8 Million? Hah! Exchange QHPs could hit 8.1M or even higher in May...

OK, now that we're past the April 15 cut-off period, I can close the books for 2014 enrollments, right?

Well, no. As I've noted many times before, Medicaid enrollments and SHOP (Small Business) enrollments are year-round; there's no deadline for those.

OK...but what about Exchange QHPs? Surely those are shut down for the year, right?

Well, no. Again, as I've noted before, the appx. 5 million Native Americans in the U.S. don't have a deadline, and of course anyone can still enroll or change plans if they have a Qualifying Life Event such as having a baby, getting married/divorced, losing their job, moving to a different state and so on.

OK...but what about everyone else? April 15th was the deadline, right?

Well, no. Here's a roundup of the state-by-state deadlines (which have been changing every day, but seem to have finally settled down for real):

  • The 36 states on the Federal exchange: You still have until 4/30 if you submitted a paper application by 4/07.
  • Maryland: Complete your enrollment by today (4/18) or possibly tomorrow (4/19) as long as you started it by 3/31.
  • Minnesota: Complete your enrollment by 4/22 as long as you started it by 3/31.
  • Oregon: Full extension (no "started by 3/31" requirement) through 4/30.
  • District of Columbia: Complete your enrollment through 4/30 as long as you started it by 3/31.
  • Hawaii: Complete your enrollment through 4/30 as long as you started it by 3/31.
  • Nevada: Complete your enrollment through 5/30 as long as you started it by 3/31.
  • Colorado: Complete your enrollment through 5/31 if you applied for Medicaid by but were denied.
  • Massachusetts: POSSIBLE extension through as late as 6/30, but only for the 200K+ people who are caught in MA's weird "limbo" status (too complicated a story for me to even try to explain)

How much will all of these oddball state extensions add up to? Well, setting aside Massachusetts (very special situation), I'm guessing the rest will add up to perhaps 50K.

When you add this to the fact that it's very unlikely that the 4/15 exchange QHP total came in at exactly 8,000,000 on the nose (I'm assuming at least a 30,000 cushion), it's entirely possible that the grand total will end up as breaking 8.1 million by late May.

That leaves the two wildcards:

  • Massachusetts: If the MA exchange and legislature is finally able to resolve the status of those 200K people (I think it was around 270K at the last update), it's conceivable that the QHP total could jump up by over 200K in one shot, potentially bringing the grand total up to 8.3M or higher. On the other hand, they may all be shoved over into some special version of Medicaid (perhaps like Arkansas' "Private Option" program?), in which case the official QHP total wouldn't change at all.
  • Qualifying Life Events: These include big life changes like getting married, losing your job, having a baby, adopting a child, becoming a U.S. citizen, getting out of prison, moving to a different state and so on. I have no idea how many people will fall into these categories, but my guess would be that it will probably end up being cancelled out by the people who are in QHP plans who cancel them due to similar life changes (ie, changing jobs, joining the military, dying or having a dependent die, going into prison, moving to a different country and so on).