A look at 2013 enrollment in the state exchanges

Fourteen states and the District of Columbia have been operating their own exchanges, with varying degrees of success. At the end of 2013, the best 12 of these account for more than 950,000 enrollments in private insurance plans. In the table, the states are rated by performance, as measured by fulfillment of their enrollment targets.

State Private
Projection %
Connecticut 34,295 103.9%
Rhode Island 9,800 81.7%
New York 175,146 80.3%
Colorado   52,773 57.4%
Vermont  25,100 41.1%
Washington 135,078 39.7%
Minnesota  25,860 38.6%
California 428,000  32.9%
Hawaii 2,034  22.6%
Kentucky  31,672 14.4%
Maryland   18,257 12.2%
Nevada    12,745 11.1%
Total 950,760  

Connecticut has already met its end-of-March goal. Three other states (Rhode Island, New York and Colorado) were ahead of schedule at the end of the year, with half of the open enrollment period remaining.

Three states alone account for almost 740,000 enrollments – and thus well over a third of all private insurance signups in the nation! In sheer numbers, no other exchanges come close to matching  California, New York and Washington.

Final, official 2013 enrollment data from Vermont and California may be even higher than indicated here, and the same is true for Nevada.

In the table, I have omitted three exchanges. The numbers from Massachusetts are quite unclear (Charles deals with this in a separate post). Bizarrely enough, the District of Columbia hasn’t provided any enrollment data since mid-November. As of the end of the year, Oregon had enrolled approx. 18,000 people by processing paper applications – but not yet a single person online. However, we’re still waiting for official numbers. If Oracle ever gets the state exchange up and working, we should see a major increase in the Oregonian signup rate.

As we enter January, a key questions to consider is whether California, New York and Washington can continue their momentum, which really picked up in the second half of December. The state of New York may well meet its enrollment target in the next few weeks; it is only lacking about 40,000 signups.

California has launched new initiatives aimed at its sizeable Latino population. Hispanics account for 29 % of that state’s uninsured, but apparently only about 5 % of enrollments so far. Clearly there is a major potential there.

One caveat in the midst of this: we are still trying to clarify how CMS/HHS set its state enrollment targets. These targets clearly vary widely relative to the state’s population as well as its number of uninsured. It is unclear what factors the analysts at CMS (Centre for Medicare and Medicaid Services) took into account when doing their calculations. Hopefully we’ll have more on that later.