OE4

Minnesota's "first-come-first-serve" enrollment cap system caused a massive surge in early QHP selections...so much so that they kicked things off by signing people up at a pace twelve times faster than last year in the first few days.

That pace has slowed down considerably since then, but they're still well ahead of last year. In the first 17 days of OE3, MNsure was enrolling 404 people per day. In the first 27 days of OE4, MNsure has enrolled 29,783 people...or 1,103 per day:

With more than four weeks of open enrollment in the books, more than 57 percent of Minnesotans enrolling in a private health insurance plan through MNsure are qualifying for financial help available only through the state-based health insurance marketplace. The average tax credit amount going to MNsure customers will be more than three times higher in 2017 than it was in 2016.

Last week I estimated that the Colorado exchange had around 26.4K QHP selections in the first 22 days of OE4 based on some fuzzy extrapolation.

Today, the Connect for Health Colorado Finance & Operations Committee had a meeting with the following slideshow...showing that they're doing even better than that: 29,045 QHP selections in those same 22 days.

However, there's also another important tidbit here (last slide below): While the average unsubsidized premium rates for Colorado exchange enrollees officially went up 16.9%, the final premium cost to the enrollees is actually dropping by 1.9% (from $214/month to $210/month):

In Colorado, the typical consumer who has already used Affordable Care Act subsidies to buy exchange plan coverage for 2017 is on track to spend less on premiums next year.

As I've noted before, Connecticut has an unusual policy for reporting 2017 QHP selections. Instead of reporting the number of renewing enrollees + new additions, they start out by assuming every current enrollee will be renewed for the upcoming year, add the new additions and the subtract those who actively choose not to renew their policy. Technically, this makes it look like Connecticut has already broken 100,000 enrollees for 2017--over 80% of their enrollment target number--even though we're only 4 weeks into the enrollment period. As a result, I can't really give an accurate "enrolled for 2017" number until the third week of December, when every state has officially entered their autorenewed enrollees into the system. 

Having said that, they are reporting the number of new enrollees signing up on a fairly regular basis:

Last year I took a shot at predicting not only total Open Enrollment QHP selections nationally, but also on a state-by-state basis. Seeing how I ended up overestimating by a whopping 2 million people nationally (projection: 14.7 million; actual: 12.7 million...about a 16% difference), it shouldn't be surprising that I was also way off on most of the individual states.

Of the 50 states +DC, I was within +/- 5% in only 13 states. 6 states overperformed my projections by more than 5 points (MA, UT, MD, SD, MN and TN)...but 32 states underperformed by more than 5 points, and 17 states came in more than 15% lower than I was expecting. Ouch.

I was therefore understandably hesitant to put my neck out there again this year...and after the unexpected results of the Presidential election, all bets seemed to be off. However, seeing how the first couple of weeks of OE4 seem to be holding pretty closely to my national projections so far, I've decided to go ahead and post my state-level calls after all.

When I last checked in on Colorado, they were reporting 2017 enrollments at a rate 30% faster than last year (16,305 in 13 days vs. 12,496 in the first 13 days last year).

Today they didn't issue an official update, but did give enough to piece together an estimate via an email to their enrollees:

Dear Connect for Health Colorado Stakeholders, 

As we approach the Thanksgiving holiday, we’re busy as ever enrolling customers. In fact, enrollments are outpacing our numbers by more than 25 percent over this time last year, with our biggest day falling the day after the election. And, this is a trend we’re seeing nationally. 

While the recent election has raised a lot of questions about the future of healthcare, what remains constant and true is the importance of protecting the health and financial future of our customers. Broken bones, disease and other chronic conditions aren’t political, but can happen at any time and in some cases, are preventable with access to care and health insurance. Our dedication to helping customers remains as strong as ever. 

Just another update: I'm fairly certain that QHP selections via HealthCare.Gov (covering 39 states) has broken 1.7 million people, with an additional 500,000 having enrolled via the 12 state-based exchanges for a total of around 2.2 million as of tonight.

The confirmed tally stands at just over 1.4 million thanks to a small update out of Minnesota.

I expect things to slow down significantly over the holiday weekend (Thursday - Sunday) before ramping back up again next week.

UPDATE: As of Wednesday night (11/23/16), I estimate the grand total is now up to around 2.4 million nationally, 1.8 million via HC.gov.

Minnesota continues to enroll people at a breakneck pace (fortunately, broken necks are covered by Obamacare). Things have slowed down somewhat from the first few days, but they're still signing people up at a rate 3.5x faster than they did last year's 404/day due mainly to their unique "enrollment cap" situation:

28,000 Minnesotans Enrolled in Individual Plans Through MNsure Since the Start of Open Enrollment
November 21, 2016

ST. PAUL, Minn.—Below is an update to MNsure's 2017 open enrollment period. Within the first three weeks of open enrollment, more than 28,000 Minnesotans have enrolled in health coverage.

