In 2018, ACA marketplace enrollment dropped 5% in the 39 states using the HeathCare.gov and 4% nationally. The more detailed data that CMS compiles for the HealthCare.gov states (accounting for three quarters of all enrollees) show that enrollment dropped most sharply at the lowest income levels -- where, thanks to Cost Sharing Reduction (CSR) subsidies, the most comprehensive coverage is available.*
Here's the breakdown of enrollment by income level in 2018 vs. 2017** on HealthCare.gov.
Enrollment by Income Level on HealthCare.gov, 2018 vs. 2017
* "Other FPL" is comprised mostly of unsubsidized enrollees. About one quarter are likely enrollees with incomes under 100% FPL, most of whom are likely legally present noncitizens time-barred from Medicaid, who are subsidy-eligible.
Why was enrollment down sharply at 100-200% FPL, down modestly from 201-300% FPL, and up at 300-400% FPL? The higher the income, the more definite the answers.
Here's the breakdown of enrollment by income level in 2018 vs. 2017** on HealthCare.gov.
Enrollment by Income Level on HealthCare.gov, 2018 vs. 2017
Total enrollment
|
100% to 150% FPL
|
150% to 200% FPL
|
200% to 250% FPL
|
250% to 300% FPL
|
300%- 400% FPL
|
Other FPL*
| |
2018
|
8,743,642
|
2,979,236
|
1,885,778
|
1,277,488
|
747,165
|
867,198
|
986,777
|
2017
|
9,201,805
|
3,208,242
|
2,050,555
|
1,312,520
|
752,403
|
786,678
|
1,091,407
|
2018 as % 2017
|
95.0%
|
92.9%
|
92.0%
|
97.3%
|
99.3%
|
110.2%
|
90.4%
|
Why was enrollment down sharply at 100-200% FPL, down modestly from 201-300% FPL, and up at 300-400% FPL? The higher the income, the more definite the answers.
