Biden's ACA special enrollment period might be good for marketplace plan risk pool

Potential ACA marketplace enrollees are younger and likely to be healthier on average

President Biden’s executive order last week to open up special enrollment for the ACA marketplace plans could bring in younger enrollees and broaden the marketplace risk pool, which has suffered from adverse election.

Biden’s January 28 executive will mean that there will be a special enrollment period for coverage sold on Healthcare.gov from February 15 to May 15. HHS is also gearing up to spend $50 million on outreach and education about the special enrollment period. The department was quick to post a press release and a fact sheet about the enrollment period.

Katie Keith, J.D., M.P.H., who writes about the ACA and federal health policy on the Health Affairs blog, pointed to a Kaiser Family Foundation analysis that found that nearly 15 million uninsured Americans could get coverage through the ACA marketplaces and who might, therefore, take advantage of the special enrollment period.

According to calculations by the foundation’s experts, about four million of those 15 uninsured American could get a free bronze plan once ACA subsidies are factored in. A second group of about five million would get a subsidy but would still pay some of the premium, according the foundation’s analysis. A third group of about six million could buy ACA marketplace coverage but are ineligible for financial assistance because of their income or the price of the premium.

Keith noted in a post last week that the special enrollment is likely to help with the marketplace risk pools because of the relatively high percentage of potential enrollees who are young and, therefore, healthier on average. According to the foundation’s analysis — which was published the day before Biden signed executive order setting up the special enrollment period — found that 39% of those eligible for a free bronze plan are ages 19 to 24.