CMS confirms open enrollment total of 12.2M, down from last year and lower than projections

The federal government has released its final enrollment figures for 2017 Affordable Care Act exchange plans, confirming that 12.2 people enrolled in coverage—half a million fewer than last year—and offering additional insights about the imperiled individual market.

Previously, the most recent sign-up data from the Centers for Medicare & Medicaid Services included only enrollment figures for the 39 states that use, but the Associated Press conducted its own count that put total signups for both state and federally run marketplaces at about 12.2 million.

Open enrollment plan selection totals. (source:

That figure, confirmed by CMS’ final open enrollment report Tuesday, is lower than last year’s total of 12.7 million and fell short of the Obama administration’s prediction of 13.8 million signups. This year’s total includes 9.2 million customers and 3 million enrolled through state-based marketplaces.

When CMS released the signup totals in February, some pro-ACA groups argued that the Trump administration’s ACA repeal efforts and decision to pull back some open enrollment advertising was to blame for the slight dip compared to last year’s figure.

Here are some additional insights from the final open enrollment report:

  • Of the 12.2 million signups this year, 31% were new marketplace customers, while 43% actively re-enrolled in plans and 23% were automatically re-enrolled
  • The most popular metal tier was silver, comprising 71% of plan selections, followed by bronze (23%), gold (4%) and catastrophic and platinum at 1% each.
  • A plurality, 37% percent of customers were aged 35-54, while 36% were younger than 35 and 28% were 55 and older
  • An overwhelming majority—83%—saw their premiums reduced by advance payments of the premium tax credit, while 58% received cost-sharing reductions

In a report released this week, the Congressional Budget Office estimated that if House Republicans’ ACA repeal and replacement bill is enacted, 14 million more people would be uninsured in 2018 than under current law, and 24 million by 2026. However, some have pointed out that its past estimates of ACA enrollment have not always been correct.