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50 States of 2022 ACA Public Exchange Plan Signup Data


The ordinary individual major medical insurance sales season ended Monday, sort of, in most of the United States.

HealthCare.gov closed for open enrollment period sales Jan. 15.

Most of the locally run “web-based supermarkets for health insurance” pulled up their welcome mats Jan. 15. Some locally run exchange programs, such as the exchange programs operated by Rhode Island and the District of Columbia, rolled down their open enrollment period shutters Monday.

But some of the highest-population states have fuzzed the final enrollment picture by extending their individual health enrollment periods even past Jan. 31.

In New York, for example, NY State of Health is keeping the open enrollment period lights on until at least March 31.

What It Means

Agents and brokers now have a better chance to sell “gap-filler” health insurance products, such as short-term health insurance, in most states.

They also have a better chance to attract consumers with special situations, such as moves to new communities, that qualify them to apply for coverage through special enrollment period applications. In some cases, however, carriers avoid paying commissions for special enrollment period signups, because of concerns that enrollees who come in through special enrollment period applications will have higher claim costs than other enrollees.

The Basics

The Affordable Care Act public exchange system gives people way to use income-based federal subsidies to pay for individual health coverage from private health insurers.

Health insurance regulators created the enrollment period calendar, or limits when people can buy individual health coverage without showing that they have a good reason to be shopping for health coverage, to shield health insurers from some of the effects of the ACA ban on medical underwriting. The idea is that enrollment period limits will push some young, healthy people to pay for coverage even when they feel great, to reduce the odds that they’ll be stuck with a broken leg and no way to buy health coverage at some other time of the year.

The Numbers

The Centers for Medicare and Medicaid Services reported recently that, as of Jan. 15, it had recorded a total of 14.5 million ACA exchange plan signups, or about 14% of the 169 million U.S. residents under age 65 who have private health coverage.

That was up 19% from the total for 2021 exchange plan coverage, and up 36% from the total for 2020, which was the last ACA exchange plan coverage year that was completely under the management of the administration of former President Donald Trump.

HealthCare.gov increased its plan signup count to 10.3 million, from 8.3 million as of Dec. 21, 2020, when the original open enrollment period for 2021 coverage ended.

The preliminary signup counts available from the locally run exchanges have increased 9.2%, to 4.2 million.

The 2021 and 2022 coverage year figures are not directly comparable because of the effects of extended special enrollment period rules on final 2021 coverage year signup counts, and because of the effect of the current enrollment period extensions on the 2022 coverage year totals.

The Broker Numbers

The ACA exchange system gets about half of its enrollees from traditional agents, traditional brokers and web brokers.

HealthSherpa, a company that helps agents and brokers with the ACA exchange plan signup process, says it has helped at least 3 million people get covered this year.

Their median gross premium was $733, and their median net premium payment, after federal premium subsidies were applied, was $21.

About 30% of the enrollees signed up for plans without having to pay for any cash for premiums out of pocket.

More Numbers

For a look at what has happened, so far, to signup counts in the three biggest ACA exchange markets, see the gallery above.

For data for all 50 states and the District of Columbia, see the chart below.

