COUNTY-LEVEL DATA ON TENNESSEE S 2018 OBAMACARE ENROLLMENT

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APRIL 19, COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT Last week, we dug into statewide data on open enrollment in private health insurance through the healthcare.

1 APRIL 19, COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT Last week, we dug into statewide data on open enrollment in private health insurance through the healthcare.gov Marketplace created by the Affordable Care Act (ACA). The maps, charts, and tables below show how key data about Marketplace enrollment vary by county. The following observations were notable in our analysis of the data, but the factors that might be driving them are not yet clear: Counties in Northeast Tennessee experienced the largest declines in enrollment from 2017 to. The average net premium for subsidized enrollees is notably higher in the rating areas that include Davidson County and the Tri-Cities. Meanwhile, these same areas have some of the lowest premiums for the minority of enrollees who are unsubsidized. Note: These county-level data are based on actual enrollment and plan selections during the open enrollment period that ran from November 1 st to December 15 th, Participating insurers, plan options and premium rates are based on 8 rating areas across the state, which are shown on the maps that follow. ENROLLMENT Tennessee s most populous counties (i.e. Davidson, Shelby, Knox, and Hamilton) have the most enrollees. Just under 229,000 Tennesseans enrolled statewide in Marketplace coverage for. (Figure 1) ranges from 1.8% of population in Montgomery County to 5.1% in Sevier County. Statewide, Marketplace enrollment amounts to about 3.4% of the state s total population. (Figure 2) Change in enrollment from 2017 to varies considerably ranging from a 7.6% increase in Williamson County to a 14.6% decline in Hawkins County. Statewide enrollment was relatively stable with only a 2% drop from (Figures 3 and 4) FIGURE 1. ENROLLMENT IN TENNESSEE S HEALTHCARE.GOV MARKETPLACE, BY COUNTY Note: Based on plan selections during the open enrollment period. Sources: Marketplace Open Period State- and County-Level Public Use Files (1) (2) 1 THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT FIGURE 3. 2017 TO CHANGE IN ENROLLMENT IN TENNESSEE S HEALTHCARE.

Sources: 2017 and Marketplace Open Period State- and County-Level Public Use Files (4) (5) (1) (2) SUBSIDIES The share of enrollees eligible for federal subsidies to offset premiums ranges from 66%

2 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT FIGURE TO CHANGE IN ENROLLMENT IN TENNESSEE S HEALTHCARE.GOV MARKETPLACE, BY COUNTY Note: Based on plan selections during the 2017 and open enrollment periods. Sources: 2017 and Marketplace Open Period State- and County-Level Public Use Files (4) (5) (1) (2) SUBSIDIES The share of enrollees eligible for federal subsidies to offset premiums ranges from 66% in Williamson County to 97% in Decatur County. Statewide, about 84% of enrollees are eligible for federal premium subsidies. (Figures 5 and 6) These subsidies are available to those with incomes under 400% of poverty (about $48,560 for an individual in ). Average monthly premium subsidies range from $569 in Williamson County to $1,082 in Perry County, while growth in subsidies from 2017 to range from 21% in Bledsoe County to 95% in Loudon County. Statewide, average premium subsidies for eligible enrollees were $797 per month, a 51% increase over average subsidies in (Table 1) Because subsidies are available on a sliding scale, growth in average premium subsidies is driven by both premiums for the benchmark plan on which subsidies are based and the income levels of actual enrollees. FIGURE 5. PERCENTAGE OF TENNESSEE HEALTHCARE.GOV MARKETPLACE ENROLLEES WITH PREMIUM SUBSIDIES, BY COUNTY Note: Based on plan selections during the open enrollment period. Sources: Marketplace Open Period State- and County-Level Public Use Files (1) (2) 2 THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT PREMIUMS There is a wide range across counties in average monthly premiums for both subsidized and unsubsidized enrollees.

