State By State: 11 states ahead of expectations, 7 states behind as of 11/26

Last week I decided to once again take a crack at projecting not only the final number of 2017 Open Enrollment Period QHP enrollments nationally, but on a state-by-state basis. I started with a simple assumption of "2016 + 8.7%" (to match the national 13.8 milliion vs. 12.7 million projection made by both myself and the HHS Dept.), and then adjusted each state higher or lower based on various factors.

Now that CMS has broken out the first 4 weeks' worth of QHP selections via the federal exchange, in addition to the partial data I have on hand for some of the state-based exchanges, it's time to see where things stand compared to my personal projections. The only states where I know of an official projection are California and Connecticut, and even these have some wiggle room as they're more ranges than exact numbers.

With that in mind, here's what it looks like at the moment. Click the graph below for a high-resolution version. Things to note:

  • Most states are as of 11/26/16 (officially the 4th week, even though it's "short" 2 days due to November starting on a Tuesday this year)
  • The red vertical line is where I expected each state to be as of 11/26/16...around 19.5% of their final projected enrollment target as of 1/31/17
  • For purposes of this graph, I'm defining "ahead" or "behind" as being plus or minus 2.5¬†percentage points. Minnesota, Hawaii, South Dakota, Florida, Wyoming, Oregon, Utah, Nebraska, Wisconsin, Alabama and Kansas are well ahead of where I expected them to be at this point. Illinois, Georgia, Arkansas, Indiana, Mississippi, Texas and especially Louisiana are all well behind so far.
  • Important Caveats:
    • I'm not counting Connecticut as being "ahead" because they include all current enrollees when they report 2017 enrollments; they start with the assumption that 100% will renew, then subtract from the total as people actively decline renewing coverage for 2017.
    • Minnesota is a special case. They're well "ahead" because they have a unique "first come, first serve" enrollment cap policy this year. Yes, they're way ahead of where I'd expect them to be at this point (34.6% instead of 19.5%), but I'm not sure if that should "count" or not.
    • The most obvious explanation for Louisiana being so far behind is that they're the only state which expanded Medicaid this year. Since current enrollees between 100% - 138% of the federal povertry line are now eligible for Medicaid instead, this is no doubt "cannibalizing" some of the QHP enrollments for the state. The same thing happened last year with Indiana and Pennsylvania. I tried to take this into account when making my Louisiana projection, but it looks like the impact is greater than I expected.
    • I wouldn't make too much of Hawaii, South Dakota or Wyoming. Their populations are so small, even a tiny projection error on my part can be way off, especially since I was rounding to the nearest 1,000.
    • I can't really count Massachusetts¬†as being "behind" yet because I only have data through 11/17. Obviously the same holds true for DC, ID, MD, NY, RI, VT and WA, where I have no OE4 data available whatsoever.
    • In terms of large states: Florida continues to kick ass. I expect FL to become the first state to break the 2 million milestone this year, and so far they're on course to do so. Texas, meanwhile, continues to severely underperform, acting as a big anchor on the country as a whole.