Pa.'s health insurance marketplace sets new enrollment record

Jan. 30—HARRISBURG — Scores of state residents who lost health care coverage through the unwinding of Medicaid found new insurance with Pennie, the Pennsylvania-run marketplace that announced record enrollment for 2024.

Pennie announced nearly 435,000 people are now covered through the state-affiliated Affordable Care Act marketplace, an increase of 17% from 2023.

Nine in 10 enrollees qualify and save more than $500 a month on average, according to Pennie data. Four in 5 nationally pay $10 or less a month for coverage, the Centers for Medicare and Medicaid Services (CMS) reports.

Pennie Executive Director Devon Trolley said more than 45,000 people who lost Medicaid are now insured through the state-run marketplace. She said the Medicaid unwinding coupled with enhanced federal subsidies that further lower customer premiums played a large role in spurring new enrollment.

"We knew there was going to be an increase," Trolley said in an interview Monday. "I would say this was higher than I even thought."

Like Trolley cited for Pennsylvania, the unwinding and temporarily expanded subsidies boosted marketplace enrollment across the country at an even higher rate.

CMS announced last week that 21.3 million people obtained health insurance through all state and federal marketplaces created by the Affordable Care Act including more than 5 million new customers — an increase exceeding 31%.

Boosted subsidies for marketplace customers resulted from the American Rescue Plan Act (ARPA) and the Inflation Reduction Act (IRA). ARPA lifted the prior cap for income eligibility, allowing customers with incomes above 400% of the federal poverty level to qualify for tax credits. Subsidy expansions authorized by that law were extended through 2025 by the IRA.

Citing data from CMS, the Kaiser Family Foundation found that 14.2 million marketplace enrollees shared in $90.4 billion in annual premium tax credits including nearly 320,000 Pennsylvanians sharing in almost $2 billion in credits.

Open enrollment closed in Pennsylvania on Jan. 19, however, qualifying life events including loss of job coverage or Medicaid, relocating to the commonwealth or a pregnancy are among the qualifiers for a time-limited special enrollment.

Created in 2020, Pennie took over the public marketplace from the federal government, which operates the Health Insurance Marketplace at Healthcare.gov. Pennsylvania's is operated by the Health Insurance Exchange Authority at Pennie.com.

There are 19 state-run marketplaces including Pennie along with three additional states that use the federal platform for their respective operations.

The unwinding of Medicaid, or Medical Assistance, is a resumption of pre-pandemic administration across the country, ending temporary automatic enrollment and resuming eligibility determinations.

The U.S. Department of Health and Human Services had estimated that nationally, as many as 15 million Medicaid recipients and Children's Health Insurance Program (CHIP) enrollees would lose coverage in a process that's continuing through March.

For Pennsylvania alone, there were nearly 421,000 fewer recipients in December compared to April when the unwinding process began, however, not all cases of lost coverage are a result of unwinding.

Also, work is ongoing to reenroll people who lost coverage for procedural reasons. Tens of thousands of people were identified as potentially dropped from coverage in Pennsylvania through procedural error. Unwinding was paused last fall in 30 states to reassess such instances.