July 23, 2020

July 23, 2020Early 2020 Effectuated Enrollment SnapshotThis report provides effectuated enrollment, premium, and advance payments of the premium tax credit (APTC)data for the Federally-facilitated and State-based Exchanges (“the Exchanges”) for February 2020 and for the2019 plan year.February 2020 Effectuated Enrollment Snapshot Key FindingsAs of March 15, 2020 1, 10.7 million consumers had effectuated coverage through the Exchanges for February2020, meaning that they selected a plan, paid their first month’s premium, if applicable, and had coverage inFebruary 2020. This number represents approximately 94 percent of consumers who made plan selectionsduring the 2020 Open Enrollment Period (11.4 million). 2 Although the number of plan selections through theExchanges were approximately equal in the 2019 and 2020 Open Enrollment Periods (OEPs), a greater numberof consumers had effectuated coverage in February 2020 compared to February 2019, as of March 15 of bothyears. 3 Total effectuated enrollment for February 2020 increased by approximately one percent from totaleffectuated enrollment for February 2019.The average total monthly premium for Exchange enrollees in February 2020 was 576.16, a decrease of threepercent from the February 2019 average premium of 594.17. Approximately 9.2 million, or 86 percent, ofExchange enrollees in February 2020 received APTC, which represents a decrease of approximately 1 percentagepoint from the share of Exchange enrollees who received APTC in February 2019. The average monthly amount ofAPTC per enrollee receiving APTC fell by approximately four percent from February 2019, to 491.53. Thenumbers reported today may be revised in future months as additional data on new effectuations, terminations, andcancellations become available. Later this year, CMS plans to publish effectuated enrollment data for the first sixmonths of 2020, which will include updated February 2020 enrollment data.2019 Average Monthly Effectuated Enrollment Snapshot Key FindingsOn a monthly average basis, 9.8 million consumers had effectuated coverage through the Exchanges in the 2019plan year. This is a decrease of slightly less than one percent from the average monthly effectuated enrollment of9.9 million in the 2018 plan year.The average total monthly premium for Exchange enrollees in 2019 was 591.26, consistent with the 20181February 2020 data for Minnesota are as of April 15, 2020. Due to Minnesota’s transition to policy-based payments in 2020, thedata for the April payment cycle (as of March 15, 2020) were incomplete.2Health Insurance Exchanges 2020 Open Enrollment Report, available at: pdf.3February 2019 and 2018 monthly effectuated enrollment and premium data in this report are as of March 15, 2019. CompleteFebruary 2019 and 2018 average monthly effectuated enrollment data are available ctuatedEnrollment.pdf1

average total monthly premium of 594.11. Approximately 87 percent of Exchange enrollees received APTC in2019, consistent with the percentage of enrollees who received APTC in 2018. In 2019, the average monthlyamount of APTC per enrollee receiving APTC fell by approximately one percent from 2018, to 512.11.In 2019, monthly effectuated enrollment peaked in January at approximately 10.5 million consumers and fell toapproximately 9.1 million by December, meaning that monthly effectuations and disenrollments followed asimilar pattern as in 2018, when monthly effectuated enrollment fell from a high of approximately 10.5 millionconsumers in February to approximately 9.2 million at the end of the year.Background InformationThe primary sources for both the February 2020 effectuated enrollment snapshot and the 2019 average monthlyeffectuated enrollment data are payment and enrollment data, which include data from both the Federallyfacilitated and State-based Exchanges. Effectuated enrollment for February 2020 is the total number ofconsumers who paid their premiums (if applicable)—thus effectuating their coverages—and who had activepolicies in February 2020 as of March 15, 2020. The 2019 average monthly effectuated enrollment is the averagemonthly number of consumers who paid their premiums (if applicable)—thus effectuating their coverages—andwho had active policies in 2019 as of March 15, 2020. The average monthly effectuated enrollment number wascalculated by adding total member months for 2019 and dividing by 12.APTC enrollment for the February 2020 effectuated enrollment snapshot is the total number of consumerswho paid their premiums (if applicable)—thus effectuating their coverages—and who received APTC inassociation with their active policies in February 2020. The 2019 average monthly APTC enrollment is theaverage number of consumers who paid their premiums (if applicable)—thus effectuating their coverages—and who received APTC in association with their active policies in 2019. APTC is generally available if aconsumer's household income is between 100 percent and 400 percent of the federal poverty level. (Certainother criteria apply to APTC eligibility and must be met in order to receive APTC.) Consumers were definedas receiving APTC if the APTC amounts applied to their premiums were greater than 0; otherwise,consumers were classified as not receiving APTC.Cost-sharing reduction (CSR) enrollment for the February 2020 effectuated enrollment snapshot is the totalnumber of consumers who paid their premiums (if applicable)—thus effectuating their coverages—and whoreceived CSRs in association with their active policies in February 2020. The 2019 average monthly CSRenrollment is the average number of consumers who paid their premiums (if applicable)—thus effectuatingtheir coverages—and who received CSRs in association with their active policies in 2019. A consumer isgenerally eligible for a CSR if the consumer is eligible for APTC, has a household income between 100percent and 250 percent of the federal poverty level, and is enrolled in a qualified health plan from the silverplan category. (American Indians and Alaskan Natives are eligible for CSRs under different criteria.)This communication was printed, published, or produced and disseminated at U.S. taxpayer expense.42

