Hey, whaddya know? Turns out my original 12.0M projection WAS dead-on target (from a certain point of view)

Yesterday, with the final HC.gov "weekly snapshot" report released, I was able to put together almost all of the puzzle pieces for 2015 open enrollment (there's still a few small pieces left...a month of Idaho data, plus the "overtime" data for California, Massachusetts and the other 12 state-run exchanges). My takeaway was that when the dust settles, the grand total of exchange-based QHP selections will be around 11.74 million people.

On the one hand, that's pretty darned good, and is a good 13% higher than the HHS Dept's official projection. On the other hand, it's still 760,000 fewer than my revised projection (12.5M), and 260,000 fewer than my original projection of 12.0 million even.

Fair enough. However, there was one more missing piece of data released yesterday which I didn't really think about until this morning, mentioned as part of the "renewal vs. new" press release:

Since then, about 200,000 who were automatically re-enrolled subsequently canceled their 2015 coverage and about 90,000 had their coverage terminated due to lack of required documentation of their eligibility. These 290,000 individuals are not included in the top-line 8.84 million number of plan selections.

I already noted the 90K who were "pre-purged" due to lack of proper legal residency verification. However, the additional 200K who were autorenewed but then cancelled their coverage are a different story. When you add both of these back into the picture, here's what it looks like:

  • Renewals from 2014: 6.32 Million (appx.)
  • New 2014 Enrollees: 5.42 Million (appx.)
  • Autorenewed, then cancelled by Enrollee: 200K
  • Autorenewed, then cancelled by HHS: 90K
  • TOTAL: 12,030,000

Put another way, that's 6.61 million total renewals from 2014 out of the 6.7 million who were still enrolled as of October 15, 2014. Presumably the additional 90K dropped their 2014 coverage between October 16th and December 15th.

Put yet another way, this means that my original 12.0 million projection from back on November 14th turned out to be dead-on target...from a certain point of view.

Don't get me wrong; I'm not saying that all of the extra 290K people should be "counted" as enrollees; the 200K presumably never saw a day of coverage in 2015 at all (presumably cancelling as soon as the January invoice showed up). The 90K are a little trickier--they presumably did pay for, and were covered during both January and February, but are being kicked off their plans as of this Saturday due to failure to prove legal U.S. residency. In addition, even with all of this, my revised projection number (12.5 million) was still off by nearly 500,000.

However, it's still good to know exactly what happened to those "missing" few hundred thousand effectuated 2014 enrollees.

In addition, as both Andrew Sprung and Katherine Hempstead noted, this actually shows an extremely impressive retention rate (at least for Healthcare.Gov enrollees...it will vary for the state-based exchanges, which are still missing some data):

National: Compared against...

  • 2014 Enrollees as of 12/15/14: 6.32 million / 6.61 million = 95.6% retained
  • 2014 Enrollees as of 10/15/14: 6.32 million / 6.70 mllion = 94.3% retained
  • 2014 Enrollees as of 04/19/14: 6.32 million / 7.08 million = 89.2% retained
  • 2014 QHP selections as of 4/19/14: 6.32 million / 8.02 million = 78.8% retained

Healthcare.Gov only: Compared against...

  • 2014 Enrollees as of 12/15/14: 4.17M / 4.46M = 93.5% retained
  • 2014 Enrollees as of 04/19/14: 4.17M / 4.80M = 86.8% retained
  • 2014 QHP selections as of 4/19/14: 4.17M / 76.5% retained