California makes up about 1/3 of my "missing" enrollees (UPDATED)

Many people have asked me why I kept using 10.4 million QHP selections as the HHS Dept's official 2015 projection instead of the 9.1 million enrollments which most media outlets have been touting.

In the same press conference/press release where the "9.1 million" figure came out, the HHS Dept. elaborated with a range of 9.0 - 9.9 million paid/effectuated enrollees...but also stated, during a follow-up Q&A, that they were expecting 10.3 - 11.2 million QHP selections. In order to narrow this down to a single number to measure against last spring's 8.0 million selections, it's a simple matter of dividing the low and high end of this range:

  • Low-end range: 9.0 million  / 10.3 million = 87%
  • High-end range: 9.9 million / 11.2 million = 88%

What have I been saying all along? That around 88% of QHP selections end up paying at least the first month's premium. It seems that the HHS Dept. agrees with me on this point.

When pressed for a specific number, the HHS Dept. settled on 9.1 million effectuations. 9.1 million = 87.5% of...10.4 million.

OK, so that explains where that number came from. What about my own? Well, 10.4 million just happens to also be exactly 30% higher than 8.0 million. In short, HHS was projecting a 30% bump over last year's total.

So, what about my own target? Well, overall, I took a look at projections & estimates from various sources, including the CBO, individual state exchanges, state government officials and so forth; these ranged anywhere from a low of 9.3 million to a high of 13.0 million.

Then, I took another look at HHS's public target (10.4 million) and tried to decide a) whether they were lowballing and b) whether there were any factors they were missing.

My conclusion was (as of November 14th) that instead of a 30% bump, the real situation would end up being about a 50%, 12.0 million flat.

A few weeks later, based on a much stronger-than-expected start, I bumped my own target up by another 500K, to 12.5 million, which corresponds to around a 56% bump nationally. That's where it stayed until about a week ago. Note that this wasn't an even 56% bump across the board--some states were higher or lower based on their own exchange's official projections. California, for instance, was projecting 1.7 million, which was only a 21% increase over their 2014 total (1.405 million). My own projection was 1.94 million, or a 38% increase.

On January 29th, I started to get a bad feeling about California in particular. I eventually dropped my own target substantially, to just 1.6 million--a whopping 340K reduction; less, even, than their own projected number. I made similar cuts to my projections for Massachusetts (my fault in the first place), Washington State, Colorado and Michigan.

In all, I lopped my personal projections by about 765K nationally. HOWEVER, based on strong overperformance by other states, I also raised my projections substantially in Florida, Virginia, Texas, Georgia, Missouri and North Carolinia.

The wild card, of course, was Saturday's massive IRS verification system outage, which screwed up potentially hundreds of thousands of enrollments, falling on what otherwise would've been the 2nd busiest day of the season.

So, fine: I shifted 600K from 2/15 to the extension period, but kept my final total projection the same: 12.5 million. 600K / 12.5M = about 5% of the total.

5% of 1.7 million--California's own official target--is 85,000. In order to meet that pattern, they would have had to enroll 1.615 million as of Sunday night.

5% of 1.6 million--my own lowered target--is 80K. In order to meet that pattern, they would have had to enroll 1.52 million as of Sunday night.

Instead, they announced 1.42 million as of Sunday night. That's either 100K or 200K of the "missing" enrollments right there.

Now, they did state that they're on track to add at least another 26,000 by the 20th, but that would still only put them at about 1.45 million total...some 150K short of my lowered target, or 250K short of their own.

I've since lowered my final projection by 700,000 people nationally, from 12.5 million down to 11.8 million as of the end of February.

Hopefully California will surprise me by Friday, but if they don't, that's a good 20 - 35% of the "missing" total right there.

UPDATED: OK, it turns out that the actual number of QHP selections was 200K higher than reported on Tuesday night! The 200K people who are being kicked off of their policies next week due to legal residency verification issues were "pre-purged" from the 11.6 million total now instead of after 2/28 as I was expecting.

In other words, instead of a 700K "shortage", it's only a 500K difference between my projection and the actual likely total...of which 1/3 is likely to be California.