New Jersey: More musings on the mandate: Do Renewals vs. New Enrollees tell the tale?

Last night, in response to CMS Administrator Seema Verma taking shots at both Covered California (for blaming their drop in new enrollment on the federal mandate being repealed) and New Jersey (for seeing a 7.1% exchange enrollment drop in spite of reinstating the mandate), I wrote a long analysis which noted that:

  • Verma may have a valid point, but...
  • There's not nearly enough data available to know one way or the other (especially the missing off-exchange data for this year), and...
  • Even if she turns out to be correct about NJ's total enrollment drop, NJ reinstating the mandate still resulted in a substantial premium drop for well over 100,000 residents.

Today, I was able to fill in some of that missing data...although some of it is still frustratingly absent.

In Covered California's press release, they were quite clear that while there was a 7.5% increase in current CoveredCA enrollees renewing their policies, there was a far more substantial 23.8% drop in their new enrollments. Their point is that the only reason they were able to achieve virtually flat enrollment year over year is because they did a much better job of holding onto existing enrollees, which mostly cancelled out the plummet in new people signing up.

Now, CMS has yet to release the big detailed Open Enrollment Report for OEP 2019 (that likely won't show up until April or so), which means I don't have access to specific demographic data for New Jersey...just their total enrollment number. They did, however, provide the top-line breakout for all 39 states hosted on the federal exchange. Sure enough, it shows a similar pattern: A small increase in renewals (0.9% higher than last year), but a dramatic drop in new enrollment (-15.8%).

That leaves the other 11 state-based exchanges. DC and New York don't wrap up Open Enrollment until tonight, and Vermont still hasn't released any enrollment data for 2019 publicly yet. That leaves Colorado, Connecticut, Idaho, Maryland, Massachusetts, Minnesota, Rhode Island and Washington State. I haven't been able to dig up new/renewal data for RI yet, but I have it for the others.

Update 2/04/19: I've also secured final numbers from New York. I hope to have Rhode Island & Vermont soon, as well as final numbers from DC.

Update 2/08/19: I've acquired the breakout from Rhode Island as well. No surprise, it follows the same pattern. Still waiting on VT and DC.

When plugged into a spreadsheet, a definite pattern starts to emerge (click table for full-size version):

Of the 10 state-based exchange listed so far and the 39 states hosted by HC.gov as a whole, only one states shows a significant increase in new enrollees this year: Massachusetts (Colorado and New York are actually essentially flat year over year; in fact, it's even possible that both CO & NY actually dropped since the numbers for each are based on percentages, not exact numbers).

Every other state, along with the 39 states on HC.gov collectively, show double-digit drops in new enrollees specifically.

That again leaves Massachusetts...which saw a dramatic increase in both renewals and new enrollments for 2019...with an active Individual Mandate Penalty.

Again, there won't be enough data to be sure about this until the state-by-state renewal/new breakout is provided by CMS for 2019, but I wouldn't be surprised if New Jersey shows a smaller-than-average drop in new enrollments while most other states are in the double digits.

However, it's the off-exchange numbers which are still needed in order to come to any conclusions...and Q1 2019 effectuations won't be known until sometime in April, I'd imagine.

Advertisement