Since the start of open enrollment, there have been:

I'm taking a break from the national panic over Trump's election to announce two subtle but important modifications to The Graph:

  • First: In yesterday's release of CMS's Weekly Snapshot Report from HealthCare.Gov for the first "2 weeks" of open enrollment, they explained that instead of running the weeks from Tuesday - Monday, they're going to measure them by the traditional calendar week (Sunday - Saturday). This means that the first two "weeks" are being cut off by 2 days (Nov. 1st - 12th instead of the 14th).

    Since all of the official reports going forward will be measured Sunday - Saturday, I've changed the graph to match. I've also modified my official Weekly Projections accordingly. It's important to clarify that the actual projections haven't changed at all, just the cut-off date (for instance, I originally projected 1.53 million people in the first 2 weeks (14 days); instead I now have it as 1.29 million in the first "2 weeks" (12 days). The actual projection itself hasn't changed at all.

Yesterday, the Access Health CT board meeting presentation gave the 2017 QHP selection tally as (I think) 9,455 renewals plus 6,630 new additions for a total of 16,085 people, though it's a little confusingly presented.

Today they issued a press release which bumps up the "new enrollee" tally to 7,043 as of 11/17.

They don't really break out the "renewal" number, so I'm not certain what the total is, but assuming the 9,455 figure is accurate, that brings it up to 16,498, or 970/day.

A very quick update out of the Bay State:

  • As of 11/17: 23,026 total QHP selections (13,523 fully paid/enrolled for 1/1/17 coverage)
  • 15,800 renewals/reenrollees (69%), 7,226 new/returning enrollees (31%)

That's 1,355/day on average for the first 17 days; this is up from 1,281/day for the first 8 days.

For comparison, last year they only averaged around 575/day (for the first 7 days anyway), so it's definitely busier (2.3x faster) so far.

Even just looking at new enrollees: The first week averaged 183/day last year; this year it was 368/day the first 8 days and 425/day the first 17 days...again, more than twice last year's rate so far.

Covered California, the largest ACA exchange outside of HealthCare.Gov, just held their board meeting and released some key enrollment data for the first couple of weeks of the 2017 Open Enrollment Period:

EARLY PROGRESS FOR NEW SIGN UPS

44,885

Individuals have selected health care plans as of November 15, 2016. This enrollment reflects a period in which Covered California did not conduct media or enrollment promotion until after November 12th .

Compares to approximately 50,700 for same period 2015 (when Covered California had conducted extensive media and “bus tour” efforts to promote enrollment).

OK, so new enrollments are down about 11% from last year, but as they note, they deliberately held off on actively promoting/advertising until after the election this year.

In a pleasant surprise, 

The Access Health CT board held their monthly meeting this morning, including their first official 2017 Open Enrollment Period enrollment numbers. This slide is a little confusing but I think I've figured it out:

If I'm reading this correctly, it looks like they currently have 85,250 people enrolled in effectuated exchange policies. 9,455 have actively renewed/re-enrolled into either their existing policy or a different one, plus another 5,570 brand-new enrollees who have signed up, for a total of 15,025 QHP selections for 2017.

What's confusing me is that they also say that "100,275 are currently enrolled"...which you only get by adding all 3 of those numbers together, which makes little sense to me.

A few days ago, I noted that MNsure had enrolled nearly 22,000 people in exchange policies in just 9 days, a rate 6x faster than last year.

Today, another update via Christopher Snowbeck of the StarTribune:

With 23,883 people signing up via MNsure for private coverage as of Nov. 13, the exchange is more than one-fourth of the way to its budget target of 83,000 enrollees at the beginning of next year.

That's 1,837 per day, vs. last year's 404 per day; while things are starting to slow down, they're still enrolling people at a rate 4.5x as fast for the moment. Again, this is mainly due to MNsure's unique first-come, first-serve enrollment cap on most of their carriers.

Some other tidbits:

Last week, regarding enrollments via the federal exchange at HealthCare.Gov, I noted:

Burwell's Tweet doesn't give the cumulative total to date, but her "best day yet" clarifier certainly helps. My pre-election model was projecting the following:

  • 11/01: 68K
  • 11/02: 92K (160K total)
  • 11/03: 92K (252K total)
  • 11/04: 92K (344K total)
  • 11/05: 75K (419K total)
  • 11/06: 51K (470K total)
  • 11/07: 92K (562K total)
  • 11/08: 92K (654K total)
  • 11/09: 85K (739K total)

I then went on to note that the actual tally for 11/09 specifically (the day after the election) turned out to be "over 100,000"...later clarified as 105,000 people, which is 24% higher than my own one-day projection.

My projections for the next few days were around 85,000 per day, for a cumulative total of 993,300 QHP selections via HealthCare.Gov as of November 12th.

Today CMS issued their first bi-weekly "snapshot" report. Lo and behold:

Biweekly Enrollment Snapshot  •  WEEKS 1 AND 2, NOV 1 - 12, 2016

But actually, he thought as he re-adjusted the Ministry of Plenty’s figures, it was not even forgery. It was merely the substitution of one piece of nonsense for another. Most of the material that you were dealing with had no connexion with anything in the real world, not even the kind of connexion that is contained in a direct lie. Statistics were just as much a fantasy in their original version as in their rectified version. A great deal of the time you were expected to make them up out of your head.

Pages