START OF 2018 OPEN ENROLLMENT PERIOD

Time: D H M S

District of Columbia

The District of Columbia is the 6th state (OK, it's not a state but it's considered one legislatively for purposes of the ACA) to post their initial 2018 rate filings (h/t to Louise Norris for the heads up). For 2017, the weighted average rate increase for the individual market was a mere 7.3%, highly unusual for this year, while the small group market increase was almost non-existent: Just 0.4% overall.

I've been cautioned that these numbers are preliminary, but that's true of all of the "final" enrollment numbers to date; there are often minor clerical corrections and the like before the final numbers are baked in.

Anyway, here's the OE4 QHP enrollment numbers for the DC exchange, which is up about 3.1% over last year.

However, according to the official ASPE report for 2016 Open Enrollment, DC's QHP tally was slightly lower (22,693); since that's the official total used by HHS, that's what I'm going with, which means they've enrolled about 4.1% more this year.

Yay! The DC exchange has issued their first OE4 enrollment report of the year! Boo! It doesn't include renewing enrollees (either active or passive):

DC Health Link Enrollment up Nearly 50% at First Deadline for 2017 Coverage  •  60% of new enrollees are 34 years old and younger

Washington, DC­­ – Today, the DC Health Benefit Exchange Authority (HBX) released preliminary individual marketplace data for the fourth open enrollment period for DCHealthLink.com, the District’s online health insurance marketplace for individuals, families and small businesses.

These preliminary data show that through December 19, 2016:

Hmmm...the Colorado exchange hasn't issued an official enrollment update since the end of November, when it stood at 37,142 QHPs.

Today, in an article about the overall national numbers (mainly noting today's Week 5/6 Snapshot report), Kimberly Leonard of U.S. News & World Report cited a number I haven't seen elsewhere; I presume she simply called up the exchange directly. It seems about right to me:

Open enrollment began a week before Election Day, and several states reported that they didn't begin running ads until after that, saying they didn't want to compete with the attention the election was getting and noting that space sold during that time was particularly expensive.

That was the choice for Colorado, where enrollment is 16.3 percent higher than last year, totalling 50,207 people.

In addition, Leonard provides a couple of quick updates/corrections for some other states:

As I keep noting, the DC exchange insists on presenting their enrollment numbers as cumulative since October 2013.

As a result, I have to subtract the prior numbers from the current ones to find out the net increase in QHP selections, Medicaid enrollments and SHOP enrollments.

Here's the latest update, through the end of October:

  • 262,928 people enrolled through DC Health Link in private health plans or Medicaid (includes open enrollment and SEPs):

  • 38,468 people have enrolled in private health plans through the individual and family marketplace;

  • 175,012 people have been determined eligible for Medicaid coverage; and

  • 49,448 people have been enrolled through the small business marketplace (includes Congressional enrollment)

Subtracting the prior numbers (which ran through June 10th) gives us:

Two bits of news out of the DC exchange today: First, they announced that the uninsured rate has been slashed in half over the past 3 years thanks in no small part to the Affordable Care Act. Not a huge shocker given the recent surveys/studies released by the CDC, Gallup, Kaiser and so on of late, but still good to see:

District's Uninsured Rate Drops by Half

Washington, DC­­ – A new survey by the Center for the Study of Services conducted for the DC Health Benefit Exchange Authority (DCHBX) concludes that the District of Columbia made huge gains during the most recent open enrollment period to provide access to health insurance coverage to people who were previously uninsured. Results from this survey show that more than 25,500 people, who were not previously covered in 2015, gained access to health insurance coverage in 2016 through DC Health Link, the District’s online health insurance marketplace.

...Additional findings show:

As I keep noting, the DC exchange insists on presenting their enrollment numbers as cumulative since October 2013.

As a result, I have to subtract the prior numbers from the current ones to find out the net increase in QHP selections, Medicaid enrollments and SHOP enrollments.

Here's the latest update, through July 8th:

  • 226,050 people have enrolled in health coverage through DC Health Link in private insurance or Medicaid:
  • 36,610 people enrolled in a private qualified health plan,
  • 171,573 people have been determined eligible for Medicaid, and
  • 36,350 people enrolled through the DC Health Link small business marketplace (includes Congressional enrollment).

