Open Enrollment 4 Update Cheryl O’Donnell, State Assistance Regional Manager

Agenda

Oe4 Enrollment trends

HealthCare.gov OE4 enrollment

Mid-OE4 Report Key Findings 50 states/DC 11.5 million plan selections 81% receiving financial help HealthCare.gov states 82% receiving financial help Average tax credit $386/person/month 65% of reenrollees actively shopped 217,101

New vs. Reenrolling Consumers All of OE3 OE4 Nov-Dec New, 24% Active, 47% Auto, 29% 106,406 New Enrollees 125,443 Reenrollees 80% Actively reenrolled 50,784 New Enrollees 160,815 Reenrollees 62% Actively reenrolled

Financial Assistance All of OE3 OE4 Nov-Dec $309 $97 $422 69% Average monthly tax credit $97 Average monthly premium after tax credit $422 Average monthly tax credit 69% w/ CSR

Age Distribution All of OE3 OE4 Nov-Dec 36% 34% [CUSTOMIZATION REQUIRED]: Slides exist for campaign FFM states: https://app.box.com/s/fvp725ow0sku4pgk6gzdkgycaf5723mu And local data can be found here: https://docs.google.com/spreadsheets/d/1ArBnj_hItH2psy6jpFNsqHNvrbxVefFwPwq4xSExHRg/edit#gid=0 You may also want to add a slide showing the changing uninsured rates by County from 2013 to 2015. You can get screen shots here: https://www.enrollamerica.org/research-maps/maps/changes-in-uninsured-rates-by-county/ [QUESTION TO THE AUDIENCE]: This is a great slide to ask your audience to read. Ask them what stands out. These are topics that should hopefully come out of the discussion: Big gains! Let’s celebrate About equal between re-enrollees and new enrollees Large majority receive fin help Proportion of young people going up Sources: CMS Weekly Marketplace Enrollment Snapshot ASPE January Marketplace Enrollment Report, 1/9/16 ASPE, Health Insurance Marketplace 2016: Average Premium After Advance Premium Tax Credits In The 38 States Using The Healthcare.Gov Eligibility And Enrollment Platform, January 2016, https://aspe.hhs.gov/pdf-document/health-insurance-marketplaces-2016-average-premiums-after-advance-premium-tax-credits-38-states-using-healthcaregov-eligibility-and-enrollment-platform 36% Under Age 35 34% Under Age 35

FUTURE OF THE ACA

Repeal and Replace

Repeal Process Budget reconciliation process Senate votes on budget resolution House votes on budget resolution Committees meet to craft legislation House: Energy and Commerce; Ways and Means Senate: Finance; Health, Education, Labor, Pensions (HELP) Senate and House vote on legislation Conference committee if Senate and House versions differ Final up / down votes from Senate and House President’s signature Budget resolutions aren’t law and don’t go to the president for signature; they are used to begin the process, and may include reconciliation instructions. X X

What Can Actual Be Changed Could be in reconciliation legislation Cannot be in reconciliation legislation Premium tax credits The expansion of Medicaid coverage for adults up to 138 percent of the federal poverty level, presumptive eligibility, maintenance of effort, and benchmark plans for Medicaid The individual and employer mandate Cap on “pay back” during tax credit reconciliation Ban on pre-existing condition exclusion and health status underwriting Caps on annual and lifetime annual limits AV requirements Age underwriting restrictions

ACA Replacement Proposals Trump: “Insurance for All” Price: “Access to Insurance” Patient Freedom Act: State block grant Better Way: Age-adjusted tax credits Health savings accounts Buy across state lines Empower states to reform Medicaid Move Medicare to the marketplace Keep protections for pre-existing conditions, 26 y.o., and no denial of coverage

CBO: Cost of Repeal No individual mandate: fewer enrollees = 20-25% premium increase next year No subsidies: sicker population = higher risk for insurers = ½ country w/o marketplace plans in 2 years

What’s Next Continuation of reconciliation process for ACA repeal Second budget resolution to achieve other congressional priorities, like ACA replacement package, Medicaid block grant, changes to Medicare, and many non-health items

Messages for Consumers Consumer Resource to compare ACA alternatives: https://www.washingtonpost.com/graphics/national/obamacare-replacement-plans/

Other Transition Issues HHS/CMS Staff Changes Tom Price for Secretary of Health and Human Services Seema Verma for Administrator of the Centers for Medicare and Medicaid Services Enrollment Reports Future Funding

Questions & Final Thoughts

HALF ALL 10% Impact of the ACA Uninsured rate for non-elderly adults declined nationally by nearly half, from 16.4 to 8.3 percent between 2013 and 2016. ALL Uninsured rate declined in all 50 states and DC, across every demographic group, including for all racial/ethnic groups, all ages and age groups, men and women, and for residents of metro and non-metro areas. 10% The number of counties with uninsured rates of 10 percent and under grew from a mere 145 counties in 2013 to 1,834 counties in 2016.