(Figures 7 and 8) Unsubsidized enrollees average monthly premiums range from $514 in Davidson County to $1,007 in Houston County. Statewide, this average amount is $619 per month.

3 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT PREMIUMS There is a wide range across counties in average monthly premiums for both subsidized and unsubsidized enrollees. Subsidized enrollees net average monthly premiums range from $12 in Haywood County to $74 in Cheatham and Johnson Counties. Statewide, this average amount is $39 per month, on average. (Figures 7 and 8) Unsubsidized enrollees average monthly premiums range from $514 in Davidson County to $1,007 in Houston County. Statewide, this average amount is $619 per month. (Figures 9 and 10) County-level data on 2017 premiums are not available, which limits our ability to do county-level analysis of premium trends. FIGURE 7. AVERAGE NET MONTHLY PREMIUM FOR SUBSIDIZED ENROLLEES IN TENNESSEE S HEALTHCARE.GOV MARKETPLACE, BY COUNTY Note: Based on plan selections during the open enrollment period. Sources: Marketplace Open Period State- and County-Level Public Use Files (1) (2) FIGURE 9. AVERAGE MONTHLY PREMIUM FOR UNSUBSIDIZED ENROLLEES IN TENNESSEE S HEALTHCARE.GOV MARKETPLACE, BY COUNTY Note: Based on plan selections during the open enrollment period. Sources: The Sycamore Institute s analysis of data from the Marketplace Open Period State- and County-Level Public Use Files (1) (2) 3 THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

4 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT FIGURE 2. ENROLLMENT IN TENNESSEE S HEALTHCARE.GOV MARKETPLACE AS A PERCENT OF POPULATION, BY COUNTY Sevier Co. 5.1% Clay Co. 4.8% Davidson Co. 4.5% Wayne Co. 4.4% Lincoln Co. 4.3% White Co. 4.3% Decatur Co. 4.2% Lawrence Co. 4.2% Pickett Co. 4.2% Henderson Co. 4.1% Williamson Co. 4.0% Van Buren Co. 4.0% Jackson Co. 3.9% Grundy Co. 3.9% Putnam Co. 3.9% Hamilton Co. 3.9% Sequatchie Co. 3.9% Knox Co. 3.9% Overton Co. 3.8% Lewis Co. 3.8% Fentress Co. 3.8% Hickman Co. 3.7% Hardin Co. 3.7% Henry Co. 3.6% Crockett Co. 3.6% Madison Co. 3.6% Giles Co. 3.6% Polk Co. 3.5% Fayette Co. 3.5% Dickson Co. 3.5% Perry Co. 3.5% Cumberland Co. 3.5% Bradley Co. 3.4% Hancock Co. 3.4% McNairy Co. 3.4% Statewide 3.4% Benton Co. 3.4% Maury Co. 3.4% Blount Co. 3.4% Jefferson Co. 3.4% DeKalb Co. 3.4% Warren Co. 3.4% Loudon Co. 3.4% Macon Co. 3.4% Washington Co. 3.4% Smith Co. 3.3% Cannon Co. 3.3% Cheatham Co. 3.3% Cocke Co. 3.3% Grainger Co. 3.3% Dyer Co. 3.3% Claiborne Co. 3.3% Shelby Co. 3.2% Hardeman Co. 3.2% Gibson Co. 3.2% Wilson Co. 3.2% Anderson Co. 3.1% Coffee Co. 3.1% Carroll Co. 3.1% Stewart Co. 3.1% Union Co. 3.1% Moore Co. 3.1% Marion Co. 3.1% Franklin Co. 3.0% McMinn Co. 3.0% Sumner Co. 3.0% Chester Co. 3.0% Obion Co. 3.0% Monroe Co. 3.0% Hamblen Co. 2.9% Sullivan Co. 2.9% Bedford Co. 2.9% Meigs Co. 2.9% Carter Co. 2.9% Unicoi Co. 2.8% Haywood Co. 2.8% Robertson Co. 2.8% Marshall Co. 2.7% Scott Co. 2.7% Campbell Co. 2.7% Greene Co. 2.7% Rutherford Co. 2.6% Humphreys Co. 2.6% Rhea Co. 2.5% Roane Co. 2.5% Bledsoe Co. 2.5% Houston Co. 2.5% Hawkins Co. 2.4% Tipton Co. 2.4% Johnson Co. 2.4% Weakley Co. 2.3% Trousdale Co. 2.1% Lauderdale Co. 2.1% Lake Co. 2.0% Morgan Co. 1.9% Montgomery Co. 1.8% 0.0% 1.0% 2.0% 3.0% 4.0% 5.0% Note: Based on plan selections during the open enrollment period and 2017 population estimates. Sources: The Sycamore Institute s analysis of data from the Marketplace Open Period State and County-Level Public Use File and the U.S. Census Bureau (1) (2) (3) 4 THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