Subtracting the prior numbers (which ran through June 10th) gives us:

The DC exchange has this frustrating habit where they do issue regular, easy-to-read enrollment reports...but they keep using cumulative numbers since 2013 in those reports. I honestly have no idea why they do it this way; since people are constantly moving on and off of different types of coverage, and even those who keep the same policy have to renew those policies every year anyway, so reporting the multi-year cumulative number of enrollments makes about as much sense to me as Ford reporting how many cars they've sold since 1903.

However, by simply comparing the cumulative numbers against older cumulative numbers, I can use the difference to see how things are going during the off season, like so:

More Than 225,000 People Enrolled in Health Coverage Through DC Health Link from October 1, 2013 to June 10, 2016

The good news about estimating the DC exchange rate hike requests is that the DC Dept. of Insurance, Securities & Banking is pretty transparent about posting this info, and they keep it simple. It's simpler still because like Vermont, DC requires that all individual and small group policies be sold on the exchange, so there's no off-exchange data to track down.

The bad news is that it's a little bit too simple: Only two carriers (CareFrist and Kaiser) offer policies via the individual exchange, and only CareFirst is offering PPOs:

Having said that, I'm not sure what to make of this part of the official press release:

This Just In...the DC exchange has issued their official enrollment report as well (note: remember that this includes the first 2 days of February as well):

DC Health Link Individual Marketplace Data for Third Open Enrollment Period

61% of New Customers are 34 years old and Younger

Washington, DC­­ – Today, the DC Health Benefit Exchange Authority (HBX) released preliminary individual marketplace data for the third open enrollment period for DCHealthLink.com, the District’s online health insurance marketplace for individuals, families and small businesses.

The third open enrollment period for individuals and families ended January 31, 2016.  District residents had two extra days to enroll due to the historic snow storm that hit the DC region.   Data includes people enrolling from November 1, 2015 to February 2, 2016.

There are 22,912 customers with 2016 health insurance coverage through DC Health Link’s individual marketplace:

Throughout the first two years of the ACA exchanges, the DCI exchange's official enrollment updates were simultaneously clear & simple as well as frustrating. On the one hand, they break out the numbers quite cleanly, such as this one from October 21st of last year:

From October 1, 2013 to October 16, 2015, 173,090 people have enrolled in health insurance coverage through DC Health Link in private insurance or Medicaid:

  • 25,702 people enrolled in a private qualified health plan,
  • 125,261 people have been determined eligible for Medicaid, and
  • 22,127 people enrolled through the DC Health Link small business marketplace (includes Congressional enrollment)

On the other hand, as noted above, these numbers are cumulative, dating all the way back to October 2013 when the exchanges originally launched. This makes the numbers shown kind of useless for the same reason that Chrysler stating that they've sold 100 million cars since the company was founded tells you nothing about how many cars they've sold so far this year.

The final 2016 deadline to enroll in a qualifying healthcare plan for policies starting coverage as of March 1st officially ended as of MIDNIGHT on January 31st.

As usual however, there are a few caveats to this...but not as many as the past two years:

If you look at the State-By-State OE3 enrollment breakdown, you'll notice that there are still 4 blank fields all the way down at the bottom, plus a special note regarding California:

If you take a look at the State-by-State chart, you'll notice that in addition to a few clarifications here and there, there are 5 states (well, 4 states +DC) all the way at the bottom labelled "NO DATA YET".

California insists, just like last year, on doing this weird thing where they release the number of new enrollees who have signed up on a fairly regular basis, but the number of renewals by current enrollees is kept a secret all the way into January. I have no idea why they do that, and it's pretty important given that we're likely talking about somewhere between 1.0 - 1.3 million people here.

On the other hand, at least they've posted data on their new additions. DC, Idaho, Kentucky, New York and Vermont haven't even done that much as of this writing.

When I updated my #OE3 state-level enrollment projections yesterday, I came across this official projection for #OE3 from Your Health Idaho's Sept. 18th board meeting minutes:

Rep. Rusche asked what our target enrollment is for this cycle and what barriers we see in making those targets. Mr. Kelly said the team is focused on the 80% goal of 92,000 as our enrollment target.Premium increases are a potential barrier. Net premium is a relatively small increase for most consumers, and each consumer will experience something different depending Page 5 of 14 on their plan, their location, their carrier, etc. We feel that while the premiums are increasing the relatively small net premium increase will mitigate this barrier to a large degree.

When I asked for clarification, they informed me that:

We currently have 86,659 effectuated enrollments with Your Health Idaho, as of September 15. The 92,000 would also refer to effectuated enrollments.

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