-run portal: 

  • Despite a slow start, 60 percent (519,561) of all completed applications were submitted through the federal Marketplace accounting for two-thirds (993,635) of all individuals seeking coverage.
  • The percent of Marketplace eligible applicants who have selected a plan is more than five times higher in state-run Marketplaces (21 percent, 79,391) than in states relying on the federally-run Marketplace (4 percent, 26,794). 
  • Three-quarters (79,391) of those who have selected coverage applied in states that had implemented their own Marketplaces.The HHS figures also include state-by-state data. In North Carolina:
  • Seventy-three percent (42,110)of people who applyed for coverage were eligible to enroll in a Marketplace plan.
  • Of those eligible for Marketplace coverage, 34 percent (15,051) qualified for federal subsidies.
  • More than 7,000 were found to be eligible for Medicaid or NC Health Choice
  • Just 2 percent (1,662) of those eligible for Marketplace coverage have selected a plan.

The new enrollment figures illuminate the perils and potential upsides of the federal Marketplace. Although the bulk of applications were submitted through the federal Marketplace, 96 percent of those who were found to be eligible for coverage have yet to select a plan suggesting significant barriers in getting people across the finish line. Regardless of demand, if the website continues to flounder enrollment will likely remain low. 

But therein lies the good news. If the website is improved, we can anticipate a surge of enrollment in December as more people are able to successfully select affordable health care coverage options.

The Washington Post prepared a graphic of which states established state-run Marketplaces, and which are using the federally-facilitated website. Coincidentally, states that are successfully enrolling applicants in Marketplace insurance have set up their own online portals.

Read the Health Insurance Marketplace: November Enrollment Report here.

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