Table 1: Total Effectuated Enrollment and Enrollees Receiving APTC and CSR by State, February 2020StateTotalEnrollmentAPTCEnrollmentPercentage ofEnrollment withAPTCCSREnrollmentPercentage ofEnrollmentwith %36%48%35%43%12%33%3

Table 1: Total Effectuated Enrollment and Enrollees Receiving APTC and CSR by State, February 2020 e ofEnrollment withAPTCCSREnrollmentPercentage ofEnrollment 40%36%32%38%49%23%Source: Data as of March 15, 2020, CMS*Minnesota data are as of April 15, 2020. Due to Minnesota’s transition to policy-based payments in 2020, the data for the Aprilpayment cycle (as of March 15, 2020) were incomplete4

Table 2: Average Total Premium and Average APTC by State,February LAMAMDMEMIMN*MOMSMTNCNDAverage TotalPremium perMonth 576.16 735.89 690.47 519.99 584.14 569.72 481.52 683.95 516.96 666.53 592.44 562.02 628.07 818.20 525.23 633.16 537.68 633.74 588.02 674.61 402.87 504.62 634.64 477.20 443.17 631.34 602.05 568.84 656.08 446.105Average APTC perMonth 491.53 670.07 624.55 382.75 469.23 454.20 374.11 633.21 389.46 571.96 530.18 493.22 518.76 803.16 478.80 498.38 394.58 544.35 505.76 562.96 266.17 443.17 546.76 364.35 294.02 562.57 558.44 483.00 605.18 321.46

Table 2: Average Total Premium and Average APTC by State,February 2020 WIWVWYAverage TotalPremium perMonth 756.07 525.39 553.24 475.10 492.40 586.04 517.82 635.83 554.71 643.03 432.39 609.74 678.80 637.16 527.77 417.41 636.24 621.68 506.65 652.89 984.40 956.60Average APTC perMonth 707.86 414.46 417.11 373.56 384.80 335.00 387.54 593.36 452.72 514.29 323.96 539.42 598.09 576.78 468.35 369.87 554.12 463.29 394.48 566.21 813.80 914.18Source: Data as of March 15, 2020, CMS*Minnesota data are as of April 15, 2020. Due to Minnesota’s transition topolicy-based payments in 2020, the data for the April payment cycle (as ofMarch 15, 2020) were incomplete6

Table 3: Total Average Monthly Effectuated Enrollment and Enrollees Receiving APTC and CSR by State,2019PercentagePercentage ofAPTCCSRTotalofStateEnrollment th 34,85452%7

Table 3: Total Average Monthly Effectuated Enrollment and Enrollees Receiving APTC and CSR by State,2019 (Cont.)PercentagePercentage ofAPTCCSRTotalofStateEnrollment th 920,79495%5,63826%Source: Data as of March 15, 2020, CMS8

Table 4: Average Total Premium and Average APTC by State,2019StateAverage TotalPremium perMonthAverage APTC perMonth (forconsumersreceiving MDMEMIMNMOMSMTNC 591.26 734.73 671.51 512.25 591.19 578.78 620.92 618.35 468.08 832.12 601.15 595.16 660.15 910.97 522.02 645.58 484.25 653.98 593.60 613.26 389.38 557.02 659.04 496.29 458.28 645.95 632.18 662.92 723.52 512.11 659.28 610.46 395.00 496.51 475.74 538.25 509.83 368.48 741.50 541.60 537.84 559.18 877.64 479.08 526.48 339.19 588.35 506.81 498.57 247.71 478.68 587.79 387.28 309.82 578.03 595.26 581.57 674.629

Table 4: Average Total Premium and Average APTC by State,2019 (Cont.)StateAverage TotalPremium WVWY 494.56 848.11 533.92 510.98 483.08 505.38 561.35 532.52 657.42 557.86 650.11 433.39 662.30 639.97 659.43 539.22 447.24 673.16 569.66 532.80 696.73 931.94 942.01Source: Data as of March 15, 2020, CMS10Average APTC perMonth (forconsumersreceiving APTC) 388.64 822.19 412.33 365.20 395.05 422.64 326.75 400.96 639.86 452.45 539.52 326.67 600.26 554.32 609.43 482.63 413.47 597.78 429.02 409.66 623.11 764.91 892.43

Table 5: Monthly Effectuated Enrollment by State, 16511

Table 5: Monthly Effectuated Enrollment by State, 2019 08912

Table 5: Monthly Effectuated Enrollment by State, 2019 ce: Data as of March 15, 2020, 820,41713

2019 plan year. February 2020 Effectuated Enrollment Snapshot Key Findings As of March 15, 2020. 1, 10.7 million consumers had effectuated coverage through the Exchanges for February 2020, meaning that they selected a plan, paid their first month’s premium, if applicable, and had coverage in February 2020.