Where Things Stand: 4.45M QHPs, 5.67 ACA-enabled Medicaid

OK, now that I've resolved the 290K discrepancy from the HHS report (short answer: they corrected the report sometime yesterday, but the total hasn't changed), and have confirmed that someone from HHS/CMS is checking on the 40K New York QHP discrepancy, I've finally been able to update both The Spreadsheets (QHP and Medicaid) and The Graph with the latest data. Here's where things stand as of the morning of March 12th:


  • Exchange-based, Paid or Unpaid for Legitimate Reasons Only: 3.91 Million
  • Exchange-based, Including Unpaid Enrollments: 4.45 Million
    (this is the figure used to measure against the CBO 6M/7M projections)
  • Off-Exchange/Direct (Known): 461K
  • SHOP (Sm. Business Exchanges): 69K
  • Grand Total, QHP Enrollments: 4.98 Million


  • Strict Expansion (only legally able to enroll due to ACA): 4.07 Million
  • "Woodworkers" (previously eligible, drawn out of woodwork by ACA): 1.60 Million
  • Grand Total, ACA-Enabled Enrollments: 5.67 Million


  • Still standing at 3.1 Million
  • Many of these may be double-counted since they've since gone on to their own plans (3.1M study was actually done in December 2011), but by the same token, the 3.1M number is also probably quite a bit higher by now, for the same reason; a prior study done just 6 months earlier had sub26ers down at 2.5M, so it's very likely to have increased since Dec. 2011. I'm guessing the two cancel each other out, thus leaving the same 3.1M, but it'd be nice to get a new study that itsn't over 2 years out of date...


  • In order to hit the CBO's lowered 6 million QHP mark, the exchanges will have to add 1.76 million by 3/31, which means averaging about 59,000 per day.
  • In order to hit the CBO's original 7 million QHP mark, the exchanges will ahve to add 2.76 million by 3/31, which means averaging about 92,000 per day.
  • For comparison, the combined exchanges averaged around 3,200/day in October, 9,200/day in November, 64,000/day in December, 33,000/day in January and 34,000/day in February.

Avalere Health, with whom I've alternately butted heads with and agreed with on all things Medicaid-related, has issued their QHP projection: They're calling for around 5.4 million total. In order to hit that number, the March average would be around 38,600/day.

Avalere is basing their projection primarily on the Medicare Part D enrollment pattern back in 2006. They could very well be correct, but I think there's too many variables and differences between that situation and this one (the most obvious one: Medicare enrollments were presumably mainly limited to those over 65, whereas it's the "Young Invincibles" that are the primary target at the moment). However, I'm not going to pooh-pooh their projection either.

I plan on updating my own projection table sometime in the next few days, but really need to resolve the New York issue first; it's too large a state, and 40K is too large a number to just shrug off.