UPDATE: Idaho: 94.5K QHPs total, 5.6% drop year over year

Breaking News from Your Health Idaho:

Despite Changes, Idahoans Flock to Health Insurance Exchange
2018 Enrollment Nears Record

BOISE, Idaho – Your Health Idaho announced today that nearly 102,000 Idahoans signed up for 2018 health insurance coverage on the exchange.

“This is a testament to Idaho’s model for operating an exchange. Despite the enormous uncertainty from Washington, combined with a shortened enrollment period, Your Health Idaho has been able to serve near record numbers of Idahoans,” said Pat Kelly, executive director of Your Health Idaho.

The enrollment numbers include new and returning customers. A significant difference for 2018 is the monthly premium pricing. Increased tax credits offset rising premiums to the extent that some Idahoans purchased plans for little to no monthly cost. Enrollments in these less expensive bronze plans increased by fifteen percentage points over the previous year. In total, 101,793 Idahoans enrolled in 2018 health coverage in just half the time of last year.

The exchange, its partners at the Departments of Insurance and Health and Welfare, and a statewide network of insurance agents have joined forces to prepare for additional federal policy changes. “We know there will be more adjustments to make in our future, and we will continue to provide Idahoans with choice and control over their health insurance coverage in the years to come,” Kelly said.

The repeal of the individual mandate doesn’t occur until 2019 and is not expected to have a significant impact in Idaho. Your Health Idaho estimates five to seven percent of customers may consider dropping coverage if there is no requirement. “Fortunately, most of our customers have found there is value to being insured,” said Kelly.

There's a lot of useful info packed into this short press release:

  • First, the main takeaway: 101,793 ACA exchange QHP selections for 2018. *The PR says it's near their record, but by my count, this is an all-time record for Idaho:

Not sure what that discrepancy's about, but regardless, they squeaked over the official ASPE report tally for both 2016 & 2017. Mazel Tov!

  • They made sure to remind people that the individual mandate isn't repealed until 2019 and is in place for 2018.
  • They include their own analysis of the impact of the mandate, which they mostly shrug off: A 5-7% projected decrease.

Here's the thing: They're probably correct that the impact on Idaho's exchange-based enrollment will indeed be fairly nominal...but that's because the vast majority of YHI enrollees are subsidized. In 2017 it was 82%; for 2018 I'm guessing it's closer to 90%, which would leave around 10% paying full price. In that context, 5-7% dropping coverage makes total sense. Idaho's off-exchange individual market, however, was around 41,000 people earlier this year according to Mark Farrah Associates. The question is what happens to those folks post-mandate repeal.

Extrapolated nationally, a 6% drop out of 12 million exchange enrollees would be around 720,000 people dropping exchange-based coverage. It's the impact on the off-exchange market--which is 100% unsubsidized--where the vast bulk of the impact will be felt. The off-exchange market was around 6-7 million people last year. I suspect it's dropping to around 4-5 million in 2018 due to the CSR cut-off earlier this year...and will probably drop to perhaps 1-2 million in 2019 due to mandate repeal.

In any event, add Idaho to the list of states which have officially outperformed prior years in spite of everything that's happened this year.

UPDATE: OK, mystery solved. Turns out the 101,793 figure includes standalone dental enrollments. When you subtract those out, actual QHPs come in at 94,507...about 5.6% shy of last year's total. Still pretty good all things considered, but no, it didn't break any records.

This also means that a 5-7% drop would bring Idaho in at perhaps 88,800 QHPs in 2019...or down over 11% from 2017.