START OF 2018 OPEN ENROLLMENT PERIOD

Time: D H M S

OE3

OK. As expected, HHS released the "top line" number for the 2016 Open Enrollment Period: 12.7 million Qualified Health Plan enrollments nationally.

On the one hand, yes, I blew it this year: This is almost exactly 2.0 million fewer than the 14.7 million I originally projected for this year.

HOWEVER, as I've noted many times before, this isn't an apples to apples comparison, because that 12.7 million is after subtracting a minimum of 300,000 cancelled plans (pre-purging). The first two years, any plan cancellations during open enrollment weren't subtracted until after the dust settled; this year, due to improved backend software, CMS was able to purge/remove most cancelled plans from HC.gov on the fly.

In other words, an apples to apples comparison of the actual grand total of QHP selections vs. the same figure last year is at least 13.0 million (actually somewhat higher, since CMS hasn't released the total number of "pre-purges").

*(mostly)

Well, it's around 7pm EST on Sunday, 1/31/16. As of this writing, HealthCare.Gov is loading quickly, as are all 13 of the state-based exchange websites. Aside from a "high call volume" message at Covered California and "extended call center hour" messages from CoveredCA and various other SBMs, I'm not seeing any evidence of website server load strain, etc.

In fact, the only site I know of to experience a significant technical snafu this weekend is the Washington Healthplanfinder, which was offline for most of yesterday (but has been up and running all day today).

In fact, the only "overtime/extension period" announcements so far are from the Maryland Health Connection and Covered California, which each announced official "In Line By Midnight" extensions for those who start their enrollment process by midnight tonight.

In short, this seems to indicate that everything is operating pretty smoothly. As for the actual volume, I've already concluded that the "final surge" will likely be decent but fairly muted compared to the first two years of Open Enrollment.

UPDATE 9:40pm: Ut-oh...this can't be good...

This is only appearing on the home page of the Massachusetts exchange website, but the wording of it suggests that it applies to all of the state-based exchanges.

Yeeks. Don't be surprised if there's a few more #ACAOvertime announcements after all....

UPDATE 10:50pm: Hmmm...it's been over an hour and no other state exchange websites are reporting any problems, nor have I seen any Tweets or Facebook posts which indicate any outages.

All websites including HC.gov are still loading smoothly.


UPDATE MIDNIGHT: Welp, that's that, at least for the Atlantic and Eastern Time Zones. *Central, Mountain West and Pacific still have a bit to go, and of course Alaska and Hawaii are 5 hours behind, but I've gotta get some sleep myself...

I assume there'll be some sort of rough tally announcement tomorrow, but all eyes will be on the Iowa Caucuses anyway, so there you go.


Once again, here's my final projection for OE3's QHP Selection Total; I assume the actual total will be announced tomorrow (at least to the nearest half million or so, anyway):

I launched the "State by State" chart feature towards the end of the 2015 Open Enrollment period last time around, and it proved to be pretty popular, so I've brought it back this year.

Note that whle the enrollment numbers for most states below are current through January 23rd, most of the state-based exchanges are either slightly more current or up to a month behind.

With that caveat out of the way:

Just a few hours ago, I said:

If, however, last week was a bust, then it doesn't bode well for the final week either:

  • 200K Week 12 x 1.33 = 266K nationally = around 12.0 million cumulatively
  • Assume 3x 266K for the final week = around 800K more = perhaps 12.8 million total

CMS just released the Week 12 Snapshot report:

Erk.

Hmmm...what about the purge factor? Last week it lopped the grand total down by 60%, from around 400K to just 154K, so perhaps something similar happened this week?

A few hours from now, CMS should be releasing the HealthCare.Gov Week 12 Snapshot report. As noted last week, the "pre-purge" factor has completely messed up my projection model this year, since the numbers for weeks 1-10 could have been lopped down by several hundred thousand people (nearly 250K of which were confirmed to have happened in Week 11 alone). While the purge numbers for the previous 10 weeks were likely much smaller, it still screws up my methodology.

As a result, my original projection for this week of around 400,000 QHP selections has an important caveat: It depends greatly on how whether that number includes the purged/cancelled enrollments or not:

UPDATE 1/21/16: Updated to include new data from Colorado, Maryland, Connecticut and California.

