This issue brief from the U.S. Department of Health and Human Services’ Assistant Secretary for Planning and Evaluation (ASPE) estimates the number of Americans who are likely to enroll for health insurance for 2016 through the health insurance marketplaces established through the Affordable Care Act (ACA). ASPE estimates that between 9.4 and 11.4 million Americans will be covered by health insurance through the federal and state marketplaces for 2016. The third open enrollment period for the marketplaces begins on November 1, 2015 and ends on January 31, 2016.
ASPE’s estimate assumes that there were 9.1 million Americans enrolled through the marketplaces in 2015, with 10.5 million uninsured and 8.5 million with other types of coverage who would be eligible for coverage through the marketplaces. ASPE estimates that:
- between 7.3 and 8.8 million of the 9.1 million currently enrolled would re-enroll for 2016
- between 0.9 and 1.5 million of the 8.5 million who now have other types of coverage will “take-up” or enroll in the marketplaces
- between 2.8 and 3.9 million of the 10.5 million currently uninsured would enroll during this third open enrollment period.
Therefore, ASPE estimates that a total of between 11.0 to 14.1 million individuals will enroll and select plans for 2016 coverage through the marketplaces. Of that number, ASPE estimates that between 9.4 and 11.4 million will pay their premiums and “effectuate” their coverage for 2016.
Given the current 2015 baseline of 9.1 million currently enrolled, this means that ASPE estimates that the total number of those covered by the marketplaces next year will only increase very incrementally, compared to the 19 million Americans now uninsured or with other types of coverage who are estimated to be eligible for new marketplace coverage in 2016.
In contrast, the Congressional Budget Office (CBO) had estimated in June 2015 that 20 million Americans, or about double the ASPE estimate, would be covered through the marketplaces in 2016 (see Table 3, page 9). The difference in the estimates are in the numbers of individuals that CBO estimated to be covered by employer plans, with CBO estimating a much higher number moving from employer-based coverage into coverage by the marketplaces. For example, ASPE estimates that most of the 8.5 million individuals with individual coverage outside the marketplaces would retain that coverage in 2016 through transitional plans or grandfathered plans. ASPE also used a much lower number of how many currently uninsured would enroll in 2016, assuming a much higher level of difficulty in effectively reaching and enrolling these remaining uninsured.