Your Health Idaho reports record enrollments, customer-satisfaction gains and plan for revenue model change

Pat Kelly, executive director of Your Health Idaho, briefed the Senate Health and Welfare Committee on the exchange's 2024 performance, open enrollment 2025 results and planned operational changes.

Kelly said Your Health Idaho finished 2024 with an average enrollment of about 120,000 Idahoans and reported what he described as strong retention: "47 percent of those having been enrolled with Your Health Idaho for 4 or more years," and later characterized the long-term retention as "over 50 percent" in subsequent remarks. Kelly attributed record results to investments in technology, outreach and broker/enrollment networks.

Highlights Kelly reported: a record-breaking open enrollment for plan year 2025 with more than 139,000 Idahoans selecting plans; 22 percent of enrollees were new customers; 71 percent of enrollments were completed with an agent, broker or enrollment counselor; a Net Promoter Score of 73 for 2024 and again for open enrollment 2025; and a reported $44 million in cumulative savings for Idahoans since the exchange's inception. Kelly said the exchange is financially self-sustaining, carries six to nine months of operating reserves, had a 2024 assessment fee of 2.49 percent and plans to move to a per-member-per-month fee in 2025 to stabilize revenue.

Kelly also outlined how a Medicaid-expansion repeal would affect exchange eligibility: he said of an estimated 85,000 people in the Medicaid-expansion population, about 19,100 have incomes between 100 and 138 percent of the federal poverty level and "would become eligible for a tax credit and then to enroll on the exchange." Kelly said the remainder of that population would fall into the "coverage gap" and would not be eligible for exchange tax credits; he recommended questions about that population be directed to the Department of Health and Welfare for detailed eligibility analysis.

Committee members asked questions about program comparisons with other states and the exchange's fiscal model. Senator Bierke asked how many states operate state-based exchanges; Kelly said 20 states now have state-based exchanges and noted that in 2013 there were 13. Senator Wintrow pressed Kelly on the Medicaid-repeal scenario and its implications for different income bands; Kelly reiterated the 19,100 figure for those who would newly qualify for exchange tax credits if expansion were repealed.

Kelly said the exchange will continue investments in bilingual customer advocates, agent training, community pop-up enrollment events (19 held during open enrollment 2025) and technology updates to simplify shopping and eligibility determination.