Your Health Idaho reports record open-enrollment numbers, shifts revenue model and highlights consumer metrics

Pat Kelly, executive director of Your Health Idaho, presented a year-end and open-enrollment update to the Senate Health and Welfare Committee, describing enrollment growth, customer-service metrics and planned operational changes.

Kelly said the exchange is financially self-sustaining and receives no state funding. Your Health Idaho reported an average enrollment of about 120,000 Idahoans in 2024, and over 139,000 Idahoans selected plans during open enrollment for plan year 2025. Kelly said 68% of 2024 enrollees renewed their coverage and 32% were new customers; more than 90% of enrollees received a tax credit that lowers monthly premiums. He reported that 71% of enrollments were completed with help from an agent, broker or enrollment counselor, and that the exchange’s Net Promoter Score for 2024 and for open enrollment 2025 was 73.

Kelly described efficiency gains tied to technology investments: 90% of enrollments are completed using self-service tools, inbound customer inquiries fell 16% while enrollments increased 21%, which Kelly summarized as a 37% net efficiency gain. The exchange’s assessment fee for plan year 2024 was 2.49%; Kelly said the organization will move from a percentage-of-premium assessment to a per-member-per-month fee structure in 2025 to increase revenue predictability.

Kelly also discussed outreach and customer access: Your Health Idaho attended 73 community events and held 19 in-person enrollment pop-up events during open enrollment; the exchange reports that more than 50% of customers have been enrolled four or more years. Kelly noted that the exchange maintains cash reserves equivalent to six to nine months of operating expenses and carries no debt.

Committee members asked about the potential impact of a repeal of Medicaid expansion. Kelly said that, if expansion were repealed, some of the Medicaid-expansion population (those with incomes at 101–138% of the federal poverty level) could become eligible for tax credits and enroll on the exchange; he provided an estimate that 19,100 people in the current Medicaid-expansion cohort have incomes in that range. Kelly said other members of the expansion population would fall into the coverage gap and should be referred to the Department of Health and Welfare for detailed eligibility analysis.

Ending: Kelly said the exchange will continue investing in technology, partnerships with agents and community outreach and will seek to sustain low operating costs while expanding enrollment tools and education to Idahoans.