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Your Health Idaho reports record open enrollment, high retention and plans revenue model change
Summary
Your Health Idaho’s executive director told the Senate committee the exchange saw record enrollments in open enrollment 2025, strong retention, broad use of tax credits, and will shift its revenue from an assessment percentage to a per-member-per-month fee.
Patrick Kelly, executive director of Your Health Idaho, presented the exchange’s statutory update to the Senate Commerce and Human Resources Committee and reported record open-enrollment results, operational metrics, and planned administrative changes for 2025.
Kelly said the exchange ended 2024 with an average enrollment of about 120,000 Idahoans, and open enrollment for 2025 produced over 139,000 Idahoans who selected a plan. He reported that 90% of enrollments receive a federal premium tax credit that lowers monthly premiums and that roughly 71% of enrollments were completed with the assistance of an agent, broker or enrollment counselor. Kelly also said 47% of current enrollees had been with the exchange for four or more years and that the exchange’s Net Promoter Score for 2024 and open enrollment 2025 was 73, which Kelly characterized as "world class." "Your Health Idaho’s operating costs continue to be the lowest of all state-based exchanges while delivering one of the highest per capita enrollment rates," Kelly said, and he told the committee the exchange has delivered about $44,000,000 in savings to Idahoans since inception.
On finance and operations, Kelly said the exchange’s assessment fee in plan year 2024 was 2.49% of premium; in 2025 the exchange plans to shift from a percentage-of-premium assessment to a per-member-per-month fee to provide revenue predictability and align administrative cost treatment with carrier partners. Kelly said the exchange carries no debt, maintains cash reserves equivalent to six to nine months of operating costs, and holds a capital expenditure reserve of $1.5 million for building and technology assets.
Kelly described investments in customer service, bilingual advocates, new web and help-center tools, and community enrollment pop-ups (19 in-person pop-ups and 73 community events in 2024). He said self-service tools accounted for 90% of enrollments and the exchange saw a 16% decrease in inbound customer inquiries while achieving a 21% increase in enrollments year over year.
Committee members asked about governance and coordination with the Department of Insurance and Department of Health and Welfare; Kelly said the exchange is an independent nonprofit (a body corporate and politic) governed by a 19-member board appointed by the governor and coordinates with the Department of Insurance on plan certification and with Health and Welfare on the "no wrong door" eligibility transfers for Medicaid.
Senators thanked Kelly for the presentation; no formal committee action was required on the informational presentation.