5 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT FIGURE TO CHANGE IN ENROLLMENT IN TENNESSEE S HEALTHCARE.GOV MARKETPLACE, BY COUNTY Dyer Co. -0.2% Bradley Co. -0.3% Union Co. -0.7% Carroll Co. -0.8% Putnam Co. -0.8% Morgan Co. -1.0% Overton Co. -1.1% Warren Co. -1.1% Hamilton Co. -1.1% Tipton Co. -1.2% Macon Co. -1.3% Cannon Co. -1.5% Maury Co. -1.6% Grainger Co. -1.7% Hardin Co. -1.7% Coffee Co. -1.8% Lake Co. -2.0% Hamblen Co. -2.0% Wayne Co. -2.3% Stewart Co. -2.3% Statewide -2.3% Marion Co. -2.7% Hardeman Co. -2.7% DeKalb Co. -2.8% Monroe Co. -2.8% Rhea Co. -3.0% Meigs Co. -3.1% Madison Co. -3.1% Clay Co. -3.2% Decatur Co. -3.3% Chester Co. -3.4% Dickson Co. -4.1% Giles Co. -4.1% Cheatham Co. -4.2% Loudon Co. -4.5% Sevier Co. -4.6% Weakley Co. -4.6% Gibson Co. -4.7% Moore Co. -4.8% Benton Co. -4.9% Shelby Co. -4.9% Jefferson Co. -5.5% Haywood Co. -6.0% Marshall Co. -6.4% Rutherford Co. -6.6% Franklin Co. -6.9% Hickman Co. -7.0% Jackson Co. -7.1% Pickett Co. -7.5% Lauderdale Co. -7.6% Knox Co. -7.7% Trousdale Co. -7.7% Bedford Co. -7.7% Humphreys Co. -7.8% Johnson Co. -8.1% Blount Co. -8.1% Lewis Co. -8.5% Crockett Co. -8.5% Cocke Co. -8.7% Hancock Co. -9.2% Washington Co % Greene Co % Scott Co % Unicoi Co % Carter Co % Sullivan Co % Roane Co % Hawkins Co % Williamson Co. 7.6% Fentress Co. 6.4% Sequatchie Co. 5.7% Davidson Co. 5.7% Van Buren Co. 5.5% McMinn Co. 3.8% Houston Co. 3.6% Bledsoe Co. 3.4% Cumberland Co. 3.3% Wilson Co. 3.1% Montgomery Co. 3.1% Polk Co. 3.0% Henry Co. 2.8% Perry Co. 2.2% Sumner Co. 2.0% Obion Co. 1.8% Robertson Co. 1.8% Claiborne Co. 1.6% Lawrence Co. 1.4% Lincoln Co. 1.4% White Co. 1.0% Fayette Co. 0.6% Henderson Co. 0.5% Anderson Co. 0.5% Campbell Co. 0.5% Smith Co. 0.5% McNairy Co. 0.5% Grundy Co. 0.2% -15% -12.5% -10% -7.5% -5% -2.5% 0% +2.5% +5% +7.5% +10% Note: Based on plan selections during the 2017 and open enrollment period. Sources: The Sycamore Institute s analysis of data from the 2017 and Marketplace Open Period State- and County- Level Public Use Files (4) (5) (1) (2) 5 THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

