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Your Health Idaho reports record enrollments, high customer scores and readiness if Medicaid-expansion changes occur
Summary
The state’s health-insurance exchange presented 2024 results and open-enrollment 2025 figures, reporting record sign-ups, high retention, a net promoter score of 73, and financial self-sufficiency; the director also explained how a repeal of Medicaid expansion could shift some residents to exchange eligibility.
Your Health Idaho briefed the Senate Health and Welfare Committee on the exchange’s 2024 operations, open-enrollment 2025 outcomes, finances, and potential impacts if the state’s Medicaid expansion were repealed.
Pat Kelly, executive director of Your Health Idaho, told the committee the exchange finished 2024 with an average enrollment of about 120,000 Idahoans and said open-enrollment 2025 saw more than 139,000 Idahoans select plans. Kelly said 47% of enrollees had been with the exchange for four or more years and that more than 90% of enrollees receive a tax credit that lowers monthly premiums. He reported an organization net promoter score of 73 for 2024 and for open enrollment 2025 — a score Kelly described as ‘‘world class.’'
Kelly described the exchange's finances as self‑sustaining (no state funding), with primary revenue from an assessment fee on plans (2.49% in plan year 2024) and other income from rent and interest. He said the exchange maintains cash reserves equal to six to nine months of operating expenses and has delivered $44,000,000 in savings to Idahoans since inception. Your Health Idaho said it will move from a percentage-of-premium assessment to a per-member-per-month fee in 2025 to improve revenue predictability.
Kelly described operational metrics: 71% of enrollments used an agent, broker or enrollment counselor; 90% of enrollments were completed via self-service tools; inbound customer inquiries decreased 16% while enrollments rose 21% — a stated net efficiency gain. The exchange reported holding 19 in-person pop-up enrollment events during open enrollment, attending 73 community events in 2024, and employing more than 1,100 agents, brokers and enrollment counselors across the state.
Senator Wintrow asked about possible effects if Medicaid expansion were repealed. Kelly said the Medicaid expansion population in Idaho is roughly 85,000 people; of that group, about 19,100 have incomes between 101% and 138% of the federal poverty level and would become eligible for a tax credit and exchange coverage in a state without Medicaid expansion. The remaining persons in the expansion group who remain below 100% of the poverty level would fall into the federal "coverage gap," Kelly said; he recommended Department of Health and Welfare staff for detailed Medicaid eligibility questions.
Kelly said the exchange’s priorities for the coming year include investing in staff, improving tools for agents and brokers, continuing community outreach and remaining fiscally conservative.
