Time: D H M S

Huh. This is kind of odd.

Minnesota's 2018 Open Enrollment Period was a month longer than the official half-length period pushed by HealthCare.Gov, but was still over 2 weeks shorter than it had been in prior years, ending on January 14th, 2018. Even so, they reported a slight increase in year-over-year policy enrollees, ending OE5 with 116,358 QHP selections.

Typically, you'd see the official QHP selection number drop off noticeably by the end of the first quarter...usually by around 13% or so. Roughly 10% of those who select policies don't ever actually pay for their first monthly premium, and another 2-3% generally drop off after only paying for the first couple of months.

I'm not sure how I of all people managed to miss this, but Connect for Health Colorado released their official 2018 Open Enrollment Period report over a week ago:

We released our End of Open Enrollment report this week, our most detailed look at the impact we are having across Colorado. This year, you will see that more of our customers are receiving help through the Advance Premium Tax Credit – 69 percent, compared to 61 percent last year – and the average level of monthly tax credit help climbed to $505 from $369 last year.

Not surprising...the 34% average rate increases (about 6 points of which is due specifically to CSR reimbursement payments being cut off...much lower than most states) meant that a lot more people qualified for tax credits in the first place, and of course the amount of credits went up accordingly...a bit more, actually (37% on average).

Press Release: NY State of Health Releases 2018 Enrollment by Insurer
Mar 14, 2018

Consumer Choice Continues to be a Hallmark of the Marketplace

ALBANY, N.Y. (March 14, 2018) -- NY State of Health, the state’s official health plan Marketplace, today released data showing 2018 health plan enrollment by insurer. Statewide, 12 health insurers offer Qualified Health Plans (QHP) to individuals and 15 health insurers offer coverage to Essential Plan (EP) enrollees through the Marketplace. Ten health insurers participate in all individual market programs offered through NY State of Health allowing consumers a smooth transition if their program eligibility changes. Throughout the 2018 Open Enrollment Period, most consumers had a choice of at least four health insurer options in every county of the State. 

I just did a light analysis of how many people would be helped or hurt by CSR funding in 2019 in Rhode Island, and concluded that at least 28% of exchange enrollees would see their premiums increase if CSR funding was restored, while only perhaps 2-3% would see their premiums drop.

It turns out that over the weekend, my colleague Xpostfactoid did a much deeper analysis of the same situation in Maryland:

So there you have the enrollment results of full-bore on-exchange silver-loading of CSR costs in one state. In all, 49,993 on-exchange enrollees with incomes up to 400% FPL chose plans other than silver. About 48,000 of them were subsidized. That's 31.2% of all enrollees, within striking distance of Aron-Dine's upper bound of 36% for all marketplace enrollees.

HealthSource RI, Rhode Island's ACA exchange, released preliminary 2018 Open Enrollment data awhile ago, but this morning they released their final, official demographic data breakout, and there's a lot going on here:

HealthSource RI sees 5% enrollment increase and nation leading lowest benchmark plan cost
State-based marketplace sees rise in enrollment of “young invincibles”

Over the past few weeks,I've posted partial 2018 Open Enrollment Period demographic data from Connecticut, Idaho, Maryland, New York and Washington State. Still missing are final wrap-up reports from the other 7 state-based exchanges...as well as The Big One: The official report from the Assistant Secretary for Planning and Evaluation (ASPE).

The 2014 ASPE report was released on May 1st, 2014...just 17 days after the first, tumultuous 2014 Open Enrollment Period ended (only 12 days, really, since the report actually ran through April 19th, 2014 even though the "overtime" period technically ended on April 15th).

Not sure when this was posted, but the trendline is interesting...according to the first chart, Colorado ended 2017 down only 16.3% from their total OE4 enrollment number (161,568 QHP selections).

The cumulative enrollment numbers are also important: During the entire off-season (from 2/01/17 - 12/31/17), 41,387 people selected QHPs via Special Enrollment Periods (SEPs), or roughly 124 per day. Of course, technically speaking the last day of SEP enrollment for 2017 should have been 11/15/17 (for coverage starting December 1st), but it looks like a few hundred people slipped in after that.

Colorado's SHOP enrollment, meanwhile, hovered right around the 3,000 person mark all year.

Press Release: NY State of Health Releases County-Level Enrollment Data

Feb 27, 2018

ALBANY, N.Y. (February 27, 2018) -- NY State of Health, the state’s official health plan Marketplace, today released county-level enrollment data as of January 31, 2018, showing that overall enrollment increased in each of New York’s 62 counties. Total enrollment in the Marketplace is now over 4.3 million people, reflecting an increase of 700,000 people (19 percent) from 2017.  Many upstate counties saw significant enrollment gains in the last year.

“Consumers from Chautauqua to Suffolk and every county in between are shopping for health plans through the Marketplace,” said NY State of Health Executive Director, Donna Frescatore. “With affordable premiums and a robust choice of plans, NY State of Health is where New Yorkers go to get covered.”

