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April 10, 2015

by Scott Lyon, Senior Vice President of SBAM

In March, the Assistant Secretary of Planning and Evaluation Office of Health Policy at Health and Human Services, the ASPE Office of Health Policy at HHS, for those acronym lovers out there, released an issue brief on enrollment in Health  I found the information interesting, and concerning.  Here are some of the highlights regarding the enrollment in the Exchanges across the country and here in Michigan.

Overall, there are 8.84 million people now receiving care that originated at  That is an increase of 4.6 million people from 2014, a 53% increase year over year.  Of the remaining 47%, roughly one-half reenrolled on their own from the previous year and the other half were automatically reenrolled.  46% are male and 54% are female.  Enrollment in Michigan stands at 341,183.

For those of you who love statistics, the ASPE Office of Health Policy breaks the enrollment down in many ways, here are some of the highlights:

On average, enrollment in Michigan is slightly older than the national average:
Age                 Nationally   Michigan 
Under 34        36%              34%
35 – 44           17%              15%
45 – 54            22%              21%
55 – 64            25%              28%

Of those enrolled, 17 percent are African-American, 11 percent are Latino and 64 percent are White.  The report did not break down the remaining eight percent.

In Michigan 88 percent of those enrolling via received financial aid, nationally that number is 86 percent.  Additionally, premiums are slightly higher in Michigan, and so are the subsidies:

Premiums/Month                              Nationally       Michigan
Average Premium Before Credit         $364                $366
Average Credit                                   $210                $236
Average Premium After Credit            $151                $130

Most enrolled chose the Silver Level for their coverage – 69 percent, followed by Bronze at 22 percent, Gold at seven percent and Platinum at three percent.  Twenty one percent are paying an after tax credit premium of less than $50 a month and 48 percent are paying less than $100 per month.  Eighty-three percent are earning less than 200 percent of the federal poverty level (approximately $22,980 per year).
Questions not answered in the report include how many of the 8.84 million now enrolled previously had coverage either in the individual market or in the employer market, and due to incentives or disincentives, made the decision to move to for their coverage?  And the big question, with subsidies so high, the average age trending to the older and more expensive demographic, is this sustainable?  Only time, and upcoming elections will answer those questions.  

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