OE4

As you may recall, there was a day or two last week where I was as despondent over the election results as anyone, and I was deeply concerned that Trump being elected—combined with his promise to join the GOP in wiping out the ACA—would cause people to abandon the currently ongoing 2017 Open Enrollment Period...thus making my pre-election projection utterly meaningless.

Instead, the exact opposite appears to be happening...or, at the very least, the election results don’t seem to be keeping anyone from signing up. Some people may be abandoning their plans to enroll via the exchange out of fear that it’s gonna get yanked away from them a few months into the new year, forcing them to scramble later...but many others seem to be realizing that the law, including the federal tax credits and CSR assistance, is still on the books and will continue to be through Jan. 20th at the very soonest...and, depending on how much squabbling and legal steps the GOP has to go through, could potentially stick around mostly as is for up to 2 more years. In any event, many have concluded that it’d be better to go ahead and sign up now so they’re covered for as long as possible.

I noted last week that contrary to my concern that OE4 might get off to a slow start due to people holding off until after the election, the early enrollment numbers appear to be right on pace with my official projections after all. In fact, the single day's worth of data provided for HealthCare.Gov ("over 100,000"* enrollments on 11/09 specifically) is 17% higher than what I was expecting it to be, although obviously that could vary widely day to day. The numbers from Minnesota are also extremely impressive, running over 6x higher than the same period last year, that's mostly due to their unique enrollment cap situation, so that's not much of an indicator of any other state.

*(Update 11:55am: This Washington Post article gives HC.gov's 11/09 tally as 105K instead of simply "over 100K").

As I noted yesterday, it appears that contrary to my concerns, the devastating election results aren't discouraging anyone from signing up for 2017 coverage after all. If anything they appear to have "inspired" people to scramble and sign up ASAP before the door presumably slams shut.

As a result, until I hear otherwise, I'm going to assume that the enrollment rate is tracking my original, pre-election projections...in which case this is where things should stand as of an hour ago:

I've only actually confirmed about 132,000 QHP selections so far, so obviously I could be off on either or both of the above, but I'm feeling pretty confident that if they didn't hit those numbers last night, they will have done so by this evening.

Just yesterday I noted that Minnesota's ACA exchange is full bore ahead, especially due to their unique first-come, first-serve enrollment cap cut-off for 4 of the 5 individual market carriers. They're still moving at a breakneck pace:

From MNsure today:

ST. PAUL, Minn.—More Minnesotans have shopped early and enrolled in comprehensive health care coverage though MNsure than ever before. In just the first nine days, more than 20,000 Minnesotans enrolled through the state's health care exchange. It took about six weeks to achieve this milestone last year.

The results of this week's elections do not change MNsure's focus on providing high quality customer service to Minnesotans shopping for health care coverage and encouraging Minnesotans to take advantage of the financial assistance available only through MNsure.

So, for about 24 hours or so I was feeling nearly suicidal, and this morning I expressed my own tiny bit of symbolic gloom by swapping out the normal header graphic for this one:

I was planning on leaving it like that for a day or so, then swapping it back again tomorrow...but since then I've received several emails/messages/comments from people along the lines of this one:

We are all devastated about the outcome of this election and that the ACA is on the line. Like so many others I wanted to crawl into a hole yesterday. I myself will lose my insurance as will so many of my family, friends and so many people that I assisted and encouraged in their own enrollment over the years.

This is why we can't/won't give up!

From MNsure:

More than 15,000 Minnesotans have Enrolled in Health Coverage in Six Days

November 7, 2016

ST. PAUL, Minn.— MNsure is providing an update on the 2017 open enrollment period. Within six days, more than 15,000 Minnesotans have enrolled in health coverage. This milestone took about six weeks to achieve during last year's open enrollment period.

Since the start of open enrollment, we have seen:

The most recent hard current exchange QHP enrollment number I have for Massachusetts is 230,412 people as of September 1st. Due to MA's unique "ConnectorCare" program, they've actually seen a gradual increase in exchange enrollment during the off-season instead of net attrition like almost every other state.

Today I was informed that as of November 8th, they had a grand total of 2,942 new QHP selections via the state exchange...of which 510 are fully enrolled (i.e., they've paid their January premiums already). This does not, however, include any renewals / re-enrollments by current enrollees, which could be substantially higher.

UPDATE: OK, I have the total enrollment numbers now: 10,251 (7,309 renewals + 2,942 new additions). That's 1,281 per day, or about 4.8% of their total enrollment last season.

Minnesota and Massachusetts are the only state exchanges I have data for so far, and MN is a special case, so here's a simple extrapolation of MA's numbers:

This just in...

First 4 days of Open Enrollment → More than half a million apps submitted thru @HealthCareGov for 2017 coverage. #GetCovered

— HHS Media (@HHSMedia) November 7, 2016

It's important to keep in mind that applications submitted are not the same as healthcare policies selected. A submitted application simply means you've created an account and filled out all of your personal data, household data, financial data and so forth; actually shopping around and selecting a plan is the next major step.

