Join our guest
blogger, Devin McBrayer, as she reviews the outcomes of the 2019 open
enrollment period for health care exchanges. Devin is a Legislative and Policy
Analyst based in Sacramento, California.
The open enrollment period to purchase Affordable Care Act
(ACA)-compliant individual health insurance coverage off the health insurance
exchanges for 2019 has come to an end. Sign-ups were off to a slow start at the
beginning of the enrollment period, leaving many experts fearful that ACA plans
would experience a significant decrease in enrollment. However, total enrollment
only decreased by about 3.8% nationwide on Healthcare.gov, much of this due to a
15% reduction in new sign-ups.
While the total enrollment drop in individual health
insurance plans on the exchange may have been less drastic than expected, it is
still worth exploring why new enrollment decreased considerably and why year-to-year
enrollment continues to decline. Several 2018 policy changes, combined with a
growing economy, could help explain the decrease in enrollment in ACA plans for
the 2019 plan year.
Are policy changes to blame?
In 2018, Congress reduced the tax penalty for not having an ACA-compliant health insurance plan to zero, effectively eliminating it. The federal government also shortened the open enrollment period and reduced marketing for open enrollment. Simultaneously, the federal government passed several rules that expanded the availability of cheaper and less comprehensive insurance plans such as short-term limited duration plans. No tax penalty for lack of coverage, combined with a shorter sign-up period and more plan options outside the exchanges, may help explain the enrollment decrease.
The impact of the economy
Another possible explanation for the drop in enrollment could be attributed to an improving economy. When open enrollment started on November 1, 2018, 2 million more jobs were added to the economy than were added at the same time in 2017. As more people head back to work, it’s possible that they’re gaining access to employer-sponsored health insurance, eliminating the need to renew their ACA plan.
What does this mean for dental?
Any loss in enrollment for medical coverage also means less people enrolled in dental coverage on the exchange. (As a reminder, dental coverage is an essential health benefit for children but not for adults.)
In the exchanges, dental coverage is included in some
health plans or consumers can get a stand-alone dental plan and pay a separate premium.
However, there is no way for consumers to purchase a stand-alone dental plan
without also purchasing a medical plan on the health care exchange. Pushing for
states and the federal government to allow for the independent purchase of
stand-alone dental plans on state and federal health insurance exchanges is a
top priority for the Public & Government Affairs team at Delta Dental.
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