CMS releases new data demonstrating increased choice, competition in the Health Insurance Marketplace in 2015
Open enrollment begins November 15; Consumers should visit HealthCare.gov to preview their plan choices today
Continuing its commitment to transparency, today the Centers for Medicare & Medicaid Services (CMS) released new data giving consumers and researchers the tools and information they need to review 2015 health insurance plan information. Because of new choices and more competition in the Health Insurance Marketplace, consumers will have even more affordable options during Open Enrollment this year. With 25 percent more issuers participating in the Marketplace in 2015, more than 90 percent of consumers will be able to choose from 3 or more issuers – up from 74 percent in 2014. Consumers can choose from an average of 40 health plans for 2015 coverage—up from 31 in 2014, based on data at the county level.
“When open enrollment begins tomorrow, November 15, many consumers will have even more affordable choices for renewing their coverage and signing up for the first time through the Health Insurance Marketplace,” said CMS Administrator Marilyn Tavenner. “We are committed to transparency and providing consumers with the information they need to choose the right health plan for them. Today’s data provide further evidence that the Affordable Care Act is working to improve competition and choice among Marketplace plans in 2015. Consumers should shop around, with new options available this year they’re likely to find a better deal.”
The data released today include:
- Health Insurance Marketplace Landscape Files. CMS is committed to increasing transparency in the Marketplace. While health plan information including benefits, copayments, premiums, and geographic coverage is publically available on HealthCare.gov through the new window shopping tool, CMS has also released downloadable public use files (PUFs) so that researchers and other public stakeholders can access Marketplace data. These files include available plans by county along with premium and cost-sharing data for selected scenarios and services for the 2015 plan year. The files provide consumers with a snapshot of the plans available to them as well as basic information associated with each plan. The premiums shown in the files do not include tax credits and represent selected rating scenarios based on age and household composition – actual premiums may change. The Landscape files include data on certified qualified health plans (QHPs) and Stand-alone Dental Plans (SADPs) for all states that use the HealthCare.gov eligibility and enrollment system, and for the Federally Facilitated Small Business Health Options Program (SHOP). There are four types of QHP Landscape files: (1) individual medical marketplace; (2) SHOP medical marketplace; (3) individual dental marketplace; and (4) SHOP dental marketplace. The files are available here: https://www.healthcare.gov/health-and-dental-plan-datasets-for-researchers-and-issuers/
- Health Insurance Marketplace Public Use Files. These files for the 2015 plan year include detailed information for researchers. They include data on certified QHP and SADPs for all states that use the HealthCare.gov eligibility and enrollment system. The seven files that make up the Marketplace PUF are: (1) Benefits and Cost Sharing, (2) Plan Attributes, (3) Rates, (4) Business Rules, (5) Service Areas, (6) Networks, and (7) the Plan ID Crosswalk. The files are available here: http://www.cms.gov/CCIIO/Resources/Data-Resources/marketplace-puf.html
- Rate Review Public Use File. Today, CMS released information on final 2015 rates in the individual and small group markets for plans inside and outside of the Marketplace for all states and the District of Columbia. The information released today does not take into account tax credits that will make premiums more affordable for the majority of consumers. We encourage consumers to visit HealthCare.gov to browse their coverage options and to see if they are getting the lowest cost possible this open enrollment season. The file is available here: https://data.healthcare.gov/dataset/2015-Unified-Rate-Review-URR-Data-Extract-Annual-2/2hu7-dm35
Before the Affordable Care Act, people who purchased health insurance plans in the individual health insurance market often saw double-digit rate hikes in their premiums every year. Today’s data show that new, lower-cost plans are available this year and premiums are remaining stable. Many consumers will be eligible for tax credits to help pay monthly premiums and make coverage more affordable. Nearly 85 percent of consumers who selected a Marketplace plan in 2014 did so with financial assistance. Nearly 7 in 10 consumers who selected plans with tax credits through the Federal Marketplace during the 2014 Open Enrollment Period got covered for $100 a month or less. Nearly half – 46 percent - were able to get covered for $50 a month or less.
Open Enrollment in the Marketplace begins November 15, 2014 and runs through February 15, 2015. Consumers should visit HealthCare.gov to review and compare health plan options. Every year insurance companies make changes to premiums, cost-sharing and benefits, and with more choices available, the vast majority of consumers will be able to find a more affordable option. They could also find a plan that offers more services, or includes more doctors. All consumers shopping for health insurance coverage for 2015— even those who currently have coverage through the Marketplace — should enroll or re-enroll between November 15 and December 15 in order to have coverage effective on January 1, 2015.
It is important to note that the QHP Landscape will be updated regularly to reflect the plan data that consumers will see when shopping for a Marketplace QHP during the annual open enrollment period. Data are presented at the county, rather than rating area-level to better reflect plan service areas and the consumer experience.
To compare plans, prices, covered benefits and physician and hospital networks in your area before open enrollment begins visit: https://www.healthcare.gov/find-premium-estimates/
Consumers can find local help at: Localhelp.healthcare.gov/. Or call the Federal Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855- 889-4325. Translation services are available. The call is free.
Small businesses and their employees can get help from the toll-free SHOP Marketplace call center at 1-800-706-7893 or for TTY, call 711. The hours are Monday through Friday, 9 a.m. to 7 p.m. EST.
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