2017 using my known flawed data was running .96% behind 2016 on the January 14th inclusive update. 2017 ended up running 5.25% behind 2016 on Healthcare.gov states. The increment (using favorable to the null hypothesis data) slowdown in pace that can be attributed to Trump Administration actions is 5.25-.96 or 4.29% of enrollment was lost due to the executive order and other Trump administration actions such as shutting down some outreach and advertising in the last eleven days of enrollment.
I've received confirmation from CMS that this "in line by midnight" grace period ONLY applies to those who CALL THE FEDERAL EXCHANGE at 1-800-318-2596and LEAVE THEIR CONTACT INFORMATION.
In other words, it does NOT appear to apply to those who are using the website application/enrollment process only; you have to CALL HC.gov and leave your number to qualify.
Every Open Enrollment Period to date, most of the ACA exchanges have ended up offering some sort of deadline extension and/or "in line by midnight" overtime grace period to allow people who started the enrollment process by the deadline additional time to wrap up their paperwork and complete the process.
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:
So, how about my projections? Well, for today specifically (12/15), I've been assuming roughly 700,000 QHP selections nationally (540K via HC.gov plus 160K via the dozen state exchanges), bringing the cumulative total up to 7.70 million nationally.
HC.gov's one-day enrollment record was set exactly a year ago today (12/15/15), when they enrolled 600,000 people in a single 24-hour period. I've been assuming that fewer people would enroll today specifically this year, if only because so many current enrollees have been actively renewing earlier than in the past; I figured this would've taken some of the heat off of the final day, so I knocked 10% off of the top.
Instead, it looks like I may have underestimated today's haul. The federal exchange could conceivably hit 700K today, and the national tally could potentially hit 800K or so. Then again, if they announce a deadline extension, some of that might spill over into the weekend.
On September 26, 2013, just 5 days before the disastrous initial launch of HealthCare.Gov (as well as ugly rollouts of many of the state-based exchanges), President Obama gave a speech pumping up the impending start of the first Open Enrollment Period at Prince Geroge's Community College.
At one point in the speech, he touted how easy and handy the website would be to use:
Starting on Tuesday, every American can visit HealthCare.gov to find out what’s called the insurance marketplace for your state. Here in Maryland, I actually think it's called MarylandHealthConnection.gov. (Applause.) MarylandHealthConnection.gov. But if you go to HealthCare.gov, you can look and they'll tell you where to go. They'll link to your state.
Now, this is real simple. It’s a website where you can compare and purchase affordable health insurance plans, side-by-side, the same way you shop for a plane ticket on Kayak -- (laughter) -- same way you shop for a TV on Amazon. You just go on and you start looking, and here are all the options.
(note: I'm live updating as I type this stuff, so keep checking back, I'll be adding more updates/analysis over the next hour)
Wow! OK, I'm back from my kid's field trip (nature center; they learned about how animals handle the winter via hibernation, migration & adaptation...learned about fossils...went on the nature trail to look for animal tracks...and even dissected owl pellets, hooray!!). Of all the days to miss a major HHS/CMS conference call, this was a big one. I'm furiously poring over the HHS Dept's ASPE January Enrollment Report which, as I expected this morning, was just released less than two hours ago.
So what about this week? Well, it should play out very much the same: Practically all QHP selections going forward should be for new additions, and we have New Year's Eve and Day included. Sure enough, last year there were just 103K added to HC.gov from 12/27 - 01/02...slightly more than Christmas week.
Assuming this year follows a similar pattern, there should be roughly 80,000 people tacked onto the HC.gov total for Week 9, bringing the cumulative total up to just over 8.6 million.
If this does happen, then yes, I'll have to seriously re-evaluate my current 14.7 million OE3 projection...because that will suggest that the final 5 weeks are gonna play out a good 20% lower than my expectations.
And if that's the case, then instead of another 3.5 million new folks signing up, it'll only be around 2.8 million...bringing a grand total of right around 14.0 million even.
As expected, Week Eight was extremely quiet; not only did the entire week take place after the (extended) deadline for January coverage, but there was also Christmas Eve and Christmas Day to contend with. Needless to say, very few people feel like enrolling in healthcare coverage on December 24th or 25th.
Last year, just 96,000 people chose to do so between 12/20 - 12/26 in the 37 states covered by HC.gov. I was expecting slightly more this year (100K even), but only 74,000 did...26% fewer than the same week in 2014. Whatever else is going on, it's safe to say that the Open Enrollment Periods are starting to become more and more "front-loaded".
As I noted last Tuesday, the Week Seven HC.gov Snapshot Report threw a bit of a curveball; while they did add most of the bulk auto-renewals to the total, they also stated that some unknown number had yet to be added. As far as I can tell, that number could be as low as 1...or (theoretically) as high as 680,000. My best spitball take is that it was somewhere around 150,000, which presumably have all been added to this week's report.
As for new enrollments, with Week Eight taking place a) entirely after even the extended deadline for January coverage and b) the same week as Christmas Eve and Day, I'm not expecting many to be added; perhaps 100,000 or so, for a grand total of roughly 250,000 for the week, which in turn would bring the cumulative total (for the federal exchange only) up to right around 8.50 million even.
Six hundred thousand people actively enrolled in private healthcare policies on Tuesday, December 15, 2015 by using HealthCare.Gov.
Forget about the cumulative total for a moment. Forget about the auto-renewals still to be added. Forget about the state-based exchanges. Just focus on the fact that in a single 24-hour period, 600,000 people signed up through the federal exchange site only.
Now think back to October 2013, when HC.gov and 17 state-based exchange websites launched...and, for the most part, immediately crashed and burned.
“Because of the unprecedented demand and volume of consumers contacting our call center or visiting HealthCare.gov, we are extending the deadline to sign-up for January 1 coverage until 11:59pm PST December 17.Hundreds of thousands have already selected plans over the last two days and approximately 1 million consumers have left their contact information to hold their place in line. Our goal is to provide access to affordable coverage, and the additional 48 hours will give consumers an opportunity to come back and complete their enrollment for January 1 coverage. ”
--Kevin Counihan, CEO of the Health Insurance Marketplaces
Welp, you can probably throw The Graph out the window now, at least in terms of the "spike" hitting right around now. My model was based on the assumption that yes, there'd be a huge spike yesterday and today, followed by perhaps 3 million auto-renewals being tacked on all at once tomorrow/Thursday.
Just a quick hit: There's now just under 7 hours to go before the December 15th deadline for January 1st coverage (I'm assuming the actual deadline is midnight Pacific time?), and it looks like we've indeed reached the server capacity limits of HealthCare.Gov; it placed me on the "Waiting Room" screen for a solid 10 minutes before redirecting me to the account login page.
Meanwhile, Covered California just issued the following statement:
COVERED CALIFORNIA EXTENDS SERVICE CENTER HOURS UNTIL MIDNIGHT TO HELP CONSUMERS BEAT KEY DEADLINE
HOWEVER, assuming that both the Week Six total as well as the "spike" trend I projected turn out to be accurate, that means that these final days should be playing out something like the following:
Sunday, 12/13: Around 350K nationally (270K via HC.gov)
Monday, 12/14: Around 460K nationally (350K via HC.gov)
Tuesday, 12/15: Around 780K nationally (600K via HC.gov)
Yes, that's right, it's conceivable that HealthCare.Gov could see up to 600,000 people select private policies in a single 24-hour period tomorrow, plus up to another 180,000 via the various state exchanges.