How many 2019 enrollments are at risk due to the TIMING of the #TexasFoldEm announcement?

Immediately after last night's bombshell* announcement of the ruling in the Texas Fold'em lawsuit by right-wing judge Reed O'Connor, one of the numerous parts of the outrage was over the timing of the decision being announced. Just about everyone, myself included, assumed that O'Connor would either...

  • ...issue his ruling "quickly" after oral arguments back in early September, as he claimed he would; or, failing that...
  • ...issue his ruling after the November midterm elections were out of the way as a blatant political maneuver to help the GOP; or...
  • ...issue his ruling after the Open Enrollment Period ended.

This last one would likely have meant sometime next week (likely on Monday, December 17th). Technically he would've had to wait until February 1st to wait until Open Enrollment was completely over, since New York and DC don't wrap up until January 31st, but I can't imagine that he gives too much of a crap about blue parts of the country anyway.

While the ruling itself would have been a lawless exercise in raw judicial power (that's not me saying that...that's conservative Case Western law professor Jonathan Adler, who was actually one of the architects of the previous "world's thinnest argument" lawsuit against the ACA, King vs. Burwell) regardless of the timing of the announcement, at the very least waiting until Monday would have caused a minimal amount of disruption to the 2019 Open Enrollment Period.

In fact, even Trump's own Justice Department--which, keep in mind, WANTED to LOSE the case and in fact went so far as to stand down and refuse to defend it in the first place--specifically asked Judge O'Connor to delay his ruling until after December 15th for this very reason.

And yet...O'Connor said "screw it" and dropped his bomb at around 7:50pm last night...around 30 hours before the enrollment deadline for 44 states (HealthCare.Gov as well as CT, ID, MD, VT & WA). As anyone who's visited this site even a few times before knows, the mid-December deadline has been the busiest enrollment date for the ACA every year since 2014 (the first year was an exception for many reasons).

So just how disruptive are we talking about?

Well, in 2015, over 600,000 people actively enrolled via HealthCare.Gov alone in a single 24-hour period...namely, December 15th. I estimate that another 100,000 or so enrolled through the state-based exchanges on 12/15/15 as well.

In 2016, that record was broken when over 670,000 enrolled via HealthCare.Gov in a single day...again, on December 15th, plus another 100K or so via SBEs.

As for last year, Trump's CMS Dept. never announced the official final-day tally on Dec. 15th, but based on my analysis of the 2018 Open Enrollment Public Use Files, I'm pretty sure that the one-day record was broken again, with around 708,000 people likely having enrolled via the federal exchange that day alone.

As for the state-based exchanges, it gets a bit tricky, but as far as I can tell, the number there also increased to roughly 117,000 people on 12/15. Combined, that means around 825,000 people selected Qualified Health Plans via ACA exchanges on 12/15/17 alone nationally.

(For what it's worth, I'm not surprised that Seema Verma and CMS didn't make a big deal about this...and to be honest, it's not that impressive since 12/15 was the final day for, whereas in previous years it was only the first deadline, with six more weeks left to enroll, so it's not surprising that there'd be a bigger surge. Still noteworthy, though).

On top of that, last year around 193,000 more people enrolled between 12/16/17 - 1/31/18 across the nine state-based exchanges which had extended deadlines: Half in California, half in the other 8 states with late deadlines (at the same time, around 79,000 enrollees were dropped from their enrollments for various reasons, for a net post-12/15 increase of just 114,000 nationally).

In the end, I estimate that roughly 1.018 million people selected QHPs on ACA exchanges after 12/14 last year, or around 8.6% of the total final enrollment number.

Assuming a similar ratio would have taken place this year in the absence of last night's news, that means the Texas Fold'em announcement has likely freaked out roughly 970,000 people who are (or were) planning on signing up either today in every state or over the next several weeks in 7 of the SBE states.

It's important to note that this doesn't necessarily mean that those people won't fact, it's even possible that the reverse will happen, and more people will sign up in a "get in while you can!" panic. It'll be interesting to see where the final numbers for today specifically end up falling, however.

*(the ruling itself wasn't a bombshell to anyone paying attention to this case or the judge in question, but the timing of it was)