The document discusses the 6 year anniversary of the Affordable Care Act and provides information on 2016 exchange enrollment, the makeup of the risk pool, and what has been learned. It notes that 12.7 million people signed up for exchange plans in 2016, slightly higher than the 11 million projected. However, the risk pool skewed older and poorer than expected. Many healthy and young individuals did not find the plans attractive without subsidies. The individual mandate also did not work as intended to increase coverage as many found ways to take advantage of ACA rules. Large attrition in enrollment occurred during 2016.

1. BRIAN BLASE
Affordable Care Act’s
6 Year Anniversary

2. WHAT WAS EXPECTED
FOR 2016 WHEN THE
LAW PASSED?

4. WHAT
HAPPENED?

5. 2016 EXCHANGE
ENROLLMENT
12.7 Million People Signed Up
11 Million Projected 2016
Enrollees During Year

6. WHAT IS THE MAKE-UP
OF RISK POOL?

7. SKEWING OLDER THAN EXPECTED

8. SKEWING POORER THAN EXPECTED

9. WHAT HAVE WE
LEARNED?

10. PLANS NOT ATTRACTIVE TO HEALTHY AND
YOUNG WITHOUT LARGE SUBSIDIES

11. MANY PEOPLE HAVE FIGURED OUT HOW
TO TAKE ADVANTAGE OF ACA RULES

12. LARGE NET ATTRITION IN ENROLLMENT
DURING YEAR
Exchange Enrollment Attrition During 2015
Mar. 31st June 30th Sept. 30th Dec. 31st
HHS Reported Enrollment 10.19 M 9.95 M 9.31 M 8.78 M
Corrected Enrollment 9.88 M 9.91 M 9.28 M 8.78 M
Quarterly Change +28,000 -626,000 -503,000
Quarterly Change % 0.3% -6.3% -5.4%

13. INDIVIDUAL MANDATE NOT WORKING
AS INTENDED
Rand: “The individual mandate has the largest
independent effect on increasing coverage; if enacted
alone, it would reduce the number of uninsured in
2019 to 31 million [from 53 million].”
Urban: “The mandate is more than a dollar amount;
it is a legal requirement. Desire to comply with the
law, aversion to an income tax penalty, and the new
social norm to have health coverage can lead to
behavioral responses much stronger than the nominal
amount of the penalty would suggest.”

14. WHAT WILL HAPPEN
THIS YEAR?