VINDICATION! Washington State: 11.5K QHPs since 3/31; net attrition only 6.4% in 4 months!

Wow! The WA Health Benefit Exchange, which hasn't issued an actual enrollment update since the end of the Open Enrollment period, just came through in a big way:

OLYMPIA, Wash. – Washington Healthplanfinder today announced 11,497 Washingtonians have taken advantage of special enrollment periods since March 31 that allow them to enroll through if they have a qualifying life event outside of the standard open enrollment period. The next open enrollment period starts on Nov. 15, 2014 for coverage beginning in 2015.

Data also shows that nearly 700,000 residents are now enrolled in new free or low-cost health coverage options, with more than 147,000 customers currently enrolled in Qualified Health Plans. Including customers who are renewing their existing Medicaid coverage, more than 1.28 million residents have enrolled in health coverage through

“We are experiencing the normal fluctuations of any health insurance risk market,” said Richard Onizuka, CEO for the Washington Health Benefit Exchange. “As people’s incomes change, we will see current customers transitioning on a monthly basis due to changes in their eligibility.”

Updated enrollments and dis-enrollment totals are included below:

Currently Enrolled

  • Qualified Health Plans: 147,888
  • Medicaid Newly Eligible Adults: 352,386
  • Medicaid Previously Eligible but not Enrolled: 199,631
  • Medicaid Redeterminations: 583,765
  • Total: 1,283,670

QHP – No Longer Enrolled

  • Disenrolled due to Nonpayment: 8,310
  • Voluntarily Ended Coverage: 7,735
  • No Longer Eligible for Qualified Health Plan: 8,027
  • Total: 24,072

*Note: These numbers reflect QHP enrollments and Medicaid enrollments through July 31.

Additionally, the Exchange has analyzed preliminary data related to customer “churn,” which means the enrollee has transitioned between Washington Apple Health (Medicaid) or a Qualified Health Plan due to a change in their eligibility and income. Results show a fairly even transition between both categories.

For example, since January, more than 8,000 customers transitioned from a Qualified Health Plan with tax credits to a plan on Washington Apple Health. Other customers were dis-enrolled from a Qualified Health Plan due to nonpayment or voluntarily chose to dis-enroll.

There's a LOT of fantastic data to use here; for my purposes, this press release is something of a jackpot:

  • Off-Season QHP Enrollments: 11,497 from 4/01 - 7/31, or 94 per day
  • Total QHP Enrollments: 146,497 as of 3/31 + 11,497 = 157,994 as of 7/31
  • Paid Enrollments: 149,684 as of 7/31 (94.7% payment rate...this is actually low for WA, since that exchange is supposed to be set up to require payment of the first month's premium as part of the enrollment process...but it's still very impressive)
  • Attrition Rate: The exchange currently had 147,888 paying QHP enrollees out of 157,994 total as of 7/31, or 93.6%...meaning a net attrition rate of just 6.4% over 4 months, or just 1.6% per month! This is actually much lower than the 2.5%/month that I've been estimating on my attrition projection chart (other states have ranged from as low as 0.33% to as high as 6.3% so far).
  • REASONS for the attrition:
    • 8,027 (51%) moved to Medicaid...higher than I would have figured
    • 7,735 (49%) dropped their coverage for other reasons:
      • 31.6% of Washington State's QHP enrollees were 55-64 years old at the time. Assuming an even spread per year, that suggests that around 3.2% (around 4,800) were 64 at the time of enrollment. Over the next 4 months, perhaps 1/3 of these folks (around 1,600, or 10% of the total attrition number) turned 65 and have presumably moved to Medicare.
      • That leaves around 6,135 who dropped their policy for other reasons...which presumably include things like marrying someone with coverage, getting a job with benefits, moving out of state and so forth.
  • Medicaid "Strict Expansion": Over 84,000 added since 3/31 (appx. 64% of total ACA expansion)
  • Medicaid "Woodworkers": Over 64,000 added since 3/31 (appx. 36% of total ACA expansion)

One other thing about those 8,000 who moved to Medicaid...while that's a much higher percentage than I would have figured, they also include a handy chart which notes that almost as many--almost 6,700--did the opposite, moving from Medicaid to enroll in QHPs!

I honestly have no idea why they chose to wait this long for a full update, but I'm very, very glad they did!

Who knows, perhaps CoveredCA and/or NY State of Health will be inspired to follow suit? (Or...dare I say it...the HHS Dept???)