Exchange Enrollment Expected to Fall Short of CBO Estimates

An analysis by Avalere finds that exchange enrollment is on track to reach 5.4 million by the end of March when open enrollment is set to end. That number falls short of Congressional Budget Office (CBO) estimates that six million people will enroll in exchanges in 2014. “The Administration is conducting aggressive outreach in March in an effort to boost enrollment.  However, success of exchanges in 2014 will depend less on the size of the market and more on the risk profile of enrollees,” said Caroline Pearson, vice president at Avalere Health.

As many as 4.2 million individuals had enrolled in exchanges through February. In comparison, when the Medicare Part D program began in 2006, 22% of voluntary enrollees signed-up in the final month of coverage. If exchanges follow the same pattern,  1.2 million people are expected to enroll in March.

In January and February, enrollment in federally run exchanges increased faster than enrollment in state-based exchanges, as federal exchanges recovered from early setbacks caused by California, Florida, Idaho, North Carolina, and Washington lead the states in terms of enrollment. Meanwhile, the exchanges of Hawaii, D.C., and Massachusetts, which have struggled with website IT problems, trail the nation in enrollment. “In recent months, enrollment in federally run exchanges has caught-up to the initial enrollment surge in many state-based exchanges. The federal marketplaces have been fixed and now surpass some states in terms of ease of consumer access, eligibility, and functionality,” said Dan Mendelson, CEO of Avalere Health. For more information, visit

Consumers Say Their Health Plans Fall Short on Coverage

Forty-one percent of consumers say that their health plan does not offer enough coverage for routine visits, serious illness or injury, health and wellness programs, routine diagnostics, or drug coverage. Concerns over not having enough health coverage reduces satisfaction by 133 points, more than any other coverage-related issue, according to the J.D. Power 2014 Member Health Plan Study. The study also reveals the following:
• 55% have experienced a cost increase in 2013, which has reduced cost satisfaction.
• 35% received a notice of changes in their coverage, networks, or rates from their health plan in the past 12 months.
• 74% maintained their preferred physician, and 83% retained their same hospital network.
• 75% submitted a claim in the past 12 months.
• The average monthly premium in 2013 was $285.
• 49% say their plan does not offer the most common types of health and wellness discount/incentive programs.

“On average, members wait eight days for communication from their provider after a pre-approval request has been submitted. Health plans must look for ways to promptly communicate pre-approvals and cost in order to minimize member anxiety and mitigate concerns about access to care, ultimately increasing customer satisfaction,” said Rick Johnson, senior director of the healthcare practice at J.D. Power.

Satisfaction is highest among health plan members in California and Michigan. Kaiser Foundation Health Plan ranks highest among health plan members in the California region for a seventh consecutive year, with a score of 756. No other plans in this region perform above the region average. For more information, visit

Last Updated 06/23/2021

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