6 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT FIGURE 6. PERCENTAGE OF TENNESSEE HEALTHCARE.GOV MARKETPLACE ENROLLEES WITH PREMIUM SUBSIDIES, BY COUNTY Williamson Co. 66% Decatur Co. 97% Wayne Co. 96% Polk Co. 95% Lawrence Co. 95% Clay Co. 95% Obion Co. 95% Henderson Co. 95% Overton Co. 95% Houston Co. 95% Moore Co. 94% Jackson Co. 94% Hancock Co. 94% White Co. 94% Fentress Co. 94% Perry Co. 94% Pickett Co. 94% Lincoln Co. 94% Meigs Co. 94% Hardeman Co. 94% Hickman Co. 94% Humphreys Co. 94% Van Buren Co. 93% Weakley Co. 93% Carroll Co. 93% Grundy Co. 93% Smith Co. 93% McNairy Co. 93% Warren Co. 93% Benton Co. 93% Coffee Co. 93% Bledsoe Co. 93% Lake Co. 93% DeKalb Co. 93% Lewis Co. 93% Hardin Co. 92% McMinn Co. 92% Sequatchie Co. 92% Henry Co. 92% Crockett Co. 92% Cumberland Co. 92% Dyer Co. 92% Cocke Co. 92% Grainger Co. 92% Putnam Co. 92% Macon Co. 92% Rhea Co. 92% Marshall Co. 92% Bradley Co. 92% Gibson Co. 92% Carter Co. 92% Unicoi Co. 92% Giles Co. 92% Greene Co. 92% Cannon Co. 92% Hawkins Co. 91% Union Co. 91% Chester Co. 91% Stewart Co. 91% Franklin Co. 91% Lauderdale Co. 91% Marion Co. 91% Johnson Co. 91% Scott Co. 91% Campbell Co. 90% Monroe Co. 90% Hamblen Co. 90% Dickson Co. 90% Maury Co. 89% Claiborne Co. 89% Bedford Co. 89% Sullivan Co. 89% Madison Co. 89% Jefferson Co. 88% Sevier Co. 88% Hamilton Co. 88% Trousdale Co. 88% Tipton Co. 87% Washington Co. 87% Roane Co. 86% Blount Co. 86% Morgan Co. 86% Haywood Co. 85% Anderson Co. 84% Statewide 84% Montgomery Co. 84% Loudon Co. 83% Robertson Co. 83% Cheatham Co. 83% Fayette Co. 82% Rutherford Co. 82% Knox Co. 81% Sumner Co. 80% Wilson Co. 79% Shelby Co. 79% Davidson Co. 77% 50% 60% 70% 80% 90% 100% Note: Based on plan selections during the open enrollment period. Sources: Marketplace Open Period State- and County-Level Public Use Files (1) (2) 6 THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

