Washington State: OFF-Exchange QHPs STILL 10% higher than ON-Exchange

This press release JUST showed up in my in box; I don't have a link to it on WA's website, so I'm reposting it verbatim below (emphasis mine):


Media contact: Public Affairs (360) 725-7055

Individual health insurance market expands more than 30 percent – enrollment now at 327,000

OLYMPIA, Wash. – The individual health insurance market grew  30 percent in one year to more than 327,000 people in Washington state, according to new information reported by health insurers to the Office of the Insurance Commissioner.

The latest enrollment numbers and other insurance market data also indicate that Washington state has succeeded in reducing the number of uninsured by more than 370,000.

Today’s individual market total includes 171,286 people enrolled outside the Washington Health Benefit Exchange, Wahealthplanfinder, and 156,155 people enrolled inside the Exchange as of June 1, 2014.

“The enrollment numbers from the insurers continue to show sustained growth in our individual health insurance market,” said Insurance Commissioner Mike Kreidler. “It’s also clear from this data that we’ve succeeded in evenly capturing all age groups, including the 18 to 34 year olds.”

At the end of 2013, more than 248,000 were enrolled in health plans in Washington state’s individual market. Some 238,000 people received discontinuation notices from their insurers and had to find new coverage by Jan. 1, 2014. The Insurance Commissioner’s Office estimated earlier this year that 113,000 of those who received notices would qualify for subsidies and 30,000 would qualify for the state’s newly expanded Medicaid program, Apple Health.

No information is available on how many of the 327,000 newly enrolled people had coverage before or how many had to find coverage because their old plan was discontinued.

Today’s data also includes a breakdown of enrollment by age for both inside and outside the Exchange, along with which metal level plan people selected and how these choices varied between urban and rural counties.

Key findings include:

  • More people purchased individual plans outside of the Exchange than inside (171,286 vs. 156,155).
  • Enrollment both inside and outside of the Exchange by age groups:
    • 28 percent – over age 55
    • 36 percent – age 35 to 54
    • 23 percent – age 18-34
    • 13 percent – under age 18
  • Silver plans were more popular inside the Exchange and bronze plans were more popular outside the Exchange.

Seventeen health insurers filed more than 230 proposed health plans for the 2015 individual health insurance market. The average proposed rate change was 8.25 percent, marking the lowest average rate request in seven years. These plans, along with their rates and provider networks are still under review.

“People looking to buy their own health insurance or switch plans next year will likely have more choices,” said Kreidler. “This, along with today’s enrollment numbers, are more evidence that health reform is working.”

Aside from the obvious good news about the average rate bump only being 8.25% (lowest in 7 years), the key point from my perspective is that even including the massive late March/early April exhcnage QHP enrollment surge, off-exchange QHPs still outnumber exchange-based ones by 10%.

Why is this important? Because, up until now I've been careful when it came to estimating the total off-exchange QHP numbers. I have 2.2 million confirmed off-exchange QHPs from a handful of states and scattered individual insurance companies, but have long known that the actual total was much higher than that. How much higher? Well, the CBO estimated that it was around 5 million back in March, while the big RAND Corp. survey placed the number up closer to 8 million, again, only through mid-March.

Until now, in the interest of caution, I've hedged my bets by listing 3 different sections on The Graph for the off-exchange number: The 2.2M confirmed, 5M low-end estimate and 8M high-end estimate.

With this latest revelation out of WA State, along with the other data from sources like the Kaiser Family Foundation's estimate of over 15 million people on the individual market nationally as of the end of March--I'm hereby going with the upper range of 8 million and scrapping the 5M low-end range completely.

As a result, the ACA-specific healthcare plan range, which I had going from 17.8M - 28.2M, now ranges between 23.6M - 28.3M.