In the upcoming open enrollment period, federal health officials have their sights set on enrolling the 10.5 million remaining uninsured Americans, yet another major challenge for the Affordable Care Act's marketplaces is to keep their current customers coming back, the New York Times reports.
The attrition in the exchanges is evident in the government's own statistics, which count 9.9 million federal and state marketplace enrollees as of June, a drop from the 11.7 million overall who signed up for coverage during the previous open enrollment period ending in February.
One driving factor may be marketplace enrollees' heightened cost concerns, causing some to drop coverage when they either lose their jobs, decide they can't fit the premiums into their budget, or are denied subsidies due to eligibility issues, the Times notes. This is especially the case in states that haven't expanded Medicaid, as this drives more low-income individuals to the marketplaces.
On the other hand, many consumers drop coverage because they don't fully understand the terms of their new insurance--in some cases not knowing they have to make monthly payments or failing to provide information such as a Social Security number, according to the article.
Consumer confusion can also cause individuals to miss out on subsidies, as 2.2 million people who qualified for such cost-sharing reductions have failed to access them, according to a recent analysis.
Finally, citizenship and immigration issues continue to drive exchange dropouts. In fact, due to changes in the length of time enrollees have to resolve documentation issues, more than 400,000 people have lost ACA coverage this year for citizenship and immigration-related reasons, almost four times as many as last year.
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