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Survey: Assisters Help Estimated 5.3 Million During 2016 ACA Open Enrollment, Down 10 Percent from Prior Year

1 in 3 Brokers Say Most Insurers Ended Commissions for Special Enrollment Policies

During the third Affordable Care Act open enrollment period, assistance programs helped an estimated 5.3 million people — a number that was 10 percent lower than the prior year and that included a higher share of people renewing coverage, finds a new Kaiser Family Foundation survey of assister programs and brokers.

Both assisters and brokers report a shift toward more return customers among those who sought assistance during the 2016 ACA open enrollment period, which ran from Nov. 1, 2015 to Jan. 31, 2016. The survey finds just three in 10 assister programs (29%) say that “most to nearly all” of the consumers they helped during 2016 open enrollment were first-time applicants for ACA marketplace coverage, a drop from 53 percent in 2015. Brokers report a similar experience: More than half (52%) say that most people they helped during 2016 open enrollment were returning ACA marketplace customers, compared to 26 percent in 2015.

In its third year, the survey tracks the experiences of assistance programs signing people up for ACA coverage during open enrollment and, for consumers who qualify, during special enrollment periods. This year, for the second time, the survey includes health insurance brokers who helped people apply for non-group coverage in an ACA marketplace.

Among notable findings from brokers were reports of some insurers changing their approach to commissions for ACA marketplace policies, particularly when sold during special enrollment periods, which are available to people whose circumstances change in between open enrollment periods. Insurers have said that people enrolling during special enrollment periods are sicker than those who sign up during open enrollment. Six in 10 brokers (60%) said at least some insurers have stopped paying commissions on ACA marketplace policies sold outside open enrollment: 33 percent said most or all insurers have stopped paying commissions for special enrollment policies.

Other findings from the 2016 Survey of Health Insurance Marketplace Assister Programs and Brokers include:

  • During the 2016 open enrollment period, assister programs helped hundreds of thousands of consumers with real-time data verification problems. This included 230,000 consumers who needed assistance resolving issues with the ACA marketplace identity proofing system; at least 259,000 consumers who needed help with data-match inconsistencies related to real-time verification of income; and at least 172,000 who needed help with verification of immigration status.
  • Despite the shift to renewing consumers, about eight in 10 assister programs say “most” or “all to nearly all” consumers sought help because they lacked confidence to apply on their own and because they wanted help evaluating plan choices.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.