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Fact check: Have most ACA exchange customers chosen bronze or silver plans?
December 16, 2016
By Cory Eucalitto
A recent article in Politico examined potential actions by Republicans to repeal the Affordable Care Act (ACA) when President-elect Donald Trump takes office. According to the article, “Republicans would be scrapping a law that covers 20 million people with no concrete alternative plan laid out.”[1]
The article goes on to quote Georgia Republican Sen. Johnny Isakson as doubtful that ACA repeal would provoke a public backlash, as claimed by writer Jennifer Haberkorn. According to Isakson (as quoted by Politico), “Most of those 20 million got bronze policies with a great big deductible and not much insurance, so I don’t know that there’s going to be a big backlash.”[1]
However, Haberkorn claimed that “most people on the exchanges chose silver plans, which provide a higher level of benefits.”[1]
Who is correct about the type of health insurance plan purchased by most people through the government exchanges?
Haberkorn was correct that most people on the exchanges (70 percent) have opted for silver plans. A total of 22 percent have selected the bronze-level plans.[2] However, both Haberkorn and Isakson were incorrect about the number of people who have purchased health insurance through the government exchanges.
Background
The Affordable Care Act increased the number of Americans with health care coverage by expanding eligibility for Medicaid and by subsidizing the purchase of health insurance through government exchanges. (It also shifted coverage of children in families with incomes between 100 and 138 percent of the poverty line from the Children’s Health Insurance Program to Medicaid.)[3]
Sen. Isakson has represented Georgia since 2005. He is a member of both the Health, Education, Labor, and Pensions Committee, and the Finance Committee.[4] He voted against the ACA.[5]
Enrollment
The U.S. Department of Health and Human Services estimates that the ACA “resulted in gains in health insurance coverage for 20 million adults through early 2016.” (Some 2.3 million of these adults gained coverage through a parent’s insurance plan.)[6]
However, the 20-million figure does not represent the sum of increased enrollment in Medicaid and CHIP, along with insurance plans purchased through the exchanges. It actually represents the net changes in health care coverage reflecting individuals’ movement in and out of various forms of coverage.[6]
In 2016, 12.7 million Americans selected a plan through a government exchange, and HHS is projecting that number will rise to 13.8 million in 2017 (though the number enrolled at any given time varies over the course of a year).[7]
From the pre-ACA baseline in October 2013 through August 2016, Medicaid and CHIP enrollment combined grew by 15.7 million, to 73.1 million total enrollees.[8]
Plan types
Individuals purchasing plans through government exchanges may choose one of five plan levels which vary by premium cost, coverage, copays and deductibles, as well as levels of subsidies. The “Catastrophic” level plans have the lowest premiums and highest deductibles; the “Platinum” plans have the highest premiums and lowest deductibles.[9]
| Plan Level | Insurance company pays | Plan holder pays |
|---|---|---|
| Estimated average for typical population | ||
| Catastrophic | <60% | >40% |
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
In the open enrollment period for 2017, the average lowest-cost monthly premium is $366 for a Bronze plan, followed by $433 for Silver, $538 for Gold, and $674 for Platinum. HHS did not report on premiums for Catastrophic plans, as they are not available to all consumers.[10]
Plan selections
In March 2016, the latest month for which a breakdown of plan selection is available, 11.1 million Americans were enrolled in exchange plans. A total of 21.9 percent had Bronze plans while nearly 70 percent had Silver plans.[2]
| Plan Level | Enrollees | Percent of total |
|---|---|---|
| Catastrophic | 67,807 | 0.6% |
| Bronze | 2,427,537 | 21.9% |
| Silver | 7,721,983 | 69.7% |
| Gold | 697,157 | 6.3% |
| Platinum | 166,846 | 1.5% |
The Centers for Medicare and Medicaid Services has published six enrollment reports between December 2014 and March 2016. Bronze plan enrollment has never risen above 22 percent of total plan selections in a given year. Silver plan enrollment has never fallen below 67 percent of total plan selections in a given year. [11]
Conclusion
In a recent Politico article about potential efforts to repeal the Affordable Care Act, Georgia Republican Sen. Johnny Isakson claimed that most of the people who purchased insurance coverage through government exchanges opted for the bronze policies while reporter Jennifer Haberkorn claims that most chose silver plans.
Isakson was incorrect. As of March 2016, nearly 70 percent of plan holders had Silver plans. Bronze plan enrollment has never risen above 22 percent of all plans chosen in a given year. Both Haberkorn and Isakson were incorrect about the number of people who have purchased health insurance through government exchanges.
See also
Launched in October 2015 and active through October 2018, Fact Check by Ballotpedia examined claims made by elected officials, political appointees, and political candidates at the federal, state, and local levels. We evaluated claims made by politicians of all backgrounds and affiliations, subjecting them to the same objective and neutral examination process. As of 2025, Ballotpedia staff periodically review these articles to revaluate and reaffirm our conclusions. Please email us with questions, comments, or concerns about these articles. To learn more about fact-checking, click here.
Sources and Notes
- ↑ 1.0 1.1 1.2 Politico, “Republicans aim to start Obamacare repeal in January,” November 16, 2016
- ↑ 2.0 2.1 Centers for Medicare and Medicaid Services, “March 31, 2016 Effectuated Enrollment Snapshot,” June 30, 2016
- ↑ Medicaid.gov, “Children’s Health Insurance Program,” accessed December 14, 2016
- ↑ Ballotpedia, “Johnny Isakson,” accessed December 14, 2016
- ↑ GovTrack, “H.R.3590 (111th): Patient Protection and Affordable Care Act,” accessed December 14, 2016
- ↑ 6.0 6.1 Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, “Health Insurance Coverage and the Affordable Care Act, 2010-2016,” March 3, 2016
- ↑ Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, “Health Insurance Marketplace Enrollment Projections for 2017,” October 19, 2016, (pg. 2)
- ↑ Medicaid.gov, “Medicaid & CHIP: August 2016 Monthly Applications, Eligibility Determinations and Enrollment Totals,” November 3, 2016, (pg. 2-3)
- ↑ Healthcare.gov, “The ‘metal’ categories: Bronze, Silver, Gold, and Platinum,” accessed December 14, 2016
- ↑ Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, “Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace,” October 24, 2016 (pg. 11)
- ↑ Data.CMS.gov, “Total Effectuated Enrollment by Metal Level and State,” accessed December 14, 2016
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