However, for no particular reason, I included the methodology for Medicaid & CHIP data in with the ACA enrollment post, since it ACA Expansion Medicaid overlaps with that.
I recently published an ambitious spreadsheet which attempted to compile a comprehensive & up to date tally of total ACA healthcare coverage (including both exchange-based Qualified Health Plans (QHPs), Basic Health Plans (BHPs) and ACA Medicaid expansion enrollment), broken out by not just state but by Congressional District.
Doing this on a state-by-state level is easy. Doing so by Congressional District (CD) gets a lot trickier.
As I noted in my prior article, for state level ACA enrollment I'm using official data reports from the Centers for Medicare & Medicaid Services (CMS) for the "baseline" numbers, supplemented by more recent state-level data from some of the state-based ACA exchanges & state Health & Human Services departments.
There's only a single CD in Alaska, Delaware, Montana, North Dakota, South Dakota, Vermont and Wyoming, as well as one non-voting House member in the District of Columbia, so no further work is needed for those. For the other 43 states, however, breaking the enrollment data out by CD gets trickier.
Welp. With last weeks news that House Republicans have decided to once again go to war with the Affordable Care Act if they gain a federal trifecta this November, it's time once again to take a look at just how many of their constituents are at risk of losing their healthcare coverage entirely or, at best, facing massive premium increases (which in most cases would have the same effect by making their coverage cost far more than they could possibly afford).
Alongside this weekends release of the final, official 2024 ACA Open Enrollment Period (OEP) data, The Centers for Medicare & Medicaid Services (CMS) has also pulled together estimates of how many residents of each Congressional District selected ACA exchange plans during the 2024 OEP:
This is, of course, extremely important since household income is one of the most critical factors in calculating how much financial assistance enrollees receive (or if they're eligible for Advance Premium Tax Credits (ATPC) at all).
If you've ever wondered why healthcare wonks (myself included) almost never even bring up the ACA's Catastrophic Level plans and why the only time I ever discuss Platinum Plans is in the context of high-CSR enrollees being eligible for "Secret Platinum" plans (labeled as Silver), this table should explain why.
Next up: Age brackets, gender, racial/ethnic groups and urban/rural communities. I'm also throwing in the stand-alone Dental Plan table here for the heck of it since I don't know where else to include it.
I don't have a ton to say about any of these, really. It's always interesting to me to see that 1.7% of ACA exchange enrollees are 65 or older. Not sure why they aren't on Medicare but I'm sure there are logical reasons.
Now it's time to move on to the actual demographic breakout of the 2024 Open Enrollment Period (OEP) Qualified Health Plan (QHP) enrollees.
First up is breaking out new enrollees vs. existing enrollees who either actively re-enroll in an exchange plan for another year or who passively allow themselves to be automatically renewed into their current plan (or to be "mapped" to a similar plan if the current one is no longer available).
The table below has the data for both Qualified Health Plans (QHPs) in all 50 states + DC as well as Basic Health Plan (BHP) enrollment in Minnesota and New York only, compared to the 2023 OEP.
