Health insurance enrollment reaches four million in first month

About four million Americans had enrolled in healthcare insurance coverage through the federal and state exchanges from mid-November to mid-December, the first month of open enrollment for 2015 plans, government statistics reveal. That total includes individuals obtaining coverage through the exchanges for the first time, as well as those re-enrolling in coverage.

Approximately 3.4 million of the enrollees live in the 37 states that use the federal Healthcare.gov platform. The remaining 600,000 are in the states (including the District of Columbia) that established their own exchanges.

Nearly 90% of those who used the Healthcare.gov platform qualify for financial assistance in paying their premiums-a fact that may take on added significance in light of an upcoming case before the U.S. Supreme Court.

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Enrollment was split evenly between those who obtained coverage through the exchanges for the first time and those who had coverage previously but selected a new plan for 2015. However, the data do not include people who were automatically re-enrolled in their plans, because that information was not available from most states.

“We’re pleased that nationwide, millions of people signed up for marketplace coverage starting January 1,” U.S. Health and Human Services Secretary Sylvia M. Burwell said in a written statement. “Interest in the Marketplace has been strong during the first month of open enrollment. We still have a ways to go and a lot of work to do before February 15, but this is an encouraging start.”

Open enrollment ends February 15, but those who signed up by December 15 were eligible to have their coverage begin January 1.

Among states using the federal Healthcare.gov platform, the largest numbers of 2015 enrollees came from Florida (673,255),Texas (379,525), North Carolina (249,784), Georgia (187,654) and Pennsylvania (180,046). For states using their own platforms, the biggest increases occurred in California (118,770), Kentucky (82,651), Connecticut (77,042), Idaho (72,262) and Washington (63,411). About one in three were under 35 years of age, compared with 29% in that age group during the first months of 2014 enrollment.

Some health policy analysts believe that the large proportion of enrollees qualifying for subsidies could affect the Supreme Court’s eventual ruling in the upcoming caseKing v. Burwell. That case challenges the legality of offering subsidies to people who obtain healthcare insurance through the federal healthcare.gov platform. A ruling against the subsidies thus would effectively gut much of the Affordable Care Act.