END OF 2018 OPEN ENROLLMENT (MASSACHUSETTS)

Time: D H M S

MULTIPLE UPDATES: Hey Trump, repeal THIS: 11.6M QHPs confirmed, likely ~12.0M when the dust settles

UPDATE: OK, it looks like the big HealthCare.Gov Final Surge Report is gonna be released sometime Thursday morning. Unfortunately, I have a can't-miss meeting in the morning as well, so there's a good chance that after sitting at my desk and constantly refreshing/checking email all day today, I may ironically end up missing the big reveal and not being able to post about it for an hour or so after it comes out.

UPDATE 12/21/17: As of 2:00pm, still nothing. Speculation now brewing that they may be hoping to bury the report at 4:59pm on the Friday before Christmas. Hoping to be proven wrong.

UPDATE 2:35pm: h/t to Adam Sacarny for the head's up:

Exchange open enrollment for 2018 coverage ended w/ approx 8.8M people enrolling in coverage. Great job to the @CMSGov team for the work you did to make this the smoothest experience for consumers to date. We take pride in providing great customer service.

— CMS Administrator (@SeemaCMS) December 21, 2017

There's still no actual press release or further details. (update: see below for press release & state data!)

Some people are confused as to whether the 8.8 million figure only includes HC.gov or the 12 state exchanges as well, but that makes no sense for several reasons: First, it would mean that HC.gov enrollment only totalled around 6 million (since I've verified 2.8 million on the 12 SBMs); second, because most of those SBMs still have open enrollment ongoing.

Therefore, unless there's a SERIOUS screwup here, the national total is at least 11.6 million QHP selections, with several hundred thousand still left to go from the SBMs with later deadlines, the hurricane special enrollment period and so forth.

It's extremely unlikely that the total will equal last year's 12.2 million (and there's virtually zero chance of hitting the 12.7 million record hit two years ago), but 12 million could be feasible if the state exchanges really kick butt in their extended periods...and that would be extremely impressive given everything the Trump Administration and the Congressional GOP has thrown at the ACA this year.

Meanwhile, to the shock of absolutely no one, after helping Trump do everything possible to sabotage the ACA exchanges all year, CMS Administrator Seema Verma is of course showing astonishing chutzpah by trying to take credit for the solid numbers:

This year CMS took a more cost effective outreach approach, spending just over $1 per enrollee on outreach and education for Exchange coverage compared to nearly $11 per enrollee last year.

— CMS Administrator (@SeemaCMS) December 21, 2017

This is nonsense, as I've been saying for two months now: HUGE shout-outs should go instead to Get America Covered and the 2018 Indivisible ACA Signup Project for their efforts; they deserve a round of applause.

I'll have to tweak The Graph as soon as CMS releases the actual press release (?) which should include the exact number of QHP selections via HC.gov, but in the meantime:

UPDATE: The press release is out with the state-level numbers!

Week 7, Dec 10- Dec 15, 2017

In the last week of Open Enrollment for 2018, 4,143,968 people selected plans using the HealthCare.gov platform or were automatically re-enrolled in a plan. As in past years, enrollment weeks are measured Sunday through Saturday.

This Open Enrollment snapshot covers the period from December 10, 2017, to 11:59PM Eastern Time on December 15, 2017. The plan selections reported in this snapshot are not final and do not include plan selections for consumers who enrolled in coverage through 3:00AM on December 16, 2017, or consumers who left their contact information at the call center due to high volume. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov. The final number of plan selections associated with enrollment activity during a reporting period may change due to plan modifications or cancellations. CMS plans to release an updated snapshot next week with the final enrollment data.

IMPORTANT: Note the highlighted section above (h/t to Emily Gee of CAP for the head's up!). How many could that be? See below...

In addition, the week seven snapshot only reports new plan selections, active plan renewals, and automatic enrollments and does not report the number of consumers who have paid premiums to effectuate their enrollment. This snapshot does not include plan selections from State-based Exchanges, other than those using the HealthCare.gov platform. CMS plans to release a detailed 2018 final enrollment report in March, including final plan selection data from State-based Exchanges that do not use the HealthCare.gov platform.

Definitions and details on the data are included in the glossary.

And here's what it looks like with the confirmed enrollment data for every state (+DC) on hand, sorted by how many people have enrolled compared to last year:

UPDATE: I have a small update from Connecticut; the table and graph below have been updated to include this as well.

A few initial takeaways:

  • I'm pleasantly surprised to see that in addition to Washington State, 11 states on the federal exchange actually surpassed their 2017 Open Enrollment Period numbers (Kentucky, Hawaii, Nebraska, North Dakota, Iowa, Nevada, South Dakota, Oregon, Missouri, Wyoming and Kansas), and another 4 came within 2% (Utah, Tennessee, Florida and Virginia).
  • Ironically, most of the state-based exchanges are now towards the bottom of the table compared to last year, except of course only 2 of them have actually hit their deadlines yet (Vermont and Idaho), and the total numbers aren't in for those anyway. This isn't just "they have more time" either...there's always at least a small surge at the deadline point, which HC.gov already reached but 10 of the SBMs haven't yet.
  • Even more impressive: 8 HC.gov states have even outperformed the record-holding 2016 Open Enrollment Period two years ago (12.7 million nationally), and the grand total is only down 8% from that.
  • At the opposite end, Louisiana and West Virginia are way down for reasons unknown. WV went "Broad Load" this year...but so did Colorado, Delaware, Indiana and Mississippi, and they seem to have done OK. Louisiana expanded Medicaid in July 2016, which cannibalized their 2017 numbers...but that shouldn't have made much difference this year. Not sure what other factors are going on in those states.
  • 2.4 million new enrollees, 6.4 million renewals. Unfortunately, they didn't break out the renewals between "active" and "passive" for the final number, but we know that at least 3.3 million of them are active renewals.
  • Remember: These numbers do not include anyone who enrolled in the final 3 hours of 12/15 (from midnight - 3:00am Eastern), nor does it include those who left their name with HC.gov because they couldn't get through, etc. I have no idea how many that might be, but consider that last December 15th, HC.gov enrolled over 670,000 people in a single 24-hour period. That's an average of 28,000 per hour, or 84,000 for 3 hours. The volume was probably higher than that as last-minute enrollees scrambled, so let's call it perhaps 100,000 or so, plus however many left their numbers for callbacks.
  • On the other hand, as Emily Gee pointed out, this will be cancelled out by some number of auto-renewal enrollees cancelling their policies, so I'd say 100K is the likely high-end which might be tacked on to HC.gov states.
  • In addition, there's the Hurricane Special Enrollment Periods, which my spitball math suggests could add perhaps 50K - 100K (?) to the total, although that's probably being optimistic.
  • Between the two, I'd say perhaps 100K - 150K could be added from the federal exchange, plus however many are added via the later-deadline SBMs, which I'm pegging at 200K - 300K.
  • All told, I could see another 350K - 400K being added before the dust settles, for a grand total of right around 12.0 million. If so, that would bring it within 2% of last year and 6% of OE3...an amazing accomplishment indeed.