I launched the "State by State" chart feature towards the end of the 2015 Open Enrollment period last time around, and it proved to be pretty popular, so I've brought it back this year.

Note that whle the enrollment numbers for most states below are current through January 16th, most of the state-based exchanges are either slightly more current or up to three weeks behind.

With that caveat out of the way:

Here's what I wrote a few days ago:

The national total was around 11.50 million QHP selections as of January 9th. Since I won't know how big of a difference the "Live Purge!" factor is making until well after the end of March (when the Q1 effectuation report comes out), I still have to work within the confines of how CMS has been reporting enrollments this season.

With that in mind, I've dropped my end-of-OE3 projection down from 14.7 million to somewhere between 13.8 - 14.2 million (call it 14.0 million even for simplicity).

In order to hit 14.0 million total, 2.5 million people will have to enroll in the final 3 weeks, most likely broken out something like:

I launched the "State by State" chart feature towards the end of the 2015 Open Enrollment period last time around, and it proved to be pretty popular, so I've brought it back this year.

Note that whle the enrollment numbers for most states below are current through January 9nd, most of the state-based exchanges are either slightly more current or up to two weeks behind.

With that caveat out of the way:

As I said a few hours ago:

With all that in mind, if the Week 10 HC.gov Snapshot comes in anywhere under 200,000 today, I'll be dropping my final estimate to a range between 13.8 - 14.2 million.

Well, the Week 10 Snapshot was just released, and sure enough, it was pretty anemic:

Yeah, that's not great. In fact, this is almost identical to the number of new enrollees during Christmas Week (just over 74,000), making this the second lowest week of the Period.

As I noted last week, I'm expecting today's HC.gov Week 10 Snapshot Report to announce around 130,000 additional QHP selections between 1/03/16 - 1/09/16, which would bring the HC.gov total up around 8.74 million. This would also likely bring the national total up to around 11.55 million.

While those numbers wouldn't be bad, they would also make it very likely that the final 3 weeks are going to be weaker than I expected. Back on December 28th, I noted the following:

As of today [last week], we should be appx. 1.9 million ahead of last year...but as you note, the question now is whether it will continue to stay ahead of last year *proportionately*.

11.2M vs. 9.3M = appx. 20% ahead. My 14.7M projection assumes 25% growth over 11.7M. It's that 5% difference I'm concerned about (again, see the final week).

I wrote about this last night as part of a larger piece, but the "Young Invincible Risk Pool" issue from yesterday's official Open Enrollment Report seems to be generating a lot of hand-wringing, so I decided to write something specifically about it.

One of the biggest concerns people have about the ACA exchanges is whether or not there are enough so-called "Young Invincibles" (ie, young adults aged 18-34 years old) in the market to help balance out the risk pool. The assumption is that "YI's" are considerably healthier than older folks, and therefore should help reduce the overall cost of medical services over the coming year. From an insurance carrier POV, it's a lot more profitable to have 10,000 healthy customers than 1,000 cancer or diabetes-ridden customers. In the past, of course, this meant that carriers would cherry-pick their enrollees; if they suspected you'd be a high risk customer, they'd simply tell you to go pound sand.

Now that I've managed to catch up with the "big picture" data dump from today's APSE Enrollment Report at both the national and state levels, it's time to dig into the meat of the report: Demographic Breakdown!

I'm not going to get into everything here, of course; a lot of this stuff is beyond my pay grade (which is to say, zilch, as I'm not paid to operate this site), while other stats just aren't of any particular interest to me, though obviously they may be useful to others. I'm mostly just running through all 81 pages (27 in the main report, 54 in the state-level supplemental) to see what catches my eye.

This entry will focus purely on the main report; I'll look at the supplemental report (which goes into state-level data) tomorrow.

Within the Marketplaces as a whole (all 50 states +DC):

(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.

I launched the "State by State" chart feature towards the end of the 2015 Open Enrollment period last time around, and it proved to be pretty popular, so I've brought it back this year.

It's important to note that I'm still missing data from some state exchanges; I have bupkis from DC, Kentucky, New York or Vermont. I also only have partial data from others (California includes new enrollees only, while several other states only have data for the first couple of weeks).

With all those caveats out of the way, here's where things stand. Just like last year:

Some Guy, 12/30/15:

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.

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