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Delaware health insurance

A single carrier offers individual health plans through state's exchange. Short-term plans are now available with plan terms up to three months.

Health insurance in Delaware

Delaware’s health marketplace

Delaware operates its health insurance marketplace, Choose Health Delaware, in partnership with the federal government. Given the state’s small population, state officials deemed this model as most financially prudent. Additionally, Delaware expanded Medicaid under the Affordable Care Act.

With an already low uninsured rate, Delaware has seen incremental gains since the Affordable Care Act took effect. As of 2013 to 2016, the uninsurance rate in Delaware had dropped from 9.1 percent to 5.7 percent, according to U.S. Census data.

Open enrollment for 2019 coverage in Delaware ended on December 15, but enrollment is still possible for Delaware residents who have qualifying events.

For 2019, one insurer – Highmark Blue Cross Blue Shield of Delaware – will offer plans for individuals through the exchange. The average rate increase for Highmark is just 3 percent for 2019.

Delaware enrollment in qualified health plans

Delaware has a partnership health insurance marketplace in collaboration with the federal government. The state’s exchange platform is called Choose Health Delaware; however, residents use HealthCare.gov to enroll in coverage.

In Delaware, 14,087 people enrolled in a qualified health plan (QHP) during the first ACA open enrollment period. At 29.1 percent, Delaware ranked 15th among the states and the District of Columbia in terms of the percentage of the estimated total market that actually signed up for QHPs during 2014 enrollment.

Roughly 85 percent of Delawareans eligible to enroll in an exchange plan in 2016 did so. About 82 percent of 2016 Delaware’s exchange enrollees purchased coverage with financial assistance in the form of advanced premium tax credits. Total 2016 enrollment increased 11 percent over 2015.

But in 2017, enrollment declined by 2.4 percent. Across all states that use HealthCare.gov, enrollment declined by about 5 percent, due to a combination of higher premiums, insurer exits, uncertainty about the future of the ACA, and the Trump Administration’s decision to cut advertising and outreach for HealthCare.gov in the final week of open enrollment.

And for 2018 coverage, enrollment decreased again in Delaware’s exchange, this time by about 11 percent. Across all states that use HealthCare.gov, enrollment dropped by about 5 percent for 2018, although it grew slightly in states that run their own exchanges. States that use the federally run exchange had to contend with a much shorter enrollment period for 2018 coverage (while most states that run their own exchanges opted to extend open enrollment, in some cases keeping it as long as it had been in prior years), and sharp reductions in federal funding for exchange marketing and enrollment assistance.

Read more about Delaware’s health insurance marketplace.

Delaware Medicaid/CHIP

Delaware is among the states that expanded Medicaid under the Affordable Care Act. Coverage effective dates for those qualifying for Medicaid expansion started Jan. 1, 2014.

More than 11,200 Delawareans were deemed eligible for Medicaid or the Children’s Health Insurance Program (CHIP) during the ACA’s initial open enrollment.

From 2013 to December July 2018, Delaware Medicaid enrollment grew by 14,142 people – a significantly smaller increase than in other states where Medicaid had expanded, likely due to the higher-than-average incomes in Delaware. As of July 2018, 247,466 Delaware residents were covered by Medicaid or CHIP.

Enrollment in Medicaid and CHIP continues throughout the year. Visit the Delaware Division of Medicaid and Medical Assistance website for information about the state Medicaid program and the Delaware Healthy Children Program.

Read more about Medicaid expansion in Delaware.

Short-term health insurance in Delaware

Delaware does not yet have state-specific regulations for short-term health insurance plans, but the Delaware Insurance Department noted in August 2018 that it was beginning the process of drafting its own regulations.

The regulations, posted November 1, will – once approved – limit the duration of short-term plans to no more than three months and prohibit renewals.

Read more about short-term health insurance in Delaware.

Delaware health ratings

In 2015, the Scorecard on State Health System Performance ranked Delaware 15th in the nation for overall health. The state maintained the same 15th place ranking in 2017. The ranking was based on several health indicators related to five key measures: Access, Prevention & Treatment, Avoidable Hospital Use & Costs, Healthy Lives, and Equity.
See Delaware’s scorecard for the state’s performance for a detailed look at its performance. Low percentages of uninsured adults and children and few at-risk adults without a routine doctor visit in the past two years were among positive indicators.

The 2015 edition of America’s Health Rankings evaluated Delaware differently, giving it an overall rank of 32nd, which increased to 30th in the 2017 edition of the Rankings. While a relatively low uninsured rate and strong public health funding bolstered Delaware’s overall ranking, several measures placed in the bottom half.

The Scorecard on State Health System Performance and America’s Health Rankings evaluate different indicators. America’s Health Rankings consider more prevention and treatment indicators, on which Delaware received generally high rankings. That difference helps explain the disparity in the overall scores between the two evaluations.

The 2016 edition of Trust for America’s Health also provides a wealth of public health information, but does not provide an overall score. See Key Health Data About Delaware.

Finally, you can see county-level health rankings for Delaware from the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin.

How has Obamacare helped Delawareans?

Delaware already had a lower-than-average uninsured rate prior to ACA implementation, with 9.1 percent of the state’s population uninsured in 2013 (as opposed to 14.5 percent nationwide). By 2016, the state’s uninsured rate had dropped by 35 percent, falling to just 5.7 percent, according to U.S. Census data.

Total Medicaid and CHIP enrollment grew by 11 percent in Delaware from late 2013 through the end of 2017. Nationwide, Medicaid/CHIP enrollment increased by 29 percent during that time, even accounting for the 19 states that did not expand Medicaid. But Delaware’s average household income is higher than the U.S. average, so relatively few people in the state are eligible for Medicaid.

Medicare in the state of Delaware

Delaware Medicaid enrollment is 19 percent of its total population; the percentage of enrollees nationwide is 17. Of the state’s Medicare beneficiaries, 84 percent qualify based on age alone while the remainder qualify due to disability.

Delaware spends about $9,010 per recipient annually and ranks 44th in overall Medicare spending with $1.5 billion per year.

Delaware residents can enroll in private Medicare Advantage plans instead of Original Medicare. These plans offer additional benefits beyond traditional Medicare coverage. In 2016, about 9 percent of all Delaware Medicare recipients selected a Medicare Advantage plan, compared with 31 percent nationwide. However, 66 percent of the state’s enrollees selected a Medicare Part D plan for standalone prescription drug coverage, a number well above the 45 percent national average.

Delaware health insurance resources

Delaware health reform

Here’s what’s happening legislatively with healthcare reform in Delaware:

  • As of June 15, 2015, HHS issued conditional approval for Delaware’s plan to transition from a state-federal partnership exchange to a federally supported state-based marketplace. However, in August, the state officially decided to continue with the state-federal partnership model, citing cost-effectiveness as the reason.

Scroll to the bottom of this page for a summary of recent state-level health reform legislation.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.