2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Now that the Democrats have officially retaken control of the U.S. House of Representatives, everyone's expecting them to try and save and improve the ACA. I stress "try", of course, because without the Senate, it's unlikely that any bill to protect or improve the law will get passed...and even if it did somehow, the odds are high that it would then be vetoed by Donald Trump (or Mike Pence, in the unlikely-but-still-conceivable event that Trump is removed from office before January 20, 2021).

HOWEVER...they can certainly at least try. With a likely 235:200 advantage in the House and a caucus which is far more progressive on healthcare issues than it was a decade ago, the Dems shouldn't have too much trouble passing a fairly robust healthcare reform package even knowing that it's unlikely to go anywhere in the Senate. The question is how robust?

#1: The 2019 Open Enrollment Period runs from November 1st - December 15th...in most states.

  • In California, open enrollment already started on Oct. 15th, and will run through Jan. 15, 2019.
    • If you enroll by Dec. 15th, your coverage will start Jan. 1st, 2019.
    • If you enroll between Dec. 16th - Jan. 15th, coverage will start Feb. 1st, 2019.
  • In Colorado, open enrollment runs through Jan. 15, 2019.
    • If you enroll by Dec. 15th, your coverage will start Jan. 1st, 2019.
    • If you enroll between Dec. 16th - Jan. 15th, coverage will start Feb. 1st, 2019.

Minnesota's ACA exchange, MNsure, released a mid-period enrollment report a few weeks back, putting their total at over 97,000 QHP selections through November 14th.

They just updated that tally for me: 104,162 signups as of EOD 12/6.

Last year, MNsure broke 100,000 enrollments as of 11/23 and 101,626 as of 12/15, which should have put them at right around 100,900 QHP selections as of 12/06/17. That means the current total is around 3.2% ahead of the same point last year.

It's important to note that unlike most states, Minnesota's 2019 Open Enrollment Period doesn't end on the 15th (although you do have to sign up by then in order to have coverage start on January 1st); Minnesotans still have until January 13th to enroll (anyone who enrolls after 12/15 will have their coverage kick in on February 1st instead).

 

With major enrollment updates from California, New York, DC and Massachusetts and especially the Week 5 update from HC.gov all rolling in over the past couple of days, I thought this would be a good point to put it all together and see where things stand just ahead of the big final push (for most states).

Here's a state-by-state breakout of confirmed QHP selections. All 39 HC.gov states as well as New York are as of 12/01, while California, Colorado and Connecticut are all as of 11/30; Rhode Island and Washington State are as of 11/28. The outliers are DC and MN (11/13 and 11/14) and Massachusetts (thru 12/04). I don't have any enrollment data from Idaho, Maryland or Vermont as of yet.

When comparing the year over year numbers, I have not corrected the HC.gov states for the missing day below, but I did add a column noting how many days worth of data are missing in each state.

As you can see, all of the HC.gov states are running behind last year as of roughly the same point in time (Florida is slightly ahead if you adjust for the missing day). As a whole, the 39 HC.gov states are down 11.3% so far.

Week 5 via CMS:

Week 5, Nov 25 - Dec 01, 2018

In week three of the 2019 Open Enrollment, 773,250 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. Consequently, the cumulative totals reported in this snapshot reflect one fewer day than last year.

Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchanges and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.

This Just In from the New York State of Health exchange...

Press Release: NY State of Health Announces 2019 Enrollment is Up in First Month of Open Enrollment Period
Dec 5, 2018

  • More than 930,000 Consumers Enroll in a Qualified Health Plan or the Essential Plan
  • December 15 is the Deadline to Enroll for January 1, 2019 Coverage

ALBANY, N.Y. (December 5, 2018) - NY State of Health, the official health plan Marketplace, today announced in the first four weeks of the 2019 open enrollment period, enrollment is outpacing last year. More than 930,000 consumers have enrolled or renewed coverage in a Qualified Health Plan or the Essential Plan for 2019. Consumers must enroll or renew by December 15, for coverage beginning January 1, 2019.

The numbers are several weeks out of date, but it's better than nothing: Here's the DC Health Link's official 2019 ACA Open Enrollment report through November 13.

Things weren't looking great as of two weeks in: Total enrollments were down 6.8% (1,202 people) year over year as of the same date. We'll have to see whether things have picked up since then.

As with most other state-based exchanges, the numbers for both years include auto-renewals, which means the vast bulk of 2019 enrollments are likely already baked in. Last year's final tally was 19,289; DC had already reached 85% of that as of 11/13.

DC's report also includes all sorts of wonky demographic breakout data, and even closes with currently effectuated numbers for both the individual and small business (SHOP) markets. Remember, DC's SHOP market is unusually high (especially compared to the individual market) because the ACA requires all members of Congress and their staff to enroll using it if they want their 72% FEHB subsidy.

I just received another official update from the MA Health Connector...

On enrollment, as of today, we have 261,619 enrolled members for January. We have an additional 14,368 plan selections made (but unpaid) for a total of 275,994 under the CMS definitions. New enrollments for 2019 continue to trend slightly ahead of last year.

