START OF 2018 OPEN ENROLLMENT PERIOD

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Week 7/December Deadline Snapshot: 6.36M QHPs via HC.gov; CMS sticking w/projection

OK, for the first time this Open Enrollment Period, my expections were off base...significantly. The past two years, HHS was posting "weekly snapshot" reports of enrollments at the federal exchange (HC.gov). This year they switched to 2-week reports, but today they decided to issue a special "week-plus" version which covers enrollments through the (extended) 12/19 deadline for coverage starting January 1st.

As I noted last Friday, based on the massive surge in enrollments (a record-breaking 670,000 people) on the final original deadline day (12/15), I bumped up my estimates for the 4-day extension period from my original 6 million or so up to an even 7 million (assuming 250K/day). However, I later realized that two of those days fell over the weekend, when enrollments drop off substantially (and since the original deadline had already passed, even the extended deadline wouldn't make much difference weekend-wise). I pulled back my projection somewhat to 6.75 million.

However, it turns out I was still overestimating, although the numbers are still pretty impressive:

Through the extended deadline for January 1, 2017 coverage, Americans are demonstrating clear demand for quality, affordable coverage as 6.4 million consumers have signed up for Health Insurance Marketplace plans through HealthCare.gov, an increase of 400,000 plan selections compared to last year at this time.

The actual total is 6,356,488, or about 640K fewer than I was originally expecting. That's a big oops on my part, not theirs.

One of the big issues I've been concerned about is the number of new enrollees. Here's the latest on that:

Total plan selections from November 1 through the extended deadline of December 19 include 2.05 million new consumers and 4.31 million returning consumers actively renewing their coverage. Consumers whose coverage will be automatically renewed for January 1 are not yet included in these totals.

A direct comparison with last year's "week 7" snapshot is a bit tricky, even though they both run through 12/19, because they had already added auto-renewals to the total, making an apples-to-apples comparison of the total enrollments tricky.

However, the new numbers can be directly compared. Last year it was 29% of 8.25M:

  • 12/19/15: 2,392,580 new enrollees via HC.gov (roughly)
  • 12/19/16: 2,049,127 new enrollees via HC.gov (exactly)

That's a 14.4% drop-off in new enrollments year over year. There were around 4.9 million new enrollees nationally last year; if that 14.4% drop-off holds continues to hold, that'd be around 4.2 million this year, for whatever that's worth.

FWIW, HHS has been assuming 9.2 million renewals + 4.6 million new enrollees (13.8 million total) by January 31. I've been assuming the same total, but broken out differently: 8.5 million renewals + 5.3 million new.

Nationally, I've confirmed a total of 2.36 million new enrollees to date, so they'd have to add either 2.24 million or 2.94 million more new enrollees between now and 1/31 to hit either HHS or my own projections respectively.

It's also worth noting that "400,000 more than this time last year" note in the press report. If there were 343,000 fewer new enrollees, but the total (not including auto-renewals) is 400,000 more overall, that must mean that around 743,000 more current enrollees actively re-enrolled than last year.

OK, so I blew it on the "overtime surge" substantially...but this is where the auto-renewals come into play. It's entirely possible that instead of, say, 2 million people being auto-renewed via HC.gov, it'll be 2.6 million...which would put things right back on track with my expectations regardless.

As I keep reiterating: Considering that immediately after the election I was deeply concerned that the numbers would flatline entirely, things aren't looking that bad even if the numbers fall short of the 13.8M target by both HHS and myself. However, I should also note one more important item: During today's conference call, CMS head Andy Slavitt reiterated that HHS still believes they're on track to hit their original target for OE4. The "hard" number they hope for is the same as mine (13.8 million), but their actual range was anywhere from 12.8 - 14.9 million, while my range was 13.5 - 14.0 million.

With today's report, I've confirmed a total of 8.78 million QHP selections nationally.