HHS Confirms: 500K HC.gov *applications* submitted in first 4 days

This just in...

First 4 days of Open Enrollment → More than half a million apps submitted thru @HealthCareGov for 2017 coverage. #GetCovered

— HHS Media (@HHSMedia) November 7, 2016

It's important to keep in mind that applications submitted are not the same as healthcare policies selected. A submitted application simply means you've created an account and filled out all of your personal data, household data, financial data and so forth; actually shopping around and selecting a plan is the next major step.

Having said that, how does this year compare with last? Well, as I noted the other day, the 150,000 applications submitted on Nov. 1st this year was higher than last year (HHS didn't provide a Day One total but did list it as 250K for the first two days).

However, compared to the first seven days of OE3, it's harder to tell. From Nov. 1 - Nov. 7, 2016, HHS reported 1.15 million applications submitted:

  • OE3: 164,753 per day (first 7 days)
  • OE4: 125,000 per day (first 4 days)

On the surface it looks like applicatoins are running 24% lower than last year. However, thee's a major difference this year: The Presidential election.

It occurred to me, looking over my own relative dearth of blog entries during what would normally be expected to be a pretty busy launch week, that a lot of people nationally are almost certainly holding off on dealing with their 2017 healthcare coverage plans until after Tuesday. Lord knows my wife and I are.

Thinking it over more carefully, with the stakes and tension running so high, I wouldn't be at all surprised if my official projections for Week One (600K via HC.gov and 785K nationally) turn out to be overshooting significantly even if those numbers are made up for the following week or two.

No, I'm not trying to excuse miscalling the Week One number: My official projections are what I'm still sticking with, and if I'm wrong, I'll own my error. But this is the first year that Open Enrollment has coincided with a Presidential election, and that Presidential election is by far the most unusual one I've experienced in my lifetime, so I think I can be cut a little slack on this.

Anyway, it's also possible that another 700K applications are rolling in over the weekend/Monday after all...but really, is anyone thinking about anything other than the election at this point?

UPDATE: Politics aside, Wesley Sanders (via Twitter) also pointed out another reason why the number of applications submitted may not mean that much relative to the eventual number of enrollees: You know those ~2.5 million current enrollees (I originally pegged it at ~2.0 million, but several more withdrawls/plan drops were announced since then) whose current policies are being discontinued? Well, like the last two years, many of them will be automatically migrated over to the nearest-equivalent policy...but unlike the past two years, where this would only happen if the same carrier still offered other plans on the exhcange, this year they'll also be migrated (or "mapped") to the closest equivalent policy from a different carrier if their current carrier drops out of that area entirely:

for 2017, there are new rules. In the Benefit and Payment Parameters for 2017, HHS noted that

“whenever feasible, the Exchange should, and the FFE will attempt to, re-enroll enrollees in silver metal-level QHPs no longer available through the Exchange into the silver metal-level QHP offered by another issuer through the Exchanges of the same product network type with the lowest premium.

If the QHPs that have become unavailable are in metal levels other than silver, then whenever feasible, the Exchange should and the FFE will seek to re-enroll the affected enrollees in the QHP available on the Exchange of the same metal level of the same product network type with the lowest premium.

Exchanges should, and the FFEs will endeavor to, implement such a re-enrollment process for enrollees of QHPs whose issuers are discontinuing their coverage, for as many groups as is feasible given the short timelines and complex operations that could be required in these scenarios.”

Essentially, the exchange will — if possible — assign people to a new plan from a different carrier in the exchange, if the enrollee’s current carrier will no longer be offering plans in the exchange after the end of the year. Note that they use the words “the FFE will attempt to…” and “the FFE will endeavor to…”

They also note that this process will involve working with the states, and some states are pushing back against the idea of the exchange automatically re-enrolling people in plans from a different carrier. Nebraska and Wisconsin have said that the proposal amounts to “the placement of business by unlicensed entities” (ie, the federal government), and have said they will not cooperate with Healthcare.gov’s efforts to automatically re-enroll people in new plans if their carriers are leaving the exchange and they don’t log back in to pick a new plan (UnitedHealthcare is exiting the exchange in both states).

What does this have to do with how many applications are submitted? Simple...last year there were also around 2 million exchange enrollees who were forced to shop around when their existing policy was discontinued...but in most cases those carriers went completely out of business (a dozen Co-Ops, plus Assurant). Under the old "mapping" policy, those folks had to actively submit a new application in order to switch over to a different carrier plan or lose coverage completely. This year, with the new policy, far fewer should have to do so (although everyone should actively shop around, of course).

In other words, "fewer applications submitted" this year could simply indicate more people choosing to let the HHS Dept. do the heavy lifting on their behalf. I don't think anyone should do that, but there's nothing necessarily wrong with it...and it doesn't necessarily mean fewer people ultimately enrolled.