"Off Season" QHP enrollment estimate: 200K - 300K/month (UPDATED)

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Last week I made a bold estimate that at least 200,000 additional QHP enrollees are likely to be added each month from 4/15 (the end of the first open enrollment period) through 11/15 (the start of the next one). That's 7 months x 200K, or around 1.4 million on top of the 8.02 million confirmed QHP enrollees during the first period (well, technically the last HHS report runs through 4/19).

Nationally, the open enrollment period average was 8.02 million in 201 days (10/1/13 - 4/19/14), or an average of 39,900 QHPs per day (201 days...this includes everything from the disastrous website launches, to the December surge, to the February "lull", to the March insanity straight through to the April "extension period").

Of course, this wouldn't be such a mystery if the HHS Dept. hadn't cut off enrollment reports during the off-season, but I won't go on that rant again.

So where am I getting this 200K estimate during the off season? Well, let's take a look at the numbers we do have since then:

  • Colorado: April 19 total: 125,402, or an average of 624 per day. May 31 total: 132,815. That's 7,413 in 42 days, or 176/day...28% of the daily rate during the open enrollment period.
  • Hawaii: April 19 total: 8,592, or 43/day. June 7 total: 8,534; that's 890 in 49 days, or 18/day...42% of the OE daily rate.
  • Minnesota: April 19 total: 48,495, or 241/day. June 9 total: 51,500; that's 3,005 in 51 days, or 59/day...24% of the OE daily rate.
  • Nevada: April 19 total: 45,390 (226/day). May 28 total: 35,700 paid...but NV was averaging around a 75% payment rate pretty consistantly for the last couple of months, so I'm assuming their total QHP number was up to around 47,600. That's 2,210 in 39 days, or about 56 per day...25% of the OE daily rate. Nevada's a bit of a special case, of course, since they kept their enrollment period open right up through 5/30.
  • Oregon: April 19 total: 68,308 (340/day). June 12 total: 87,522, or 19,214 in 54 days (356/day). This is rather astonishing since it's actually a higher daily average for Oregon than during the open enrollment period!
  • UPDATED: District of Columbia: April 30 total: 11,108. June 11 total: 11,582, or 474 in 42 days (11/day), vs. 52/day, or about 21% of the open enrollment rate.

If you average all 6 states out, you get 1,526/day during the OE period and 676/day since then...a whopping 44% of the open enrollment rate.

Now, 44% of 39,900 would be 17,500 per day, which is almost certainly way too high, especially given the Oregon outlier. If you take that out of the loop, it drops down to 320 / 1,186, or about 27% in the off season...or around 10,800 per day (roughly 320,000/month).

Now, if that rate is accurate nationally and if it holds true for the rest of the summer/autumn (neither of which is even close to certain), that would mean an additional 2.2 million added to the 8 million confirmed, for a grand total of up to 10.2 million...from which you'd have to subtract:

  • Perhaps 10% who haven't/won't pay their first month's premiums
  • Another, say, 20-25% who drop coverage at some point for various reasons

...which would leave you with somewhere around 6.6 - 7.2 million fully paid-in-full QHPs as of 11/15.

Since I only have 4 or 5 states to work with, however, I'm playing it extremely conservatively here (no pun intended) and lopping my estimate down even further, to just 7K per day...or around 210,000 per month.

This will likely result in around 9.5 million total, minus nonpayments/drop-offs, for a net total of between 6.2 - 6.7 million paid-in-full QHPs.

As always, I'll be more than happy to be proven wrong on this...as long as I've underestimated instead of overestimating :)