Affordable Care Act Public Exchange Signups

.. .. Individuals Signed Up for Coverage ..
Jurisdiction Exchange Runner 2019 2020 2021 2022 (as of Jan. 15) Signup Change, between 2021 and Jan. 15, 2022
Alabama HealthCare.gov 136,832 144,225 178,931 219,314 +22.6%
Alaska HealthCare.gov 14,985 15,467 18,230 22,786 +25.0%
Arizona HealthCare.gov 133,377 136,278 157,996 199,706 +26.4%
Arkansas HealthCare.gov 56,139 58,392 67,403 88,226 +30.9%
California Local 1,343,855 1,559,133 1,629,883 1,781,491 +9.3%
Colorado Local 140,330 157,464 166,850 197,516 +18.4%
Connecticut Local 94,904 98,498 98,960 112,633 +13.8%
Delaware HealthCare.gov 19,285 23,099 25,936 32,113 +23.8%
District of Columbia Local 15,961 17,133 15,952 15,926 -0.2%
Florida HealthCare.gov 1,537,445 1,842,474 2,248,336 2,723,094 +21.1%
Georgia HealthCare.gov 364,828 424,280 549,066 701,135 +27.7%
Hawaii HealthCare.gov 16,580 18,526 20,033 22,327 +11.5%
Idaho Local 84,986 67,710 67,388 73,359 +8.9%
Illinois HealthCare.gov 258,472 261,401 277,642 323,427 +16.5%
Indiana HealthCare.gov 128,024 129,117 130,406 156,926 +20.3%
Iowa HealthCare.gov 46,238 52,801 59,482 72,240 +21.4%
Kansas HealthCare.gov 76,642 77,520 90,852 107,784 +18.6%
Kentucky Local 71,134 72,150 76,105 73,490 -3.4%
Louisiana HealthCare.gov 76,784 76,701 82,316 99,626 +21.0%
Maine Local 58,875 56,695 56,834 66,095 +16.3%
Maryland Local 133,065 151,354 161,971 181,603 +12.1%
Massachusetts Local 288,221 295,638 259,743 263,063 +1.3%
Michigan HealthCare.gov 231,516 237,598 258,393 303,550 +17.5%
Minnesota Local 98,818 106,665 106,647 121,322 +13.8%
Mississippi HealthCare.gov 72,498 90,207 108,978 143,014 +31.2%
Missouri HealthCare.gov 177,128 187,326 220,162 250,341 +13.7%
Montana HealthCare.gov 39,098 40,356 43,794 51,134 +16.8%
Nebraska HealthCare.gov 80,832 85,819 87,257 99,011 +13.5%
Nevada Local 65,614 74,108 84,559 101,411 +19.9%
New Hampshire HealthCare.gov 38,746 41,268 46,552 52,497 +12.8%
New Jersey Local 209,237 217,374 270,573 311,692 +15.2%
New Mexico Local 36,765 36,902 40,871 45,664 +11.7%
New York Local 249,217 243,548 213,776 219,215 +2.5%
North Carolina HealthCare.gov 422,685 461,322 548,420 670,223 +22.2%
North Dakota HealthCare.gov 19,629 20,333 24,482 29,873 +22.0%
Ohio HealthCare.gov 169,855 175,793 201,728 259,999 +28.9%
Oklahoma HealthCare.gov 136,917 146,779 174,520 189,444 +8.6%
Oregon HealthCare.gov 125,052 128,061 130,205 146,602 +12.6%
Pennsylvania Local 297,296 292,331 328,366 374,776 +14.1%
Rhode Island Local 33,079 32,925 32,403 31,343 -3.3%
South Carolina HealthCare.gov 176,298 190,291 238,175 300,392 +26.1%
South Dakota HealthCare.gov 26,388 28,531 33,504 41,339 +23.4%
Tennessee HealthCare.gov 169,733 181,225 218,896 273,680 +25.0%
Texas HealthCare.gov 885,754 1,026,498 1,406,841 1,840,947 +30.9%
Utah HealthCare.gov 177,134 186,237 214,690 256,932 +19.7%
Vermont Local 25,679 24,651 24,126 26,705 +10.7%
Virginia HealthCare.gov 242,101 234,032 258,789 307,946 +19.0%
Washington Local 192,680 197,532 210,535 239,566 +13.8%
West Virginia HealthCare.gov 18,300 17,734 17,788 23,037 +29.5%
Wisconsin HealthCare.gov 177,245 177,474 186,068 212,209 +14.0%
Wyoming HealthCare.gov 21,962 23,112 27,980 34,762 +24.2%
TOTAL .. 9,714,218 10,642,088 12,199,393 14,492,506 ..
MEDIAN .. .. .. .. .. 17.5%
Source: Centers for Medicare and Medicaid Services

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(Image: Igor Negovelov/AdobeStock)

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