RHODE ISLAND: Holy Smokes! RI hits 84% of my #OE3 target in 1st week...but hold on a second...

I'm not sure how this press release slipped by me (it was posted quietly on Nov. 11th), but my eyebrows immediately shot up when I read the first bullet point...only to turn into eyerolls when I read the second one:

PROVIDENCE – HealthSource RI (HSRI) has released certain enrollment, demographic and volume data through Saturday, November 7, 2015, for Open Enrollment.


  • 30,680 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.
  • Nearly all of these individuals are current HSRI enrollees that have been auto-renewed into a 2016 plan.
  • 306 individuals have selected a plan for 2016 coverage and are new to HSRI this year or returning after being enrolled with HSRI at some point during a prior year.

SHOP ENROLLMENT Cumulative as of November 7, 2015

  • Small employer accounts created: 2,140
  • Small employer applications completed: 725
  • Small employer enrollment (paid): 570
  • These employers represent 3,970 covered lives
  • 81% of small employers are enrolled in the Full Choice Model
  • 91% SHOP renewal rate (2015 to date)

Seeing how Rhode Island is such a tiny state, and their 2015 Open Enrollment tally was only 31,337 people, that 30,680 figure looks astonishing--wow, they've managed to hit 98% of their #OE2 number (and 84% of my #OE3 projection of 36,000) in the very first week!!

However, the next bullet kind of deflates that balloon. All that's happened here is that the Rhode Island exchange is "auto-renewing" all current enrollees now instead of waiting until after December 23rd (RI, along with 3 other states, sets their enrollment deadlines 8 days later than most of the country). This is really just a logistical distinction, since every one of those current enrollees can still choose a different policy (or cancel it) between now and 12/23 if they wish. In practice it doesn't really make much difference in what the final QHP selection total ends up being.

This is doubly-interesting because last year, Rhode Island was the only state not to allow for automatic renewals (well, technically MA, MD, OR & NV didn't allow it either, but that's because they had no choice for technical reasons; all 4 states moved to completely different technologica platforms and didn't have the ability to import their 2014 databases). Rhode Island made a policy decision not to allow auto-renewals in order to encourage (force) people to shop around. It worked quite well (over 60% of enrollees switched policies, much higher than the national average), but I guess they had a change of heart this year anyway.

They also included these pie charts, although honestly, considering that 99% of these folks were autorenewed before even having a chance to switch to a new plan, I'm not sure how accurate the breakout will end up being:

Rhode Island "front-loading" their renewals also means I really can't include their numbers when trying to make projections before 12/23, since they're the only state doing so; if I used RI's number to extrapolate from, it would make it look as though something like 9 million people signed up in Week One, which obviously isn't the case.

The only really usable number here is the 306 new QHP selections, which, from the wording above it ("nearly all are autorenewals") appear to be included in that 30,680 total.

In other words, it looks like the actual numbers are:

  • 30,374 people automatically renewed (ie, every current enrollee), of which some percentage will switch to a different plan or drop coverage
  • 306 new additions

Again, if I'm reading this correctly, Rhode Island's number should start off at 30,680...but only add a few hundred more per week. The question is whether they can add another 5,600 by the end of January while not losing more than a handful of the renewals.

Put another way, unlike HealthCare.Gov, where I expect the QHP selection total to increase by around 85% from Week 1 to Week 2 (543K to 1.0 million), I don't expect HealthSource Rhode Island's 2nd week total to be mroe than perhaps 31,000 or so.