FOR IMMEDIATE RELEASE
December 18, 2015
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AUSTIN—The Texas Association of Health Plans (TAHP) today announced the findings of a TAHP-commissioned study conducted by national research and consulting firm Milliman that examines Texas-specific enrollment trends and figures under the Affordable Care Act (ACA). This study, which includes 2015 figures, builds on a similar study also commissioned by TAHP that examined trends in 2014. Corresponding infographics can be found here.
Most notably, the Milliman study found that the ACA has had a significant impact on enrollment in Texas in the traditional fully-insured commercial insurance market, with a 20 percent increase in the number of individuals covered since implementation of the ACA’s key provisions in January of 2014. Prior to the ACA, 3.73 million individuals were covered in the traditional insurance market in Texas. The Milliman report found that that figure has increased by 760,000 individuals to a total of 4.49 million people covered in 2015.
The most dramatic change in Texas has occurred in the individual market, which has grown by 115 percent and now makes up 33 percent of the fully insured market. Prior to the ACA, the individual market’s share of the fully insured market was less than 19 percent.
Also notable is the decline in the fully insured small group market, which decreased by 10.3 percent from 2013 to 2015. The Milliman study only examines the fully insured market, so it is unclear if there is an overall decline in individuals receiving insurance through small employers, or if small employers are increasingly taking on more risk and shifting to the self-funded market.
“TAHP is pleased to share this important study that gives us a clearer picture of how the Affordable Care Act is impacting health insurance enrollment in Texas. It’s clear through this report that this impact has been significant, with a substantial increase in the number of Texans gaining health insurance in the traditional fully insured market and an explosive growth of the individual market,” said Jamie Dudensing, TAHP CEO and a former practicing nurse. “This report also provides more insight into Texans as consumers of health insurance, including a close look at how and where they are seeking and purchasing health coverage.”
The Milliman report examines where Texans are seeking health insurance and whether they have chosen to remain with the coverage they had prior to the ACA’s implementation or to seek new coverage.
In the first year of the ACA marketplace (2014), a majority of Texans (54 percent) seeking coverage in the individual market chose to purchase that coverage outside of the federal ACA marketplace exchange. Overall, 40 percent of individuals stayed with the same coverage they had prior to the ACA’s implementation.
This trend shifted in 2015, with approximately 60 percent of individuals purchasing plans through the ACA exchange. The number of these individuals who have chosen to remain with their pre-ACA coverage has declined by more than 50 percent, with only 17 percent of individuals in Texas currently remaining enrolled in their pre-ACA plans.
Small Business Trends
Small businesses are still predominately purchasing plans outside of the small employer marketplace or the Small Business Health Options Program (SHOP) (99.7%). Even though small employers are not purchasing plans in the SHOP, there has been an 80 percent increase in enrollment in ACA-compliant plans and a 31 percent reduction in the enrollment in pre-ACA plans. Approximately 55 percent of covered individuals in the small group market remain in pre-ACA plans, primarily in “transitional plans,” which groups were allowed to temporarily renew under the Centers for Medicare & Medicaid Services’ (CMS) guidance. (Under the 3/5/2014 CMS Memorandum, carriers can allow individuals and small employer groups to choose to renew these plans for policy years beginning on or before October 1, 2016).
Background on the Milliman report:
Milliman was asked by the Texas Association of Health Plans to compile the results of an enrollment survey of its members. This is the second year this survey has been conducted, soliciting information on the number of enrollees in the Texas commercial health insurance market segments (individual, small group, and large group). The first survey compiled enrollment as of 12/31/2013 and 7/31/2014, while this year’s study covers enrollment as of 12/31/2014 and 7/31/2015. This report contains the summarized results and describes the underlying methodology and assumptions.
- This is an updated enrollment survey for the traditional fully-insured commercial insurance market in 2013, 2014, and 2015.
- This survey only represents enrollment in the fully-insured market, and does not include self-funded groups.
- Over 95% of the 2014 Texas fully-insured commercial market is represented in the survey (96.0% of the individual segment, 97.6% of the small group segment, and 98.3% of the large group segment).
The Texas Association of Health Plans
The Texas Association of Health Plans (TAHP) is the statewide trade association representing private health insurers, health maintenance organizations, and other related health care entities operating in Texas. Our members provide health and supplemental benefits to Texans through employer-sponsored coverage, the individual insurance market, and public programs such as Medicare and Medicaid. TAHP advocates for public and private health care solutions that improve the affordability, access and accountability of health care for many Texans. As the voice for health plans in Texas, TAHP strives to increase public awareness about our members’ services, health care delivery benefits and contributions to communities across Texas.