Nearly 1 Million Enrolled through Special Enrollment Periods

According to data released by CMS, since the 2015 open enrollment period closed in mid-February, nearly 944,000 consumers have enrolled in coverage through HealthCare.gov. Most plan selections occurred due to three types of Special Enrollment Periods (SEPs): 50% due to loss of minimum essential coverage, 19% due to loss of Medicaid coverage, and 15% due to the tax season SEP. The tax season SEP was for individuals who became aware of the requirement to obtain coverage when they filed their 2014 taxes. On average, plan selections due to a SEP ranged between 5,000 and 6,000 per day, though plan selections peaked to 38,000 on the final day of the tax season SEP (45% of these plan selections were due to the tax season SEP). The data also indicate that SEP enrollees are younger than those who signed up during open enrollment—47% of SEP enrollees were between 17 and 34 years of age, as compared to 31% of open enrollment enrollees.

Number of Uninsured Continues to Decline

The National Center for Health Statistics released new data showing a steady, on-going decline in the number of uninsured since 2013. From first quarter 2014 to first quarter 2015, uninsurance decreased by nearly 7 million people, reducing the overall rate of uninsurance from 11.5% to 9.2%. Long-term trends show an even more dramatic drop. In the first three months of 2010, 22.3% of adults aged 18-64 were uninsured, compared to just 13% (roughly 29 million people) in 2015.

HealthCare.gov Medicaid Special Enrollment Period Glitch

CMS alerted enrollment assisters earlier this month that HealthCare.gov is experiencing a technical glitch that prevents individuals who have lost Medicaid or CHIP coverage to obtain the Special Enrollment Period they are eligible for through the online platform, according to Politico. CMS is conducting outreach to impacted individuals to help them get coverage through the Marketplace call center. Consumers seeking other special enrollment periods, such as due to marriage or loss of employer sponsored coverage, are not impacted.

OIG Claims Some HealthCare.gov Verification Controls Were Ineffective in 2013 and 2014

The HHS Office of Inspector General (OIG) reviewed 90 applications for 2013 and 2014 coverage to assess the effectiveness of HealthCare.gov’s verification processes and found that some “controls” were ineffective for determining eligibility and for resolving inconsistencies. The report recommends CMS redetermine the eligibility of applicants impacted by the ineffective controls and improve internal controls and procedures. CMS concurred with the recommendations and stated that system issues identified have been rectified.