OE7

Last year, California passed several important bills related to expanding coverage in their ACA exchange, Covered California. Two of the biggest changes were the expansion of subsidies to middle-class enrollees earning 400-600% FPL (as well as enhancing subsidies for existing enrollees), and the reinstatement of the individual mandate penalty (the revenue from which is actually supposed to be used to help finance the expanded subsidies).

Just before Christmas, I noted that there may be a major awareness problem with the first of these:

Again, there's still another five full weeks of Open Enrollment in California (six, if you include the missing data from last week). As I've noted, they'll have to add at least 134,000 total enrollees to beat last year, or nearly 200,000 to beat their all-time high. From the looks of things, they're on track to hit that 615K figure in the 200-400% range, but the 400-600% range is gonna be a much steeper climb...which is ironic since that's the population which is eligible for the most dramatic price cuts.

Last month the Washington Healthplan Finder, which bumped out their 2020 Open Enrollment Period deadline by a couple of weeks to 12/30, announced that they had enrolled 210,000 people in medical Qualified Health Plans (QHPs) as of 12/19.

Today they issued their final report through the extended 12/30 deadline. While they did tack on a few thousand more people, total enrollments still came up about 3.7% short of the previous year:

Washington Healthplanfinder Sees More Than 212,000 Sign Ups During 2020 Open Enrollment Period

OLYMPIA, Wash.

Washington Health Benefit Exchange (Exchange) today announced more than 212,000 customers selected a 2020 health plan through Washington Healthplanfinder, the state’s online health insurance marketplace. The total number was slightly lower, 3.8 percent, than the nearly 221,000 selections last year.

Earlier today, CMS quietly issued the FINAL 2020 Open Enrollment Period HealthCare.Gov "Snapshot Report":

Final Snapshot: Nov 1-Dec 21

Approximately 8.3 million people selected or were automatically re-enrolled in plans using the HealthCare.gov platform during the 2020 open enrollment period.

These snapshots provide point-in-time estimates of weekly plan selections, call center activity and visits to HealthCare.gov or CuidadoDeSalud.gov. The final snapshot reports new plan selections, active plan renewals and automatic enrollments. It does not report the number of consumers who paid premiums to effectuate their enrollment.

As we do each year, CMS also plans to release a detailed 2020 final enrollment report in March, including final plan selection data from State-based Exchanges that do not use the HealthCare.gov platform.

I just received the following 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):

Here are numbers as of yesterday:

  • We have 290,769 members enrolled in January coverage
  • We have 4,444 members enrolled in February or March coverage
  • We have 5,270 plans selected (1st premium not paid yet)
  • That’s a total of 300,483 people
  • We have 41,477 new enrollments.

I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for January vs. February or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).

This Just In via email...

Your Health Idaho enrolls 89,000 Idahoans for 2020 health insurance coverage

  • Idaho exchange sees increase in new customers as overall enrollments decline amid Medicaid expansion

BOISE, Idaho – More than 89,000 Idahoans signed up for 2020 health insurance coverage through the state insurance exchange, Your Health Idaho, during open enrollment which ended Dec. 16, 2019.

Enrollments are down approximately 14,000 from the same time last year. This decline is largely due to Medicaid expansion and was expected by the exchange. Your Health Idaho originally estimated that around 18,000 individuals would move from the exchange to Medicaid under the newly expanded program. 

DISCLAIMER: HealthSherpa has a banner ad placement agreement with ACASignups.net.

As regular readers know, for the past two Open Enrollment Periods, I've had a banner ad agreement with HealthSherpa, a 3rd-party Web Broker which enrolls people in ACA exchange policies. It's important to understand that unlike some other web brokers which sell ACA policies alongside non-ACA compliant plans, I only entered into this agreement with HS because they only offer on-exchange ACA-compliant policies. And no, I'm not being paid extra for this blog post; I don't work that way.

Having said that, there's no denying that their press release today is intriguing and an important look at the public/private status of the ACA:

HealthSherpa enrolls over 1 million Americans during Open Enrollment Period

Just another quick update from AccessHealthCT:

As of today, their press release page states the following:

Stats as of December 20, 2019:

Qualified Health Plans (QHP):

  • Net Total QHP Enrollment: 104,799
  • 2020 OE Acquisition Summary: 22,026

...Medicaid: Completed applications/redeterminations processed through the integrated eligibility system: 44,950

That's as of today (?). They'll have to have added another 6,267 people to beat last year's total of 111,066.