UPDATE: (sigh) OK, it looks like the final number for the District of Columbia was slightly too low; I've received official notice from the DC exchange that it was actually 22,584, 115 enrollments higher than the NASHP report pegged it at. The Graph and spreadsheet below have both been updated...

OK, here it is...

This morning Covered California issued their final 2018 ACA Open Enrollment numbers. I was a bit disappointed to discover that instead of beating out last year slightly, they ended up coming about 2.3% short year over year...but there's a very good reason for that: Like Maryland, California not only utilized the full "Silver Switcharoo" strategy with individual market premiums, they actively encouraged current UNSUBSIDIZED on-exchange Silver enrollees to switch to off-exchange Silver plans instead.

Note: This is more of a placeholder for the moment; it'll be updated as soon as the numbers are available.

At around 10:30am this morning, Covered California will be announcing their final, official 2018 ACA Open Enrollment Period numbers, along with other various demographic info.

Keep in mind that California is second only to Florida in terms of ACA exchange enrollees, with around 13% of the national total each year, so this is a big deal.

The most recent updates from the largest state-based exchange pegged their numbers at 1,542,000 QHP selections as of January 21st, including:

  • "more than" 1.2 million renewing enrollees, and
  • "more than" 342,000 new enrollees signing up.

Last year Covered CA's 1/31 total hit 1,556,676 (or just under 15,000 enrollees higher). In 2016 they had their all-time high of 1,575,340, so they'd have to have tacked on about 34,000 more over the final 10 days of Open Enrollment this year in order to beat their record.

Maryland was originally one of 3 state-based exchanges which stuck to the "official" half-length, December 15th Open Enrollment Period deadline this time around. However, with just 2 days to go before the original deadline, the MD Health Connection announced that they had decided to bump out their deadline by an extra week after all, through December 22nd.

When the dust settled, 153,571 Marylanders had signed up for 2018 coverage, down about 2.7% from 2017. This made MD one of only three fully state-based exchanges to come in short year over year...and the only one to do so with an extended deadline (both Idaho and Vermont stuck with the 12/15 cut-off). Even so, achieving over 97% of their prior-year numbers is still pretty impressive, all things considered.

Look what I dug up on the Washington Health Benefit Exchange website!

That's right...it's time for another state-level Datapalooza!® The first two slides come from the Feb. 2nd board meeting Open Enrollment Report; the rest come from the "Open Enrollment For 2018 Plan Year Performance Dashboard" report, which is a bit different; it actually runs through January 26th instead of January 14th for whatever reason. so some of the numbers are slightly different.

Idaho is one of only 2 state-based exchanges which stuck with the "official" December 15th deadline for the 2018 Open Enrollment Period (the other was Vermont). Unfortunately, they haven't released an official, detailed demographic breakout report yet, but they did discuss some relevant stats in their December board meeting...which, as it happens, took place on December 15th, which means it's still missing a bit of final data. For now this is the best I can do:

d) Enrollment Update

Mr. Kelly said YHI’s goal in enrollments is to be flat year-over-year, and it is within reach. When we look at average enrollments for 2017 of around 90,000 Idahoan’s, we appear to be ahead of that for 2018. As of this morning, we have almost 96,000 enrollments. This week alone, we have gained over 6,000 enrollments, way ahead of our growth for the same time last year. We also had well over 2,100 calls into the support center yesterday.

At this point, the only significant top-line 2018 Open Enrollment numbers missing are the final 10 days out of California (which could add perhaps 40,000 to the total) and a solid month of enrollment from the District of Columbia (23 days, actually, but they extended their deadline by 5 extra days, which may or may not be included in the final, official report from CMS). DC's tally through 1/08 was 21,352 QHP selections. Their all-time high was around 22,700 set in 2016, so I can't imagine that they added more than perhaps 2,000 more since 1/08. In other words, about 99.5% of the 2018 OEP QHP selections have likely been accounted for.

That means it's time to move on to...breaking down the demographic data! Woo-hoo! Parrrr-tyyyy!!

The big, official CMS report from the Assistant Secretary for Planning and Evaluation (ASPE) presumably won't be released for a couple of weeks, but some of the state-based exchanges are faster about posting their demographics. First up: Connecticut!

This Just In, courtesy of Dan Goldberg of Politico New York...

.@charles_gaba NY releases final numbers --253,102 in QHP with 41% receiving NO financial assistance. (That's amazing!) 738,851 in Essential Plan 374,577 in Child Health Plus

— Dan Goldberg (@DanCGoldberg) February 1, 2018

New York had already broken their 2017 numbers (just barely) a couple weeks ago, so this is effectively icing on the cake: Total QHP selections are up 4.2% year over year vs. the 242,880 they signed up last year.