During the fourth week of the 2020 open enrollment period, from November 22-28, 523,020 people selected plans using the HealthCare.gov platform.
That brings the total number of enrollees to 2,903,547 after the first four weeks of open enrollment. That's an increase of 523,020 people from last year, which saw 2,380,527 consumers sign up for plans after the first four weeks.
It's important to note, however, that in 2020 there were more days in this four-week period than last year, since the Centers for Medicare and Medicaid Services measures enrollment Sunday through Saturday. Nov. 1 was on a Sunday this year and on a Friday in 2019, so the first week of 2019 had only three days, while the first week this year measured a full seven.
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The numbers are a dip from the third week of open enrollment, during which 758,421 signed up for coverage.
The HealthCare.gov platform is used by the federally facilitated exchange and some state-based exchanges. Notably, New Jersey and Pennsylvania transitioned to their own platforms for 2021, and due to this they're absent from HealthCare.gov for 2021 coverage. Those two states accounted for 578,251 plan selections last year, 7% of all plan selections. These enrollees' selections will not appear in CMS' figures until it announces the state-based marketplace plan selections.
Open enrollment lasts six weeks and ends on December 14. Those who sign up within that timeframe will see their coverage begin January 1, 2021.
WHAT'S THE IMPACT
This is the fourth snapshot of open enrollment figures by CMS during this sign-up period.
Of those selecting plans, 138,183 were new consumers, while 384,837 were renewing coverage. This brings the total number of new consumers to 659,455 since the beginning of open enrollment, while the tally for those renewing coverage now stands at 2,244,092. More than 4,386,530 consumers have been on the applications submitted to date.
A consumer is considered to be a new consumer if they did not have 2020 exchange coverage through Dec. 31 of this year and had a 2021 plan selection. They're considered a renewing consumer if they have 2020 exchange coverage through Dec. 31 and actively select either the same plan or a new plan for 2021.
The numbers represent those who have submitted an application and selected a plan, net of any cancellations from a consumer, or cancellations from an insurer. The weekly metric represents the net change in the number of uncanceled plan sections over a given period.
Plan selections will not include those consumers who are automatically re-enrolled into a plan. To have their coverage effectuated, consumers generally need to pay their first month's health plan premium. CMS did not report the number of effectuated enrollments.
In all, there were 1,749,555 HealthCare.gov users recorded during the fourth week, and 57,502 of the Spanish-speaking equivalent, CuidadoDeSalud.gov, bringing the four-week totals to 9,582,790 and 317,487, respectively.
To date, Florida tops in the number of plan selections over the first four weeks with 871,361 sign-ups, followed by Texas (471,849) and Georgia (198,090).
THE LARGER TREND
President-elect Joe Biden has said he is favorable to strengthening and expanding the Affordable Care Act, and favors a government-run public option to run parallel with private offerings.
But prior to Biden's inauguration on Jan. 20, 2021, CMS may release a final rule based on a proposed rule it released late on Thanksgiving Eve to allow states to implement Section 1332 waivers to waive certain ACA requirements. This allows states to decentralize enrollment through insurers and web brokers. Opponents have said this will expose consumers to junk plans.
Georgia has already been approved for such a waiver.
According to a recent report from the Kaiser Family Foundation, insurer participation in the ACA marketplace in 2021 is seeing a third straight year of growth as several insurers are entering the market or expanding their service area. For 2021, 30 insurers are entering the individual market, and an additional 61 are expanding their service area within states.