2018 MIDTERM ELECTION

Time: D H M S

6.5 million RENEWALS/RE-ENROLLMENTS confirmed; up to 2.3 million remaining.

Last week I asked "How many HC.gov auto-renewals are left to be added?" I noted that 5.86 million current exchange enrollees have been confirmed to have been renewed/re-enrolled via the federal exchange (71% of 8.25 million total), and that there could theoretically be up to 680K left to be auto-renewed, assuming that the currently-effectuated number is indeed still 9.1 million nationally:

The 9/30/15 number isn't what's relevant here; what we need to know is the December number. For that, HHS is still quite insistent that it'll end up being 9.1 million. While I was more optimistic earlier this year (I assumed it'd still be close to 9.7 million nationally as of now), it's pretty obvious that the attrition rate has indeed been higher than I figured, so I'll go with their 9.1 million.

If so, and assuming the federal-to-SBM ratio has remained the same, that suggests that as of December, HC.gov states are down to 6.54 million people as of today.

We also know that about 5.86 million people have already re-enrolled (either actively or passively) via HC.gov (71% of 8.25 million).

That means that there are potentially up to 680,000 more people left to be auto-renewed via the federal exchange.

OK, so that's 5.86 million out of a potential 6.54 million via the federal exchange. What about the state exchanges, though?

Well, five of them still haven't released any renewal/re-enrollment data as of 12/28: California, DC, Kentucky, New York and Vermont (CA has stated that over 197K new folks have signed up, but hasn't said a peep about current enrollees renewing yet). In addition, while Colorado has issued several enrollment updates, they haven't broken the number out between new/current enrollees yet, so I can't really use that. For these states, I'm basing the maximum potential number who could re-enroll on 97.8% of their 9/30/15 effectuated enrollment number (ie, 9.1 million / 9.3 million = 97.8%).

On the other hand, Connecticut, Idaho, Maryland, Massachusetts, Minnesota, Rhode Island and Washington State have all given full or partial numbers for current enrollees.

With all that in mind, here's what I've come up with:

Add these all up and you get:

  • 619,457 current state-based exchange enrollees have been confirmed to have renewed/re-enrolled so far
  • Up to 1.97 million more could potentially remain, including:
    • up to 1.3M in CA
    • up to 107K in CO
    • up to 14.5K in DC
    • up to 84.5K in KY
    • up to 13K in MA
    • up to 39.7K in MN
    • up to 350K in NY
    • up to 30.4K in VT
    • up to 31.8K in WA

Add these to the HC.gov numbers and you get:

  • 6.48 million current enrollees have been confirmed to have renewed nationally (either actively or automatically)
  • up to 2.65 million more current enrollees could potentially still be renewed nationally

Of course, not everyone who's currently enrolleed will renew. Last year, of the 4.31 million people who were still enrolled in effectuated policies via HC.gov states as of 12/31/14, 4.16 million of them either renewed or re-enrolled for 2015 (96.5%). Assuming a similar ratio this year, that would be roughly 8.78 million of the presumed 9.1 million nationally that HHS is expecting.

If so, that would lop about 320K off the total. That would leave up to 2.33 million left to add, which would bring the grand total up to just over 11.6 million nationally, plus whatever new folks are added over the remaining 5 weeks of open enrollment.

Here's another interesting twist on this:

  • Assuming that there are indeed 9.1 million currently effectuated nationally, and
  • Assuming that 8.8 million of them do end up re-enrolling/renewing their policies, thus bringing the grand total up to 11.6 million just ahead of New Year's Eve, then
  • That would leave 3.1 million new folks who would have to sign up in the final 5 weeks in order to hit my 14.7 million projection, right?

Well, get this: When you look at last year's Graph/Spreadsheet, here were the national numbers for 12/20/14 and 2/22/15:

  • 12/20/14: 8.57 million
  • 02/22/15: 11,688,074
  • Difference: 3.12 million

In other words, the same number of people will have to enroll during the final 36 days of the 2016 Open Enrollment Period as did during the final 64 days of the 2015 Open Enrollment Period (including the 7 day "overtime" period) in order to hit my target.

It's a tall order; as always, it really depends on how much of a Final Surge there is the last week of January.

Plus, of course, my assumptions about the 9.1M and 8.8M renewal figures could also simply be wrong; they could each be higher (unlikely) or lower (quite likely). If you assume only 8.5 million total renewals, that would increase the number needed by another 300K to around 3.4 million in 36 days (95K/day) vs. 3.1 million in 64 days (49K/day), a near doubling of last year's daily average.