END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

Oregon: At least 44.6K Off-Exchange QHPs, at least 43.7K ACA-compliant ESI's

Hat Tip To: 
Nick Budnick

A big shout-out to Nick Budnick of The Oregonian, who has been all over Cover Oregon's horribly-troubled-but-surprisingly-successful healthcare exchange from the get-go. He just released a big new story which features an extensive breakdown of Oregon's overall individual insurance market, including both on-exchange QHPs, off-exchange QHPs, grandfathered noncompliant plans and even the "small group" ESI market, among other things. Thankfully, all of these numbers are broken out so I'm able to make sense of them.

The only major caveats are a) it doesn't include the "large group" market (so the ESI numbers have a big gap), and the other numbers only cover up through 3/31, so all of April and May are missing. This may not sound like a big deal, but consider that Oregon's exchange was held fully open through the end of April (no "started by 3/31" requirement). Their exchange QHP total was only 55,000 at the end of March, yet now sits at over 76,000, a gain of over 38%. Assuming the off-exchange and/or ESI enrollments followed a similar pattern, that could be a pretty huge hole in the data. Even so, it's a hell of a lot better than what we've had to work with so far, so let's take a look:

  • On the individual market, the total number of ACA-compliant QHPs (both on- and off-exchange) stood at 120,898 as of 3/31. If you subtract the 76,275 exchange QHPs, that leaves a minimum of 44,623 off-exchange QHPs. If that 38% April/May gain held true, this would be closer to 62,000, but I'll leave it at 44.6K for now. Also noteworthy: There's an additional 75,000 or so "grandfathered" non-compliant plans; presumably most/all of these are the low-hanging fruit for QHPs in the 2nd open enrollment period starting in November.
  • On the small group market, the total number of ACA-compliant policies (off-exchange only; like most states, Oregon's SHOP system wasn't active for the first open enrollment period) stood at 43,732 as of 3/31. Again, this could potentially be 60,000 or more if it shot up 38% in April/May, but that's not known at this time. This is still useful, however, since it single-handedly more than doubles my off-exchange ESI total (which was under 40,000 until now). Again, there's an additional 137,000 non-ACA compliant ESI's in the small group market which will be potential conversions into compliant ones this winter.
  • As a reminder, there's no data available yet on Oregon's large group market, which could dwarf these numbers.