California: Up to 500,000 more Exchange QHPs by 4/15! (UPDATED x2)

Hat Tip To: 

A lot of people have asked me if I plan on doing a 4/15 QHP projection. Honestly, I'm a little burnt out at the moment and need some chill time on the prognosticating thing. However, if this news is any guide, it could be huge:

Now topping more than 3 million, the number of Californians who have enrolled in a private health care plan or in Medi-Cal through the state's health insurance exchange will likely rise by about 500,000 people who started but did not finish their applications by Monday's midnight deadline, exchange officials said Thursday.

At a news conference, Peter Lee, executive director of the Covered California exchange, told reporters that of the half-million individuals who had started their applications in the last week of March, at least 20,000 had finished their applications by Tuesday.

Now, I'm assuming that "finished their applications" in this case actually means "enrolled", because 500K / 15 days = 33,333 per day if they plan on squeezing that many in under the new 4/15 wire.

In any event, during the regular enrollment period, after making up around 20% of the total for the first 5 months, California ended up making up about 17% of the overall exchange QHP total (1.2M / 7.1M). This means that they dropped to only 12% of the March total. If they end up with 20% of the extension period total, it suggests up to 2.5M nationally, which would be monstrous.

However, part of the reason CA dropped from 20% down to 12% in the last month is because they did an unusual "triage" operation on the last day; they deliberately discouraged actually enrolling people in favor of getting as many people as possible started on the process before midnight.

This makes sense (I assume you can get, say, 5 applications started in the time it takes to get 1 of them fully enrolled), and explains both the lower enrollment rate at the very end as well as the huge number of extension-ready applictions.

However, if they were the only state which did this (which is what it sounds like), it suggests that instead of 20% of the total, that 500K is more likely perhaps 1/3 of the national total.

In addition, remember that there are several states which are not offering an extension period at all: Washington, Hawaii, Connecticut and possibly Rhode Island (their press release was a bit confusing). Both WA and CT were fairly significant players during the OE period, so removing them from the mix will hurt the overtime tally a bit.

On the flip side, there are two states which are offering longer extensions: Oregon has "full" enrollment out until 4/30, while Nevada has the "started by 3/31" rule...but the extension itself last all the way out until May 30. Ironically, this may reduce the number that both of these states may otherwise have enrolled between 4/1 - 4/15, since people may procrastinate even longer.

So...I really don't know. My best guess at this point is that we may be looking at somewhere between 1.0 - 1.5 million additional exchange QHP enrollments during the 4/1 - 4/15 period.

UPDATE: OK, late-night bonehead move on my part; I forgot that those 500K in CA also include some people bound for Medicaid (Medi-Cal). So, let's say between 800K - 1.2M, perhaps?

UPDATE x2: Arrrgh...OK, Ruth37 notes that Peter Lee of CoveredCA says that the 500K are actually about 50/50 QHP/Medicaid. So, if 250K = 1/3 of the total, that's 750K nationally; if it's 1/4 of the total, that's about 1M nationally. Plus, not every single one of those folks will actually enroll. So...downshifting again to perhaps 700K - 1M or so.