Fact Sheets

2021 Marketplace Special Enrollment Period Report

2021 Marketplace Special Enrollment Period Report

February 15 – June 30, 2021

The Centers for Medicare & Medicaid Services (CMS) reports that over 1.5 million Americans have signed up for health insurance through HealthCare.gov since February 15, 2021, the start of   the 2021 Marketplace Special Enrollment Period (SEP) opportunity became available through HealthCare.gov, through June 30, 2021; with 373,000 consumers signing up for health insurance in the month of June.¹

The number of new plan selections, from the start of the SEP opportunity on February 15, 2021 through June 30, 2021, represents a substantial increase in enrollment from the same period in 2020 and 2019, when 625,000 and 443,000 consumers signed up for Marketplace coverage, respectively.² In previous years, SEPs were available primarily only for qualifying life events, whereas this year, the Biden-Harris Administration opened a SEP available on HealthCare.gov in response to             the COVID-19 Public Health Emergency.

Under the American Rescue Plan Act of 2021 (ARP), most consumers are now eligible for more generous advance payments of premium tax credits (APTC), which further reduce the portion of monthly premiums paid by consumers. Since HealthCare.gov implemented the expanded APTC amounts on April 1, 2021, 2.5 million consumers have returned to the Marketplace and reduced their monthly premiums after APTC by      40 percent, from $104 to $62, on average, and 30 percent (735,000) of returning consumers newly selected plans for $10 or less per month after APTC.

The ARP also makes it more affordable for new consumers to purchase and use Marketplace coverage. For new consumers selecting plans under the SEP, the average monthly premium after APTC fell by 25 percent, from $117 for those enrolling from February 15, 2021 through March 31 2021 to $87 for those enrolling from April 1, 2021 through June 30, 2021, and 44 percent (487,000) of new consumers since April 1, 2021 selected plans for $10 or less after APTC. The ARP also helped to lower out of pocket costs for many new consumers. The median deductible for new consumers during the SEP fell by nearly 90 percent, from $450 prior to April 1, 2021 to $50 for new consumers enrolling from April 1, 2021 through June 30, 2021.

¹ Cumulative plan selections from February 15, 2021 through June 30, 2021 reflect new plan selections net of terminations and cancellations during that period and count consumers that were not actively enrolled as of February 14, 2021. The June 1, 2021-June 30, 2021 total only reflects plan selection activity since June 1, 2021 and counts consumers who were not actively enrolled as of May 31, 2021.

² New Jersey and Pennsylvania transitioned to State-based Marketplaces in 2020, and Nevada transitioned to a State-

based Marketplace in 2019. Plan selections from these three states aren’t included in this report

³ Other Race includes multiracial, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander.

⁴ Represents consumers with an active plan selection as of March 31, 2021 who returned to the Marketplace and made a new plan selection (which could include re-selecting their current plan) during the period that had a premium

of $10 or less after APTC. Does not include returning consumers who had a premium of $10 or less after APTC prior to April 1, 2021.

Glossary

New Plan Selections: The number of unique consumers who didn’t have an active enrollment as of February 14, 2021, and made a plan selection on or after February 15, 2021, that is active as of the end of the reporting period. An active plan selection is one that is non-cancelled with an end date of December 31, 2021. While this plan selection metric is net of cancellations and terminations that occur during the reporting period, it doesn’t represent effectuated enrollments because reconciliation activity may continue in later periods.

HealthCare.gov States: This report refers to the 36 states with Marketplaces that use the HealthCare.gov platform for the 2021 coverage year. The 36 states for 2021 include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.

New Consumers Requesting Coverage on an Application Submitted on or after February 15: The number of unique consumers who submitted an application and are requesting coverage on or after February 15, 2021, and didn’t have an active enrollment as of February 14, 2021. If determined eligible for Marketplace coverage, a consumer still needs to pick a health plan (i.e., plan selection) and pay their premium to have coverage (i.e., effectuate enrollment).

Marketplace Eligible: The number of unique new consumers requesting coverage on an application submitted on or after February 15, 2021 who are determined eligible to enroll in a Marketplace health plan, regardless of whether they applied for or are eligible for financial assistance.

Medicaid/CHIP Eligible: The number of unique new consumers requesting coverage on an application submitted on or after February 15, 2021 who are assessed or determined eligible for enrollment in Medicaid or the Children’s Health Insurance Program (CHIP).⁵

Call Center Volume: The total number of calls received by the Marketplace call center, which supports HealthCare.gov, over the course of the reporting period. Calls with Spanish-speaking representatives are not included.

Calls with Spanish-Speaking Representative: The total number of calls received by the Marketplace call center, which supports HealthCare.gov, where consumers chose to speak with a Spanish-speaking representative over the course of the reporting period. These calls are not included in the Call Center Volume metric.

⁵ Individuals are generally identified in this report as eligible for either a QHP or Medicaid/CHIP, but there are cases where a consumer is considered eligible for both types of coverage or neither. As a result, the eligibility breakouts do not sum to the total number of consumers requesting coverage on applications submitted.