Hawaii: Exchange QHPs actually DROP by 156...which is completely normal

When we last checked in on Hawaii's ACA exchange on 6/21, the QHP tally stood at 9,586 people, and another 965 SHOP enrollees.

There have been 2 updates from the exchange since then; QHPs went up another 12 over the next week (6/28)...but in the most recent update, the number has dropped down to 9,442...a loss of 156 people:

Connector Updates for July 5, 2014

Total since October 1, 2013

32,959 Applications completed in the Individual Marketplace
9,442 Individuals and families enrolled in the Individual Marketplace

So, what's going on? Well, as I've noted several times, just as people are continuing to enroll in QHPs in the off season as they experience major life changes (getting married, having a child, losing a job, etc) they're also dropping out of their exchange QHPs for similar reasons (getting divorced, the death of a loved one, aging into Medicare age, etc). The only question is whether the number of people being added to the tally is going to end up being higher or lower than the number of people being removed from the total.

For every other state that I have post-4/19 data for, so far the additions have exceeded the subtractions. In the case of Hawaii, the opposite appears to have been the case over the past week.

Now, this does raise one important point. Until now, I've been operating on the assumption that all of the exchanges are only reporting their gross enrollments, with 4 exceptions. Massachusetts and Washington State only report enrollees who have already paid their first month's premium, while Connecticut and Oregon have been "purging" older unpaid enrollments. I didn't think that any of the states were doing this, but I appear to be wrong. If Hawaii were only reporting additions, their number should continue to go up (or, at worst, stay the same) instead of dropping.

So, the question is, is the number lower because a) they're following CT & OR's lead by purging unpaid enrollments, or b) because they're subtracting those who were enrolled for one or more months but then dropped their policies? I'll look into this.

Meanwhile, I'm sure that ACA opponents will pounce on this to "prove" that the bloom is off the rose, bla bla bla, but there's nothing unexpected here. Given the tiny numbers that we're talking about here (Hawaii only has 1.4 million people to begin with, and already had the 2nd lowest uninsured rate after Massachusetts at the time the ACA exchanges launched last October anyway), even a small shift in the numbers will have a dramatic impact on the total enrollment for the state.

Still, I'll be keeping a close eye on Hawaii, Oregon, Minnesota and the other state exchanges releasing regular updates to see if this is the start of a trend or just statistical noise.