2018 MIDTERM ELECTION

Time: D H M S

Colorado mystery solved; Idaho mystery still unanswered (Updated)

In my post about today's official ASPE ACA Enrollment Report, there weren't too many surprises....but there were a few notable items. As I noted:

  • HAWAII: I was assured 8 ways from Sunday that Hawaii's23,000 enrollee figure was specifically for 2015 enrollment. This made no sense to me given their tiny enrollment last year, but I was assured of it. Well, apparently my original instincts were correct, because they're showing up with only 12,625 in the end.
  • IDAHO: This is the only state which hasn't given their own enrollment update in forever. According to the prior ASPE report, they were at around 90.5K as of January 17th...yet somehow they only managed to rack up another 6,500 enrollees over the entire final month of Open Enrollment?? I was expecting upwards of 30K or so. This makes zero sense to me...am I missing something here?

In addition, there are a few states where their most recent official enrollment reports had some confusing data, which the ASPE report pretty much trumps regardless of anything else (at least, this is the official number which will be tossed around no matter what anyway):

  • CALIFORNIA: The CoveredCA report made it sound as though the total number selected was 1.439 million as of 2/26, minus 31,000 who had past-due payments or whatever. However, today's report gives the total as 1.412M, or 27K fewer. Whever; they still barely squeaked past 2014.
  • COLORADO: Yesterday's official report added an extra week to the tally, but again, there seems to be around a 10,000 enrollee discrepancy due to the confusing nature of the CO report. 140.3K is CO's final official number.
  • Between Hawaii, California and Colorado, that's about 47,000 enrollees "lost" due to confusing reporting/interpretation.
  • Finally, for all the grief that California has taken for coming up 17% short of their internal target, New York really came up short; they were targeting an insanely ambitious 720,000, which would have been a whopping 94% increase over 2014. Instead they only hit 409K, which was just a 10.5% increase.

As I noted the other day, of the roughly 800,000 gap between the actual final number (11.7 million) and my personal projection (12.5 million), a whopping 56% of the difference could be found in just 2 states:

  • 288,000 in California (the exchange had targeted 1.70 million, but only hit 1.41 million)
  • 161,000 in New York (the exchange had targeted 720K; I only targeted 570K, but they only hit 409K)

Hawaii appears to be a simple case of the HI exchange issuing confusing-as-hell enrollment reports. They had a tendency to use cumulative enrollment figures, which made me suspicious when they supposedly had broken 23,000 this year (vs. last year's 8,600). However, according to the reporter who broke the story:

"Exec. director says there are currently 23k who selected plans for 2015."

That's pretty specific and direct, and came after she and I had a Twitter conversation about the confusion and she had gone back to double-check.

Apparently either the Executive Director of the exchange itself misunderstood her question, or she misunderstood his response.

Anyway, in the end Hawaii came in at pretty much exactly what I had originally pegged them at (13K).

So, that leaves Colorado and Idaho. The other day I had a lot of confusion about Colorado's latest report, which gave a top-line grand total of about 154K, but mixed in SHOP enrollments and had some confusing language as well. Fortunately, they just responded to my clarification request over at the Connect for Health Colorado Facebook Page:

OK, so the first thing you need to do is subtract out 3,716 SHOP enrollments from both numbers. That leaves you with 150,229 total QHP selections (which is what I thought it was!), of which 141,639 have actually paid or at least haven't gone past-due on their payment deadline. This is very similar to what Rhode Island has been doing with their enrollmente reports (except that they were more clear about it). This amounts to roughly a 92-94% payment rate overall, which is excellent...but it also means that their official "plan selected" number is still about 8,600 fewer than I thought.

And then there's...Idaho.

Idaho, again, is unique. They're the only state to have operated on HC.gov last year before moving to their own exchange this year.

They're the only state exchange set up by a completely Republican-run state (the GOP has full control over Nevada now, but didn't the past couple of years when they set up their exchange...and they've moved the opposite way, over to HC.gov this year anyway).

With all of that, Your Health Idaho seemed to have a pretty smooth, successful launch and run this year. They didn't issue updates often, but seemed to be doing pretty well:

Now, the first number is obviously misleading, since most of those are renewals from 2014 (even if they aren't counted as such for technical reasons). However, they still managed to enroll 8,694 more people between 12/15 - 12/31 (511/day), and another 7,184 between 1/01 - 1/17 (422/day).

And then...nothing. Radio silence, all the way up through today. According to the official ASPE report, as of 2/21/15, Idaho's grand total comes in at...97,079???

That's just 6,512 additional people in a whopping 35 days...or just 186 per day.

Remember, that's including the big mid-February deadline surge, as well as the "Waiting in Line" extension period. Even if you assume every one of those 6,512 came in by the 2/15 deadline, that'd still only be 224/day.

For comparison, nationally, enrollments rose 23% between 1/16 and 2/22 (including all 50 states + DC).

If you subtract Idaho out of the loop, that's 11.590.995 / 9,449,128 = 22.7%.

Even if you're just looking at the 14 state-based exchanges, they rose 19.6% (2,849,783 on 2/22 vs. 2,383,004 on 1/16).

Subtract out Idaho (ie, the other 13 state exchanges only) and it's 2.752.704 / 2,292,437 = 20.1%.

Idaho itself? They only went up 7.2%.

So...what the heck happened in Idaho over the final month (+ one week)? No clue, but that accounts for another 23K of the "shortfall" from my projection.

Anyway, they still managed to garner a 28% increase over their 2014 total, which isn't bad, all things considered.

UPDATE: Out of curiousity, I've plugged in the "3rd month vs. 1st+2nd month" numbers for every state, and sure enough, aside from DC (which is sort of a special case anyway), Idaho is definitely the odd man out when it comes to 3rd Month performance. Every other state ramped up their numbers in the final month (final 5 weeks, really) by at least 12%.

Of course, it's possible that I'm looking at this the wrong way--perhaps the "issue" isn't that Idaho stalled out in the final lap, it might be that they overperformed in the earlier portion of the enrollment period, making the 3rd month seem weak in comparison.

Anyway, just thought this was interesting.