Your Health Idaho reports record open enrollment, to switch fee to per-member monthly charge

Pat Kelly, executive director of Your Health Idaho, presented the exchange’s year-end review and open enrollment 2025 results to the House Health & Welfare Committee, reporting record participation, persistent use of tax credits, and a planned change to the exchange’s revenue model.

“Your Health Idaho's mission is to deliver a flawless customer experience,” Kelly said, and he summarized several operational and financial metrics the exchange tracks. Kelly reported that more than 139,000 Idahoans selected a plan during open enrollment 2025 and that about 97% of customers had paid for their coverage as of the morning of the presentation.

Kelly said the exchange will move from a 2.49% assessment on premiums in plan year 2024 to a per-member-per-month fee of $11.75 in 2025. He told the committee that, on an apples-to-apples basis, $11.75 translates to roughly 2.44% of premium and that the change is intended to provide revenue predictability for the exchange and its carrier partners.

On enrollment and demographics, Kelly said Your Health Idaho averaged 20,000 enrollees during the year and that 71% of consumers used an agent or broker to enroll. He said more than 90% of enrollees receive an advance premium tax credit (APTC) to lower monthly premiums and that the exchange’s technology and self-service tools now complete roughly 90% of enrollments.

Kelly highlighted customer-satisfaction metrics: Your Health Idaho reported an average Net Promoter Score of 73 for 2024 and achieved the same NPS during open enrollment 2025. He also said the exchange carried cash reserves equal to six to nine months of operating expenses, carries no debt, and generated rental and interest revenue from a building purchased in 2020.

Committee members asked a range of operational and policy questions. Representative Levitt asked about the average cost per person; Kelly said enrollees pay an average net premium of about $120 per month but that results vary widely and can range from $0 up to many hundreds of dollars depending on household size, income, location and plan choice.

Representative Fuhrman asked about the new fee level; Kelly confirmed the per-member-per-month fee will be $11.75 in 2025 and said that translates to about 2.44% on an apples-to-apples basis with prior percent-of-premium methodology. Fuhrman also asked whether brokers are paid by the exchange; Kelly said carriers compensate agents and brokers directly and the exchange does not handle broker compensation.

Representative McCann asked how people who leave the exchange are replaced or where they go; Kelly said people move on to Medicare, employer-sponsored coverage, or other private plans and that the exchange does not have a precise number for off-exchange transitions. On the question of Medicaid expansion, Kelly explained that eligibility for APTC differs depending on expansion status; he gave historical counts from 2018 to illustrate how enrollment shifted when expansion was implemented but said current exact counts were not provided in his presentation.

Representative Erickson asked whether behavioral health is covered on exchange plans; Kelly said benefit design is managed by the Idaho Department of Insurance and offered to follow up with the committee by email after researching the question.

Several committee members praised the exchange. Representative Fuhrman told Kelly the exchange is “a well oiled machine” and thanked staff for responsiveness and options. Kelly closed by thanking the committee and offering to follow up on outstanding questions.