7 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT FIGURE 8. AVERAGE NET MONTHLY PREMIUM FOR SUBSIDIZED ENROLLEES IN TENNESSEE S HEALTHCARE.GOV MARKETPLACE, BY COUNTY Statewide $39 Loudon Co. $35 Union Co. $35 Fayette Co. $35 Houston Co. $34 Knox Co. $33 Tipton Co. $33 Jefferson Co. $31 Franklin Co. $31 Pickett Co. $30 Sevier Co. $30 Cocke Co. $29 Shelby Co. $28 Blount Co. $28 Marion Co. $28 Bedford Co. $28 Morgan Co. $27 Dickson Co. $27 Maury Co. $27 Cumberland Co. $27 Hamilton Co. $26 DeKalb Co. $26 Marshall Co. $26 Coffee Co. $26 Roane Co. $25 Anderson Co. $25 Sequatchie Co. $25 Humphreys Co. $25 Monroe Co. $24 McMinn Co. $24 Cannon Co. $24 Hamblen Co. $24 Warren Co. $24 Moore Co. $23 Decatur Co. $23 Hickman Co. $23 Fentress Co. $23 Rhea Co. $23 Stewart Co. $23 Macon Co. $23 Polk Co. $23 Putnam Co. $23 Bradley Co. $22 Scott Co. $22 Weakley Co. $22 Benton Co. $22 Chester Co. $21 Meigs Co. $21 Clay Co. $21 Lincoln Co. $21 Madison Co. $20 Lauderdale Co. $20 Hardin Co. $20 Carroll Co. $20 Bledsoe Co. $20 Smith Co. $20 Grundy Co. $20 Claiborne Co. $19 Gibson Co. $19 Giles Co. $19 Lewis Co. $19 Obion Co. $18 White Co. $18 Campbell Co. $18 Grainger Co. $18 Van Buren Co. $17 Lake Co. $17 Perry Co. $17 Overton Co. $17 Henry Co. $17 Henderson Co. $17 Wayne Co. $16 Hardeman Co. $16 Lawrence Co. $16 Jackson Co. $16 Dyer Co. $15 McNairy Co. $14 Crockett Co. $13 Haywood Co. $12 Johnson Co. $74 Cheatham Co. $74 Greene Co. $73 Hawkins Co. $72 Robertson Co. $72 Sumner Co. $69 Sullivan Co. $68 Unicoi Co. $68 Wilson Co. $68 Williamson Co. $67 Washington Co. $67 Trousdale Co. $66 Carter Co. $63 Davidson Co. $62 Montgomery Co. $61 Rutherford Co. $60 Hancock Co. $57 $- $10 $20 $30 $40 $50 $60 $70 $80 Note: Based on plan selections during the open enrollment period. Sources: Marketplace Open Period State- and County-Level Public Use Files (1) (2) 7 THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

8 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT FIGURE 10. AVERAGE MONTHLY PREMIUM FOR UNSUBSIDIZED ENROLLEES IN TENNESSEE S HEALTHCARE.GOV MARKETPLACE, BY COUNTY Houston Co. $1,007 Decatur Co. $960 Weakley Co. $926 Jackson Co. $919 Hickman Co. $902 Giles Co. $894 Carroll Co. $872 Polk Co. $869 Lewis Co. $867 Benton Co. $866 Moore Co. $842 Cocke Co. $840 Grainger Co. $838 Overton Co. $828 Clay Co. $828 Roane Co. $827 Dyer Co. $821 Bledsoe Co. $820 Rhea Co. $819 Smith Co. $815 Crockett Co. $813 Obion Co. $813 McNairy Co. $805 Marshall Co. $804 Grundy Co. $801 Coffee Co. $796 Monroe Co. $781 White Co. $780 Henderson Co. $772 Humphreys Co. $772 Cannon Co. $770 Fayette Co. $768 Henry Co. $765 Hardeman Co. $765 Bedford Co. $763 Dickson Co. $759 Perry Co. $759 Tipton Co. $758 Lauderdale Co. $757 Marion Co. $756 Haywood Co. $755 Van Buren Co. $752 Lincoln Co. $750 Meigs Co. $745 Maury Co. $741 Cumberland Co. $741 Franklin Co. $740 Campbell Co. $736 Chester Co. $732 Gibson Co. $730 Hamblen Co. $730 Pickett Co. $729 Fentress Co. $729 Union Co. $728 Wayne Co. $727 Anderson Co. $722 Unicoi Co. $722 Jefferson Co. $722 Loudon Co. $722 DeKalb Co. $721 Stewart Co. $718 McMinn Co. $716 Lawrence Co. $715 Madison Co. $715 Sevier Co. $704 Bradley Co. $700 Blount Co. $699 Hardin Co. $683 Lake Co. $681 Warren Co. $678 Hamilton Co. $674 Macon Co. $673 Morgan Co. $673 Shelby Co. $669 Carter Co. $656 Cheatham Co. $650 Claiborne Co. $639 Hawkins Co. $636 Trousdale Co. $632 Knox Co. $631 Sequatchie Co. $625 Johnson Co. $621 Putnam Co. $620 Statewide $619 Sullivan Co. $615 Greene Co. $603 Scott Co. $598 Robertson Co. $593 Washington Co. $590 Sumner Co. $552 Wilson Co. $549 Montgomery Co. $545 Hancock Co. $543 Rutherford Co. $523 Williamson Co. $519 Davidson Co. $514 $0 $200 $400 $600 $800 $1,000 $1,200 Note: Based on plan selections during the open enrollment period. Sources: The Sycamore Institute s analysis of data from the Marketplace Open Period State- and County-Level Public Use Files (1) (2) 8 THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

