2018 MIDTERM ELECTION

Time: D H M S

Total Off-Exchange QHP Enrollments bumped to 7.8M

Hat Tip To: 
Paul Mullen, Ruth37

I've been shouting from the rooftops about OFF-exchange QHPs for months now (I first added a column for them on January 3rd and had my first significant data update on January 31st), and until recently few in the news media seemed to catch on to the significance of these.

Until a few weeks ago, I had only officially documented about 560,000 off-exchange QHPs, but guestimated that there were easily 4 million or more out there (I had mused off-handedly back in mid-February that the total could potentially be 7.7 million, but decided to backtrack to "4M or more" out of caution).

Recently there were two major updates to this figure: For one thing, the BCBS Association confirmed over 1.7 million off-exchange QHPs from their family of companies alone (ie, not including other heavy hitters such as Humana, United Healthcare, CIgna, Aetna and so on). This brought the total documented tally up to about 2.09 million, which is the number included on The Graph...and that 1.7M figure doesn't even include any of March!

In addition, however, there was the now-famous/infamous RAND Corp. survey which claimed up to either 7.8 million or 9 million off-exchange enrollments (the wording is a bit confusing in different places), a difference of around 5.7 million or 6.9 million.

Until today, I've tried to be very cautious about including these 5.7M/6.9M "undocumented" off-exchange QHPs on the graph itself, since it's a very large number and I hadn't actually documented the additions yet.

However, today Kaiser Health News reports that Larry Levitt, one of the most respected experts on health insurance in the country, has openly stated that:

"I think it's probably the case that there are more people insured in the individual market off the exchange than on the exchange right now."

Now, this is not absolute confirmation. Mr. Levitt is not giving out exact numbers or specific data points, but he is also not known for hyperbole.

When you combine my own speculation about up to 7.7 million (made on February 20, well before the March surge), the RAND Corporation survey which projects at least 7.8 million, the fact that I've documented a minimum of 2.1 million and Mr. Levitt of the KFF giving his voice of support for there "probably" being more people enrolled off-exchange than via the exchanges...which happens to be somewhere around 7.7 million or more at the moment...

...I think it's time for me to go ahead and officially add the additional 5.7M off-exchange enrollments onto The Graph.

Now, the tricky part is that without the documentation, I can't really say when these extra millions of people were added. My guess is that most of them enrolled back in late November through late December, to either replace the "OMG!! CANCELLED!!" policies or otherwise to take advantage of the better coverage offered by many of the new policies being offered.

I'd also imagine that there was another big surge in these enrollments towards late March, coinciding with the exchange-based March Surge to get covered before the deadline.

SO, instead of mixing these in with the documented off-exchange QHPs, I'm hereby adding them as yet another separate section. I'm giving very rough guesses as to when they tended to sign up, but the grand total as of today will still come in at around 5.7 million (in addition to the 2.09M documented enrollments).

PS My power is still out, but our generator is operating so I'm back online, yay!

PPS I should also note that The Graph has now been updated with my final 4/15 exchange QHP estimate of around 7.78 million people.