Final 2020 Open Enrollment Projection: HCgov down, SBMs up, total down 0.3% y/y

California and New York have both released updated 2020 Open Enrollment numbers, so I figured I'd update my spreadsheet one more time before the final data is released. This time I've included a smaller secondary table at the bottom which adjusts the Federal and State-based exchange numbers for Nevada.

OFFICIALLY, HealthCare.Gov enrollment is down nearly 128,000 people this year, but that's not fair because Nevada broke off of onto their own full state-based exchange platform this year. When you adjust for that, is only down 119,000 people for the remaining 38 states. Meanwhile, the state-based exchanges are officially down 2,900 at the moment, but again, with Nevada joining them, they're actually down around 8,900.people.

That leaves the missing enrollment data from five states. Rhode Island and Vermont haven't released any data...I'm assuming they'll both be very close to last year (call it at least 33,000 and 24,000 respectively). I'm assuming New York + DC will be good for perhaps 3,000 more enrollees combined in their final days. And California will likely tack on another 30,000 or so in their final 2 days of Open Enrollment.

All told, I expect the final number to increase by around 90,000 people. If so, that would give the following:

  • (adjusted for NV): 8.21 million, down 119,000 people or 1.4%
  • SBMs (adjusted for NV): 3.20 million, up 81,000 people or 2.6%
  • TOTAL enrollment: 11.41 million, down 38,000 people or 0.3%

One other factor to consider this year is that both Idaho and Maine expanded Medicaid, along with carryover for Virginia's expansion from last year (Medicaid expansion enrollment transitions take 2 years to be fully reflected). If you assume that 2/3 of the year over year shortfall in each of these states is due to enrollees earing 100-138% FPL being shifted over to Medicaid, that's around 35,000 people on states and perhaps 10,000 in SBM states. However, none of the official CMS reports have ever "accounted" for other states expanding Medicaid post-2014 like Pennsylvania, Louisiana, Montana etc, so this is just something to keep in the back of your head.