9 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT TABLE 1. TENNESSEE HEALTHCARE.GOV MARKETPLACE DATA, BY COUNTY Marketplace as a % of 2017 Population 2017 to Change in % of with Subsidies Average Subsidy 2017 to Change in Average Subsidy Average Net Monthly s Subsidized Unsubsidized Tennessee 228, % -2.3% 84% $797 51% $39 $619 Anderson Co. 2, % 0.5% 84% $883 79% $25 $722 Bedford Co. 1, % -7.7% 89% $951 34% $28 $763 Benton Co % -4.9% 93% $1,016 36% $22 $866 Bledsoe Co % 3.4% 93% $976 21% $20 $820 Blount Co. 4, % -8.1% 86% $881 87% $28 $699 Bradley Co. 3, % -0.3% 92% $875 31% $22 $700 Campbell Co. 1, % 0.5% 90% $958 80% $18 $736 Cannon Co % -1.5% 92% $865 33% $24 $770 Carroll Co % -0.8% 93% $993 30% $20 $872 Carter Co. 1, % -13.3% 92% $727 55% $63 $656 Cheatham Co. 1, % -4.2% 83% $691 44% $74 $650 Chester Co % -3.4% 91% $946 32% $21 $732 Claiborne Co. 1, % 1.6% 89% $930 77% $19 $639 Clay Co % -3.2% 95% $889 36% $21 $828 Cocke Co. 1, % -8.7% 92% $1,009 81% $29 $840 Coffee Co. 1, % -1.8% 93% $951 35% $26 $796 Crockett Co % -8.5% 92% $953 34% $13 $813 Cumberland Co. 2, % 3.3% 92% $924 34% $27 $741 Davidson Co. 30, % 5.7% 77% $574 40% $62 $514 Decatur Co % -3.3% 97% $989 31% $23 $960 DeKalb Co % -2.8% 93% $898 36% $26 $721 Dickson Co. 1, % -4.1% 90% $946 34% $27 $759 Dyer Co. 1, % -0.2% 92% $948 33% $15 $821 Fayette Co. 1, % 0.6% 82% $911 84% $35 $768 Fentress Co % 6.4% 94% $874 33% $23 $729 Franklin Co. 1, % -6.9% 91% $948 30% $31 $740 Gibson Co. 1, % -4.7% 92% $948 29% $19 $730 Giles Co. 1, % -4.1% 92% $995 35% $19 $894 Grainger Co % -1.7% 92% $980 82% $18 $838 Greene Co. 1, % -10.6% 92% $738 55% $73 $603 Grundy Co % 0.2% 93% $1,008 27% $20 $801 Hamblen Co. 1, % -2.0% 90% $913 83% $24 $730 Hamilton Co. 14, % -1.1% 88% $822 29% $26 $674 Hancock Co % -9.2% 94% $828 n/a* $57 $543 Hardeman Co % -2.7% 94% $955 30% $16 $765 Hardin Co % -1.7% 92% $1,018 33% $20 $683 Hawkins Co. 1, % -14.6% 91% $761 55% $72 $636 Haywood Co % -6.0% 85% $975 82% $12 $755 9 THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

