Policy Wonks Parse the Curious Case of Declining State-Based Marketplace Enrollment
With nearly all the 2023 open enrollment period data now tallied, it appears that something curious is happening in states that run their own Affordable Care Act exchanges: Enrollment levels are on track to decline compared to 2022. That trend follows years in which state-based marketplaces (SBMs) outperformed states using the HealthCare.gov platform in terms of year-over-year enrollment growth, and it comes as HealthCare.gov states are reporting a significant signup surge compared to 2022.
Health policy experts tell AIS Health, a division of MMIT, that there are likely multiple factors causing the reversal of fortunes between HealthCare.gov and SBM enrollment. But in an important takeaway for health insurers that operate in the exchanges, they say the trend could indicate that the “addressable market” in certain states is reaching its saturation point.