BRIAN BLASEAffordable Care Act’s 6 Year Anniversary

WHAT WAS EXPECTED FOR 2016 WHEN THE LAW

PASSED?

WHAT HAPPENED?

2016 EXCHANGE ENROLLMENT

12.7 Million People Signed Up

11 Million Projected 2016 Enrollees During Year

WHAT IS THE MAKE-UP OF RISK POOL?

SKEWING OLDER THAN EXPECTED

SKEWING POORER THAN EXPECTED

WHAT HAVE WE LEARNED?

PLANS NOT ATTRACTIVE TO HEALTHY AND YOUNG WITHOUT LARGE SUBSIDIES

MANY PEOPLE HAVE FIGURED OUT HOW TO TAKE ADVANTAGE OF ACA RULES

LARGE NET ATTRITION IN ENROLLMENT DURING YEAR

Exchange Enrollment Attrition During 2015Mar. 31st June 30th Sept. 30th Dec. 31st

HHS Reported Enrollment 10.19 M 9.95 M 9.31 M 8.78 M

Corrected Enrollment 9.88 M 9.91 M 9.28 M 8.78 M

Quarterly Change +28,000 -626,000 -503,000

Quarterly Change % 0.3% -6.3% -5.4%

INDIVIDUAL MANDATE NOT WORKING AS INTENDED

Rand: “The individual mandate has the largest independent effect on increasing coverage; if enacted alone, it would reduce the number of uninsured in 2019 to 31 million [from 53 million].”

Urban: “The mandate is more than a dollar amount; it is a legal requirement. Desire to comply with the law, aversion to an income tax penalty, and the new social norm to have health coverage can lead to behavioral responses much stronger than the nominal amount of the penalty would suggest.”

WHAT WILL HAPPEN THIS YEAR?