10 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT Marketplace as a % of 2017 Population 2017 to Change in % of with Subsidies Average Subsidy 2017 to Change in Average Subsidy Average Net Monthly s Subsidized Unsubsidized Henderson Co. 1, % 0.5% 95% $920 32% $17 $772 Henry Co. 1, % 2.8% 92% $1,016 34% $17 $765 Hickman Co % -7.0% 94% $989 33% $23 $902 Houston Co % 3.6% 95% $993 24% $34 $1,007 Humphreys Co % -7.8% 94% $961 32% $25 $772 Jackson Co % -7.1% 94% $957 37% $16 $919 Jefferson Co. 1, % -5.5% 88% $934 82% $31 $722 Johnson Co % -8.1% 91% $775 56% $74 $621 Knox Co. 17, % -7.7% 81% $819 87% $33 $631 Lake Co % -2.0% 93% $1,008 n/a* $17 $681 Lauderdale Co % -7.6% 91% $927 79% $20 $757 Lawrence Co. 1, % 1.4% 95% $974 33% $16 $715 Lewis Co % -8.5% 93% $1,015 29% $19 $867 Lincoln Co. 1, % 1.4% 94% $961 34% $21 $750 Loudon Co. 1, % -4.5% 83% $936 95% $35 $722 McMinn Co. 1, % 3.8% 92% $911 29% $24 $716 McNairy Co % 0.5% 93% $955 29% $14 $805 Macon Co % -1.3% 92% $886 33% $23 $673 Madison Co. 3, % -3.1% 89% $901 34% $20 $715 Marion Co % -2.7% 91% $947 30% $28 $756 Marshall Co % -6.4% 92% $945 31% $26 $804 Maury Co. 3, % -1.6% 89% $891 33% $27 $741 Meigs Co % -3.1% 94% $945 26% $21 $745 Monroe Co. 1, % -2.8% 90% $977 79% $24 $781 Montgomery Co. 3, % 3.1% 84% $631 38% $61 $545 Moore Co % -4.8% 94% $979 36% $23 $842 Morgan Co % -1.0% 86% $990 81% $27 $673 Obion Co % 1.8% 95% $965 30% $18 $813 Overton Co % -1.1% 95% $872 29% $17 $828 Perry Co % 2.2% 94% $1,082 33% $17 $759 Pickett Co % -7.5% 94% $931 36% $30 $729 Polk Co % 3.0% 95% $961 29% $23 $869 Putnam Co. 3, % -0.8% 92% $789 35% $23 $620 Rhea Co % -3.0% 92% $938 29% $23 $819 Roane Co. 1, % -13.8% 86% $924 86% $25 $827 Robertson Co. 1, % 1.8% 83% $659 39% $72 $593 Rutherford Co. 8, % -6.6% 82% $596 43% $60 $523 Scott Co % -11.0% 91% $938 89% $22 $598 Sequatchie Co % 5.7% 92% $922 29% $25 $625 Sevier Co. 4, % -4.6% 88% $897 85% $30 $704 Shelby Co. 30, % -4.9% 79% $820 80% $28 $ THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

