A bit of self-congratulations...and BTW, actual paid QHP total won't be known until MAY (or later)

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

After having my enrollment projection model confirmed by the administration twice in the past week, I thought this would be a good point to see how close I've gotten various milestones since I started this thing:

Private QHPs: Total thru the end of December
ACA Signups, 12/25 2,100,000 98.24% accurate
Actual (HHS), 1/13 2,137,630
Medicaid/CHIP: Total thru the end of December
ACA Signups, 1/21 6,320,000 99.68% accurate
Actual (CMS), 1/22 6,300,001
Private QHPs: Total thru the end of January
ACA Signups, 2/07 3,300,000 99.98% accurate
Actual (HHS), 2/12 3,299,492
Private QHPs: Percent Paid
ACA Signups, 2/13 (10 AM) 75-80%

basically the same

New York Times, 2/13 (5 PM) 75-80%
Private QHPs: Total thru Feb. 19
ACA Signups, 2/19 3,860,000 at least 95% accurate
Pres. Obama, 2/20 "close to 4M"
Private QHPs: Total thru Feb. 24
ACA Signups, 2/25 (3:48pm) 4,013,762 99.66% accurate
Actual (HHS), 2/25 (5:59pm) 4,000,000


On a completely separate note, I should also point out that while the actual enrollment period for Private QHPs ends on 3/31/14, we won't know how many actual enrollments there are until mid-April, and we won't know how many paid enrollments there are until sometime in early to mid-May.

There's a simple reason for the latter point. Any policies enrolled in between March 16 - March 31 won't actually start coverage until May 1st.

Since people tend not to pay for services until the payment is actually due, and since many insurance companies are being unusually lenient with their premium payment deadlines, this means that some people who enroll before the 3/31 deadline may not actually be paid in full until late April or potentially early May.

In fact, this number is likely to be pretty high, since the administration is expecting a December-like mass rush to enroll just before the penalty deadline...which means there's likely to be a huge spike in enrollments during the last 2 weeks of March...the very dates that won't start coverage until May.

Update: But wait, there's more! I was reminded by David Napoli that the ACA also includes a little-known provision related to the Advanced Premium Tax Credit which states that:

Finally, the ACA provides for a 90 day grace period during which QHPs cannot terminate coverage for premium tax credit recipients who fail to pay their share of the premium. Insurers expressed considerable concern that this would allow recipients to game the system, paying for coverage only 9 months a year.

The final rule provides that QHPs must cover the first month of nonpayment, but for the second and third months may “pend” payments.  If the enrollee finally pays up, the QHP must reinstate the enrollee and cover the bills. Otherwise, the QHP can deny payment and must refund advance tax credits received for the second and third month.   The enrollee will be left responsible for paying providers and repaying the tax credit received for the first month, as well as the first month’s premium.

In other words, if I'm reading this correctly, for the 80% or so of QHP enrollees who are receiving tax credits, the ones who enroll between 3/16 - 3/31 could theoretically have up until as late as August 1st to make their payments for May coverage before they can be dropped from their policies.

Now, I'm not going to get into a discussion of whether this is a fair or reasonable rule or not; that's a separate discussion. What all of the above does mean is that we won't have a total, final number of paid QHP enrollees until quite some time after the window closes on March 31st.

Just wanted to get that out there now.