1. Health insurance marketplace participation grew rapidly in 2014 and 2015, but slowed in 2016. The number of enrollees at the end of the selection period grew from 8 million in 2014 to 11.7 million for 2015, but only grew slightly to 12.7 million for 2016.
2. There are still huge uninsured populations in many markets and most of those people are healthier than the current nongroup enrollees, according to the report. If a large number enrolled, it would improve the average health of the people with non-group policies. The healthier enrollees would also help moderate premiums.
3. A percentage of the population, largely health people, are currently in “grandmothered” plans they were allowed to keep because the plans existed before the ACA passed. However, the plans are only allowed to continue until 2018. At that point, people will transition into ACA-compliant plans.
4. A large premium increase for future plans could drive current enrollees to other plans. Those most likely to leave are healthier people while the sicker people are more willing to stay and pay the increase, according to the report.
5. Premium tax credits protect some enrollees from premium increases if enrollees stay in low-cost plans, but those people may need to switch insurers.
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