UPDATE: Have total effectuations might have dropped below 9 million?

OK, this is a bit of a downer on an otherwise extremely positive day, but given my recent obsession with trying to track down the number of people still currently enrolled in effectuated policies for 2015, it seems worth making note of.

Remember, the official exchange effectuation figure as of 6/30/15 was 9.95 million people.

Back in early November, I cobbled together the effectuated enrollment data from 8 different state-based exchanges, and concluded that the numbers stayed relatively from the end of June through the end of September. With Massachusetts included, the numbers were actually higher, and even without MA included (special case) it was only down a nominal amount. With only 8 states representing a small percentage of the national population, however, there was no way of knowing how representative this was.

However, the data from 8 major insurance carriers told a very different story. From June through September, their collective exchange-based enrollments were down about 8% overall. If representative nationally, that would've meant the total number was down to around 9.15 million by 9/30, and presumably down even further as of December. I concluded that the actual figure was likely somewhere in between the two...perhaps 9.4 million or so.

Today comes more evidence that there has indeed been further attrition since September, out of Washington State.

In June, the Washington exchange reported 164,280 effectuated enrollees. By the end of September this was down to 152,517, a drop of about 7%.

Today, it appears that WA's effectuated exchange number has slipped further:

  • Total Plans Selected 123,209
  • New Customers Selecting Coverage 10,952
  • Renewing Customers Selecting Coverage 112,257

Email outreach to:

  • 5,600 new customers who haven’t selected a plan yet
  • 31,840 renewal customers who haven’t selected a plan yet
  • Reminder calls to more than 30,000 renewal customers

So, they've had 112,257 current enrollees renew their policies so far, plus another 31,840 current enrollees who haven't done so yet. Add those up and they're at 144,097 currently effectuated enrollees as of mid-December. That's a 5.5% drop since September, or a 12.3% drop since the end of June.

Again, I have no clue how representative Washington is of other states. Data from the other state exchanges are all over the place, some dropping slightly while others have actually increased since June. However, assuming WA is indeed representative, a 12.3% drop nationally would bring the current total down from 9.95 million to around 8.7 million today.

If so, this would be lower than my original projection of 9.7 million, and would even be lower than the HHS Dept's official projection of 9.1 million as of December.

8.7 million as of December would also be roughly in line with the carrier data, which showed the number dropping from 9.95 million in June to 9.15 million in September.

On the other hand, the public comments by CMS officials at their most recent press conference suggested that current effectuations are higher than expected:

...the number of current enrollees who had actively re-enrolled as of 12/05 was around 1.82 million. Normally this wouldn't be that significant, but during the conference call, CMS also dropped one other crucially important data point: "this year, over 25% of current enrollees have actively renewed."

At the time, they were just trying to point out that current enrollees are more engaged/likely to actively renew than last year, when it was only "in the teens" percentage-wise at this point. However, this "1/4 have renewed already" tidbit tells me something else that's pretty important.

  • If 1.82 million current enrollees have renewed already, and...
  • If 25% of current enrollees have renewed already...

That means that there's roughly 7.2 million people still currently enrolled in 2015 policies via HC.gov states.

Since HC.gov makes up roughly 76% of all ACA exchange enrollees, that in turn suggests that nationally, there should be roughly 9.4 million people still enrolled in effectuated policies...which, as it happens, is right in between my projection of 9.7 million and HHS's official projection (which they've stuck with since over a year ago) of 9.1 million.

In other words, there's a lot of uncertainty here, so I'm not drawing any conclusions. Also, even if the number of current enrollees is only 8.7 million, the percentage of those who renew their policies could still end up being higher than the 8.1 million HHS was expecting.

Stay tuned...

UPDATE: OK, two more updates have muddied up the water even further:

  • Second, today's CMS conference call reiterated what I noted above: They stated that there have been 3.6 million active renewals via HC.gov, and that those 3.6 million represent "more than half" of all current enrollees. Assuming "more than half" = 52%, that would be roughly 7.0 million currently effectuated enrollees via the federal exchange...which, again, in turn suggests around 9.3 million nationally, give or take.