11 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT Marketplace as a % of 2017 Population 2017 to Change in % of with Subsidies Average Subsidy 2017 to Change in Average Subsidy Average Net Monthly s Subsidized Unsubsidized Smith Co % 0.5% 93% $888 33% $20 $815 Stewart Co % -2.3% 91% $1,018 34% $23 $718 Sullivan Co. 4, % -13.4% 89% $705 56% $68 $615 Sumner Co. 5, % 2.0% 80% $629 42% $69 $552 Tipton Co. 1, % -1.2% 87% $860 84% $33 $758 Trousdale Co % -7.7% 88% $718 39% $66 $632 Unicoi Co % -12.2% 92% $766 56% $68 $722 Union Co % -0.7% 91% $965 83% $35 $728 Van Buren Co % 5.5% 93% $945 31% $17 $752 Warren Co. 1, % -1.1% 93% $876 37% $24 $678 Washington Co. 4, % -10.0% 87% $668 60% $67 $590 Wayne Co % -2.3% 96% $1,016 33% $16 $727 Weakley Co % -4.6% 93% $946 29% $22 $926 White Co. 1, % 1.0% 94% $867 32% $18 $780 Williamson Co. 9, % 7.6% 66% $569 44% $67 $519 Wilson Co. 4, % 3.1% 79% $646 41% $68 $549 *Average premium subsidy data for 2017 are unavailable for Hancock and Lake Counties. Note: Based on plan selections during the 2017 and open enrollment periods. Sources: The Sycamore Institute s analysis of data from the Marketplace Open Perioid State- and County-Level Public Use Files and the U.S. Census Bureau (3) (4) (1) (2) (3) 11 THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

12 COUNTY-LEVEL DATA ON TENNESSEE S OBAMACARE ENROLLMENT THE SYCAMORE INSTITUTE The Sycamore Institute is an independent, nonpartisan public policy research center for Tennessee. Sign up for alerts at: SycamoreInstituteTN.org Written By Mandy Pellegrin Policy Director MPellegrin@SycamoreInstituteTN.org Courtnee Melton, PhD Policy Analyst Other TSI Staff Laura Berlind Executive Director Brian Straessle Communications Director RELATED WORK BY THE SYCAMORE INSTITUTE Tennessee s Obamacare (April 13, ) Analyzes statewide data on Marketplace enrollment and premiums. CSR Payments, Uncertainty, and Tennessee s 2017 ACA Marketplace (September 29, 2017) Analyzes Marketplace premiums and explains cost-sharing reduction payments and what they might mean for Tennessee. Health Insurance Markets 101 Key Concepts that Influence Access and Affordability (April 5, 2017) Discusses key health insurance terms and concepts that influence insurance access and affordability (e.g. risk pooling) Health Insurance Coverage in Tennessee in 2016 (October 5, 2017) Analyzes the most recent data on the rate of the uninsured and where insured Tennessean s get health coverage. Click here for all Affordable Care Act (ACA)-related posts by The Sycamore Institute. References 1. Centers for Medicare and Medicaid Services. Marketplace Open Period State-Level Public Use File. U.S. Department of Health and Human Services. [Online] April 3,. [Accessed on April 4,.] Accessed via Products/_Open_.html. 2.. Marketplace Open Period County-Level Public Use File. U.S. Department of Health and Human Services. [Online] April. [Accessed on April 17,.] Accessed via Systems/Statistics-Trends-and-Reports/Marketplace-Products/_Open_.htm Marketplace Open Period State-Level Public Use File. U.S. Department of Health and Human Services. [Online] May 11, [Accessed on April 4,.] Accessed via Systems/Statistics-Trends-and-Reports/Marketplace-Products/Plan_Selection_ZIP.html Marketplace Open Period County-Level Public Use File. U.S. Department of Health and Human Services. [Online] May 11, [Accessed on April 17,.] Accessed via Systems/Statistics-Trends-and-Reports/Marketplace-Products/Plan_Selection_ZIP.html. 5. U.S. Census Bureau, Population Division. Annual Estimates of the Resident Population: April 1, 2010 to July 1, [Online] March. [Accessed on April 17,.] Accessed via US THE SYCAMORE INSTITUTE SycamoreInstituteTN.org

Tennessee Housing Development Agency Andrew Jackson Building 502 Deaderick Street, Third Floor Nashville, Tennessee /

Ralph M. Perrey Tennessee Housing Development Agency Andrew Jackson Building 502 Deaderick Street, Third Floor Nashville, Tennessee 37243 615/815-2200 Writer s Phone Number: Executive Director 615-815-2210