ENDGAME: Are 7 Million QHP Enrollments by 3/31 Still Possible? Yes, but...

With the October website disaster at HC.gov and serious problems still plaguing some of the state exchanges, is it still even remotely conceivable that private QHP enrollment could reach the CBO's original 7 Million projection? Well, the CBO doesn't think this is likely; they issued a revised projection last month which dropped that projection down to 6 million.

IMPORTANT: I should stress that this ONLY refers to exchange-based, individual/group policy enrollments. It doesn't include SHOP small business enrollments (about 58,000 to date) or direct/off-exchange enrollments (almost half a million confirmed, likely several million more as well). It also doesn't include Medicaid/CHIP enrollments either, though you probably figured that already.

However, let's look at the possible scenarios, about 6 weeks away from the enrollment deadline.

Here's what my February enrollment projection currently looks like, based on the 15 states which have provided (partial) enrollment data since Feb. 1st. My confidence in this model was greatly bolstered yesterday by President Obama's mention of the tally being "nearly 4 million" (the model has the actual number at right around 3.86 million at the moment, which certainly counts as "nearly 4 million" in my book):

Depending on the actual final February tally, here's the potential final Exchange-based Private QHP Enrollment projections as of the end of the open enrollment period on March 31st:

I've listed 9 possible scenarios, ranging from March's daily enrollment average equalling that of February up through the possibility that March triples the rate.

As you can see, it's looking like a pretty straightforward projection. If March roughly equals February's rate, enrollments will break 5 million. If March doubles the February rate, they'll hit 6 million (the CBO's revised projection); and if March is truly a blowout month and it triple's February's rate, there's even the outside chance that ACA enrollments will still manage to hit the original 7 million figure that the CBO originally projected.

How likely is this? Well, look at the prior months:

Month Enrollments Days Daily Avg. M/M
October 106,185 33 3,218 n/a
November 259,497 28 9,268 2.88x
December 1,788,739 28 63,884 6.89x
January 1,146,071 35 32,745 0.51x
February (proj.) 875,000 28 31,250 0.95x
March ??? 30 ??? ???

Will March be similar to January and February, bringing in about 1 million more enrollments? That would be the 5 Million Total scenario.

Or will it be (as the administration is hoping for, and as anyone who's been following this seriously has been expecting) more like December, with a huge spike in enrollment as the Big Deadline approaches? If that happens, they're looking at about 2 million enrollments, or 6 Million Total. This is why the CBO revised their projections down from 7 to 6 last month.

The only way that they'd hit the original 7M figure would be if March is truly a blowout finish, not just matching December's frenzied scramble but surpassing even that by 50%. Could it happen? Certainly. Is this likely? Probably not...but who the hell knows?