Having said that, how does this year compare with last? Well, as I noted the other day, the 150,000 applications submitted on Nov. 1st this year was higher than last year (HHS didn't provide a Day One total but did list it as 250K for the first two days).

Minnesota's ACA exchange, MNsure, continues to absolutely obliterate last year's open enrollment numbers during the first week:

The numbers as of Friday morning:

  • 13,040 people completed enrollment for health coverage
  • 187,683 visits to the MNsure website
  • 43,298 sessions or visits on the comparison shopping tool
  • 4,027 page views on the Assisters page
  • 12,121 accounts created
  • 13,701 applications completed

Assuming "Friday morning" means around 8am, that's 13,040 people actually enrolling in a healthcare policy in 3.3 days, or about 4,000 per day on average.

As I noted Thursday:

As i noted back in August:

I don't write about Idaho much, which is a bit surprising when you think about it because it's kind of a unique state when it comes to the ACA exchanges. Most states never set up their own exchange platform. A dozen or so set them up and are still using them. Two states (Massachusetts and Maryland) scrapped their original, failed platforms and completely overhauled them. Three states started out with their own platform but gave up when they failed, moving home to the mothership (HealthCare.Gov). One state, New Mexico, was supposed to move off of HC.gov after the first couple of years, but changed their mind and is still hosted by the federal platform. Oh, and there's also Kentucky, which is scheduled to scrap their perfectly-functioning tech platform for absolutely no good reason other than the petty whim of their new Governor, Matt Bevin.

And then there's Idaho.

Last year, MNsure, Minnesota's technically (and actuarially) troubled ACA exchange enrolled "several hundred" people in Qualified Health Plans (QHPs) in the first day, and exactly 6,864 people in the first 17 days...which breaks out to an average of 404 per day for the first couple of weeks.

This year, just as I estimated last night, MNsure has already enrolled over 10,000 people...in just the first 2 days of operation:

With improvements at the call center and on the website, MNsure has enrolled a record number of Minnesotans in coverage, O’Toole said.

“We’ve helped more Minnesotans than we have in any two day period in our history,” she said. “We’ve now enrolled more than 10,000 Minnesotans. That’s a benchmark that we didn’t hit until after Thanksgiving last year.”

Last week, ahead of the launch of the 2017 Open Enrollment Period, I took a look at what's new over at HealthCare.Gov this year. For the most part I was pretty impressed; they've made it more mobile-friendly, added refinements and changed the plan filtering interface so that it's consistent across both desktop, laptop and mobile devices.

The actual enrollment process itself also appears to be running smooth as silk; here's a comment from just this morning:

However, there are still a few user interface glitches which need to be addressed, at least on the "Window Shopping" tool. Here's two of them (three, really, although two are the same problem for different functions):

Problem #1. The "Household Member" Glitch:

Modern Healthcare has an OE4 Launch roundup of sorts; most of the data is stuff I've already written about, and there isn't much in the way of hard enrollment data, but in general it sounds like things are off to a pretty promising start. First they note the 150,000 submitted applications on Tuesday which I wrote about earlier today; after that:

Open enrollment so far “has been going really well,” said Ambar Calvillo, national director of field and partner engagement at Enroll America, a D.C.-based not-for-profit group that helps people sign up for coverage. Calvillo said the group, which works with enrollment assistors across the nation, hasn't seen any major obstacles. Before open enrollment, exchange shoppers scheduled more than 5,400 appointments for in-person enrollment assistance through Enroll America's Get Covered Connector tool, up 80% over last year. 

...State-run exchanges in California, Colorado, Idaho and Massachusetts reported no problems on the first day of enrollment.

Hmmm...OK, yesterday the HHS Dept. reported 60,000 applications submitted in the first 6 hours of Open Enrollment, a 50% increase over last year. Today, they report:

Day 1 of Open Enrollment → 150K apps submitted thru @HealthCareGov. More than day 1 last year. Today, tens of thousands are submitting apps.

— HHS Media (@HHSMedia) November 2, 2016

Again, here's how it compares with the previous two years:

Remember three years ago when HealthCare.Gov launched with all sorts of horrible technical problems, and many people were speculating that at least some of the tech issues may have been the result of deliberate, malicious attacks (hacking, DDoS attacks, etc) by those opposed to either President Obama, the ACA or both?

Well, that turned out to be mostly hooey; while I'm sure there were some attempts at messing with the system, the technical problems were for the most part good old fashioned unintentional screw-ups by either the vendors, the HHS management or a combination of both. The Obama administration quickly brought in the Code Red crash team to fix the problems, and for the most part the federal exchange started working pretty well. Further improvements the past few years have completely transformed it into a pretty quick, easy, seamless experience for most people, to the point that it's now literally operating 100,000 times better than when the website first launched.

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