A week or so ago I noted that Massachusetts had enrolled just over 264,000 people (10,000 of whom hadn't actually paid their January premium yet...MA's exchange is one of the only states which is able to actually track payment data live, since they handle it themselves). They were up 10K over the same date in 2017, or up around 4% year over year.

I don't have a hard "thru 12/05" number for 2017 this week, but they did confirm the 276K number is still "slightly ahead", which is good.

Michigan was pretty much Ground Zero for the 2018 Blue Wave midterm elections. In addition to Democrats flipping the Governor's seat (and holding onto Debbie Stabenow's U.S. Senate seat), they also flipped the Attorney General, Secretary of State, one of two state Supreme Court seats, both of the state Board of Education seats which were up and all six state University Board seats which were up. In addition, they picked up two U.S. House seats, five state Senate seats and five state House seats.

It was a complete and utter repudiation of both Republican governance and their agenda.

You might expect the Michigan GOP to accept the clear will of the voters. You would be very, very wrong.

As Democratic candidates prepare to take three statewide offices on Jan. 1 — governor, attorney general and secretary of state — Republican lawmakers introduced bills Thursday to challenge their authority.

"But the whole point of the doomsday machine is lost if you keep it a secret! Why didn't you tell the world, eh?

--Dr. Strangelove, 1964

No one applauded the New Jersey legislature and Governor Phil Murphy louder than I did when they swiftly passed several laws this past spring which cancelled out much of the Trump Administration's sabotage of the Affordable Care Act. As a reminder, the laws and waivers they put into effect included:

"But the whole point of the doomsday machine is lost if you keep it a secret! Why didn't you tell the world, eh?

--Dr. Strangelove, 1964

No one applauded the New Jersey legislature and Governor Phil Murphy louder than I did when they swiftly passed several laws this past spring which cancelled out much of the Trump Administration's sabotage of the Affordable Care Act. As a reminder, the laws and waivers they put into effect included:

This just in...

Covered California’s Open Enrollment Is off to a Solid Start as the First Key Deadline Approaches

  • More than 90,500 new consumers selected a plan through Nov. 30.
  • While plan selections are ahead of the pace set in 2016, when Covered California also delayed its marketing until after Election Day, they are slightly behind the pace set during 2017.
  • Roughly 1.2 million Covered California enrollees have been renewed for 2019, similar to last year’s totals.
  • An estimated 1.1 million uninsured Californians are eligible to enroll in Covered California or Medi-Cal. New research shows that 82 percent of uninsured consumers surveyed, who are eligible for financial assistance, do not know that they qualify.
  • Consumers must sign up by Dec. 15 in order to have their health insurance start on Jan. 1, 2019. Open enrollment in California continues through Jan. 15.

This just in...

Connect for Health Colorado Reports Increase in 2019 Medical Plan Selections

DENVER — More than 46,000 Coloradans selected health coverage through Connect for Health Colorado® during November, a number 6 percent ahead of the pace one year ago, according to new data released today.

“We started with a strong month but there are now only 12 days left to get coverage in place for Jan. 1,” said Connect for Health Colorado® CEO Kevin Patterson. “It is time for Coloradans who buy their own health insurance to act to protect their health and their family finances.”

During November, Connect for Health Colorado customers made 46,332 medical plan selections. The total was 43,881 medical plan selections for the comparable period in 2017. Fifteen percent of the plan selections are by customers who are new to Connect for Health Colorado and 85 percent are renewing customers.

Two weeks ago I reported that Access Health CT, Connecticut's ACA exchange, had enrolled 12,777 people in 2019 ACA exchange policies, running neck and neck with last year. This included active renewals and new enrollees only.

Last night, CT Post reported that as of November 30th, the CT exchange had gone ahead and auto-renewed all current enrollees as well, for a total of 101,054 people:

HARTFORD — Enrollment in Access Health CT is higher this year than it was last year at this time, but time is running out.

Officials said they’ve enrolled 9.685 customers who are new to the exchange this year, and they’ve auto-enrolled more than 91,000 customers who purchased plans with them in 2018. That brings total enrollment up to 101,054 individuals as of Nov. 30.

Last year, about 90,428 individuals had enrolled by this time.

A couple of weeks ago I reported that the Washington Health Benefit Exchange reported enrolling a seemingingly astonishing 190,000 people into 2019 policies in just the first 10 days of the 2019 Open Enrollment Period. This is highly misleading, of course, because only a small fraction of these are new enrollees, and a somewhat larger portion are current enrollees actively renewing their policies.

The vast bulk of that 190K are current enrollees who are auto-renewed into 2019 policies by the exchange itself...with the option to then actively go into the system and opt to cancel their renewals if they wish. There's nothing wrong with this, and in fact more and more of the state exchanges seem to be doing it this way as they improve and streamline their software (I've confirmed that Maryland, Massachusetts, Minnesota, Rhode Island and Washington State are "front-loading" autorenewals this year, although Maryland hasn't actually reported their data yet).

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