KFF: Study of other programs suggest only 7-14% of QHP enrollees likely to switch policies (Update: Or up to 2/3???)

Hat Tip To: 
Margot Sanger-Katz, Scott M.

Thanks to Margot Sanger-Katz for bringing this KFF study to my attention; Tricia Neuman has done an interesting study to try and predict how many of the appx. 7.3 million current ACA exchange policyholders are likely to make the move from their current policy to a different one (either through the same company or a different one).

She goes pretty deep in the weeds on some of it, but her takeaway is that, based on 3 other government healthcare programs (Federal Employee Health Benefits, Medicare Part D and the Commonwealth Care program in MA), it's likely that only about 7 - 14% of enrollees are likley to switch:

...even with wide variation across plans and the potential to lower costs by switching plans, our researchconfirms a high degree of “stickiness” among Part D enrollees, with just over ten percent voluntarily switching plans during a recent  open enrollment period.  Our focus groups of Medicare beneficiaries help explain why.  Seniors told us that they are generally aware of the open enrollment period, in part because they are inundated with marketing materials during the fall of each year.  But, they also said that they have little appetite for what they consider the drudgery of comparing plans – even though they recognized it might be a good idea to do so.

The low rate of plan switching among Medicare Part D enrollees should not come as a total surprise.  Similar results have been reported in studies of younger adults in health insurance marketplaces, including federal workers in the Federal Employees Health Benefits Program (FEHB) and among enrollees in Commonwealth Carein Massachusetts that was established prior to the ACA – suggesting a very high degree of satisfaction or a strong preference for the status quo, or both, in all three health insurance marketplaces (Exhibit 1).

She goes on to note that none of these are an absolute indicator of the ACA exchange; there's still too many unknowns. Younger people are more likely to be comfortable with moving from one policy to another online since they're already comfortable moving between, say, AT&T and Verizon for their wireless service. On the other hand, they're also more likely to be healthy, and therefore less likely to need to use their policies as often, which means that unless there's a significant premium increase they may not have to deal with any customer satisfaction issues, etc.

In the end, there's really no way of knowing how much shifting there will be. In fact, to date, the only hard data I have on shifts between one company and another is extremely limited:

In Oregon, as of June 30th, LifeWise had 1,538 people enrolled in policies via CoverOregon. As of September 30th, they were down to 1,501, a drop of 37 people. Meanwhile, PacificSource increased their enrollments from 1,802 to 1,830 in the same 3 month period, a gain of 28 people.

So, one insurer lost 2.5% of their enrollees while another gained 1.5% over 3 months. Of course, without a ton of other data this is pretty much meaningless. These two companies only hold less than 5% of Oregon's total enrollment tally. There are 9 other carriers on the Oregon exchange, and I don't have their current numbers. Even if I did, I have no way of knowing whether those 37 people moved to another carrier, dropped their coverage entirely, died, aged into Medicare, swiched to Medicaid or what.

UPDATE 10/27/14: But wait, there's more! Thanks to Scott M. for this:

According to a completely different survey, the actual number of enrollees who are likely to switch to a different plan could be more like 66%, even though 80% of respondents are OK with their current plan:

...are one or two aspects of Obamacare enrollment more important than the others? I'd certainly contend so following a recent study from Radius Global Market Research, or Radius GMR as it's better known, which was released nearly two weeks ago.

According to Radius GMR, the vast majority of households covered by the ACA are satisfied with their current coverage, with the majority of respondents believing they are receiving equal or better care compared to before Obamacare was implemented. As the study further noted, only 20% of respondents indicated they weren't satisfied.

...Yet, two-thirds of respondents voiced to Radius GMR their intention to change plans in 2015. Why would they change plans if they're satisfied? Because consumers felt that they could get a better deal by shopping around. Radius GMR specifically listed lower-plan costs and improved access to doctors as the two compelling factors that would cause consumers to shop around.

As I said last week, in the end, we won't know how much shifting there is until the 2nd open enrollment period is over.

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