END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

New survey suggests appx. 8.4 million ACA exchange enrollees to renew for 2016?

Morning Consult has released the results of an interesting survey about 2016 Open Enrollment attitudes/intentions:

Premiums are slated to rise steeply next year for health plans across the board. Yet almost half of voters who have health coverage under Obamacare say they will keep their current plan through 2016, according to a new Morning Consult online poll.

The findings could be a worrying sign for the Obama administration, which is urging people who buy their insurance on state or federal exchanges to shop around for new plans to avoid premium increases. But the results could also be seen as a positive sign for Obamacare, generally. Half of enrollees are satisfied with their current plan and another one-third are comfortable enough with the online exchanges to look for cheaper coverage, as intended.

The poll, conducted between Oct. 29 and Nov. 1 to coincide with the start of the Affordable Care Act’s third enrollment season, found that 47 percent of respondents plan to sign up for the same health plan in 2016. One-third of respondents said they plan to shop for a new plan, and another 15 percent said they were undecided. Five percent said they did not know or had no opinion.

The article is, appropriately enough, fairly neutral about what their findings mean, and there are plenty of important caveats here; for instance:

The poll, which has a margin of error of 2 percent points, consisted of 2,351 registered voters. The question about exchange coverage was answered by a subset of 293 voters who said they have bought their health coverage on the ACA exchanges.

From the wording of this, that 2% margin of error only applies to the full 2,351 pool, not the 293 people who answered the are currently enrolled in ACA exchange policies, so that's important to keep in mind. In addition, what people say they plan on doing obviously is not necessarily related to what they actually end up doing.

The good news here, however, is that they apparently ran a similar survey with the same question asked last year, which means I can compare the results. The survey itself may or may not be accurate, but if the methodology is consistent, then the results should still give some guidance:

The same question was asked a year ago in poll by Morning Consult, with similar results. At that time, 52 percent of respondents said they planned to keep their existing coverage. Another 31 percent said they would shop for a new plan. Fourteen percent said they were undecided, and 3 percent said they did not know or had no opinion. That poll also had a margin of error of 2 percentage points.

OK, so the survey itself and the results are nearly identical for each year. What does that tell us?

Well, at the end of 2014, there were just over 6.3 million people still enrolled in effectuated ACA exchange policies as of December 2014. Of those, around 6.1 million either renewed their policies or switched to a different one via the exchanges (technically, almost all 6.3 million did so, but at least 200K of them immediately cancelled their auto-renewed policies, so they don't really count). That's a final retention rate of around 97%. (Of course, not all of those folks actually followed up and paid for their January, February or March premiums, but at the moment I'm primarily interested in how many official QHP selections there are during open enrollment).

Now, the HHS Dept. is still projecting about 9.1 million people to be enrolled in effectuated exchange policies as of December. Until recently I've been more optimistic, with an assumption of around 9.7 million, but my recent findings have suggested that the December number is more likely to be close to HHS's 9.1 million, so let's go with that for the moment.

A 97% retention rate out of 9.1 million would be an impressive 8.8 million people renewing (or switching) their policies. HHS is cautiously estimating that "somewhere between 7.3 - 8.8 million" renewals, but settled on around 8 million (plus another 4.5 million or so new additions), so 8.8 million would be at the high end of their range.

Here's where the Morning Consult survey comes in. Let's assume for the moment that there's a direct correlation between their findings and the renewal results. If so, that would mean:

  • 2014: Morning Consult says 83% of enrollees plan on either renewing or switching exchange plans
  • 2015: Morning Consult says 80% of enrollees plan on either renewing or switching exchange plans

Proportionately, 80/83 = around a 96% ratio, or 96% x 97% = around 93% of December enrollees would presumably either renew or switch exchange plans this time around.

93% of 9.1 million would be around 8.46 million people. Lop this down a bit for good measure and it suggests that perhaps 8.4 million will renew/switch.

8.4 million would be 300K higher than the 8.1 million "mid-range" that HHS is projecting, but 600K lower than the 9 million which I (until recently) have been projecting, which sounds about right to me.

Of course, this is all sheer speculation. It's possible that a good portion of that 80% will have sticker shock after they actually shop around on the exchange websites and take a pass...but this is the best I have to go on at the moment.

Oh, one other thing about the Morning Consult survey:

There has also been a significant drop in the number of voters who plan to visit an Obamacare exchange website this enrollment season. The new poll found that only 24 percent of respondents said they plan to visit an exchange site within the next few months. That is a substantial shift from two years ago, when HealthCare.gov launched. In Nov. 2013, 65 percent of respondents said they planned to visit HealthCare.gov or a state online exchange during the first enrollment season.

I actually don't think this particular data point means much of anything. In November 2013, the exchange websites had just launched, and while they were an utter clusterfuck for the most part, they were heavily in the news on a constant basis (whether in a positive or negative light). Most people, including detractors, were very interested in "visiting" the exchange websites at the time, if only to see what all the fuss was about or just how screwed up they were.

This year, the sites are (for the most part) working quite smoothly...which is a good thing, but also isn't terribly interesting to anyone who doesn't plan on actually enrolling in a policy.