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ACA marketplace enrollment is up 13% nationally in 2023; 19% in the 33 states using the federal exchange, HealthCare.gov states; 23% in states that have not expanded Medicaid (all of which use HealthCare.gov), and 32% in Texas. Who’s buying in? In advance of the detailed enrollment data that CMS typically releases in spring, I spoke to health insurance brokers based in Texas and New Jersey.
High-income enrollees entering the marketplace
I touched base first with Dallas-area health insurance broker Jenny Hogue, president and CEO of KG Health Insurance, who had noted on Twitter in late 2021 that a number of higher-income people who had been priced out of the ACA marketplace before the American Rescue Plan Act removed the income cap on subsidy eligibility were buying in. Jenny’s perceptions were borne out by 2022 enrollment data, which showed enrollment at income over 400% FPL had more than doubled year-over-year in HealthCare.gov states, including Texas. I wanted to know if the surge was continuing this year.