This Just In from Nevada Health Link:

Nevada’s State Based Exchange Announces Enrollment Figures for Plan Year 2020

Carson City, Nev. – The Silver State Health Insurance Exchange (Exchange), Nevada’s state agency that helps individuals get connected to budget‐appropriate health coverage through the online marketplace, Nevada Health Link, enrolled 77,410 Nevadans during Open Enrollment for Plan Year 2020. The Exchange's seventh Open Enrollment Period ended Dec. 15, 2019 and included an extension for consumers who started the enrollment process on or before Sunday, Dec. 15 to complete their application by Friday, Dec. 20.

This Just In from MNsure...

MNsure Reports Strong Enrollment Numbers in Seventh Open Enrollment Period

ST. PAUL, Minn.—117,520 Minnesotans signed up for private health coverage during MNsure’s seventh open enrollment period which ended on December 23, 2019—2,525 more sign-ups than the exchange received by December 23 of the previous year. 

That's a 2.2% enrollment increase year over year (114,995), although CMS's official total was slightly lower than that (113,552 QHP selections). I don't know if the 1,443 discrepancy is due to clerical error cleanup, standalone dental plans being included in the higher number or what, but assuming the 117,520 figure stands, that's actually a 3.5% increase.

MNsure’s operations were notably smooth, and consumers reported improved customer experiences with the new online shopping and enrollment tools MNsure unveiled this year.

A couple of weeks ago, Covered California reported that as of December 7th, over 486,000 residents were taking advantage of their newly-expanded & enhanced state ACA subsidies:

...More than 486,000 individuals have been determined eligible for the new state subsidy, including about 23,000 in the 400 to 600 percent range of the federal poverty level, which could extend to an individual making up to $74,940 and family of four with a household income of up to $154,500. Of those in this income range who have signed up through Covered California, 44 percent have been found eligible for the state financial assistance.

...If I'm following correctly, the total breakout is:

  • 777,000 = either 138 - 200% FPL or not eligible for any subsidies
  • 463,000 = 200 - 400% FPL; receiving both federal & state subsidies
  • 23,000 = 400-600% FPL; receiving state subsidies only

The press release also broke out the household average for the new/expanded subsidies:

Your Health Idaho, the states' ACA exchange, reminds residents who completed their enrollment applications that they still have until midnight tonight to actually select a policy:

Last chance to #GetCovered!
For those Idahoans who submitted an application for 2020 health insurance coverage by December 16, you have one more day to pick a plan! Do not wait! Find your perfect plan today at YourHealthIdaho.org!

— Your Health Idaho (@YourHealthIdaho) December 23, 2019

The lastest 2020 Open Enrollment Period data was released last week by most of the exchanges, including HealthCare.Gov, Covered California, Connect for Health Colorado, Access Health CT, Maryland Health Connection and the Washington HealthPlan Finder. When combined with the existing data from the MA Health Connector, MNsure, New York State of Health and the brand-new Nevada Health Link, we should now have over 95% of the total 2020 Open Enrollment QHP selections locked in.

Update 12/23: I've updated the text and graph to include the final numbers from Minnesota & Nevada.

This is by no means the final version of The Graph for 2020, of course; there's still no data at all from the District of Columbia, Idaho, Rhode Island or Vermont, and the deadline is still days, weeks or even a month away for nine states.

Having said that, with the Week 7 HC.gov Snapshot Report being released earlier this afternoon, this is a good time to pause and take a look at how the 2020 Open Enrollment Period is shaping up. Remember, even HC.gov's total will change slightly when the dust settles...they're still missing the final 3 hours of the extended Open Enrollment Period (I'm guessing perhaps 30,000 more?), plus an unknown number of "callbacks" to people who were unable to get through on 12/15 but left their contact information (perhaps another few thousand?).

This just in via the Washington HealthPlanFinder:

Washington Healthplanfinder Reminds Customers to Make First Premium Payment

  • Payment options available online and by phone or mail through insurance companies.

Washington Health Benefit Exchange (Exchange) is reminding customers who selected a plan during 2020 open enrollment to make the first month’s premium payment to their health insurance company.

“It is critical that customers make their first premium payment associated with their 2020 health insurance coverage,” said Pam MacEwan, chief executive officer at the Exchange. “This simple action will prevent unintended loss of health coverage or delays in accessing care in the new year.”

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