2021 OEP Week 3 HC.gov Snapshot Report: 758K QHPs; 2.38 million total

Hot off the presses, via the Centers for Medicare & Medicaid:

Week Three, November 15 - November 21, 2020

In Week Three of the 2021 Open Enrollment period, 758,421 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. 

Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchange and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.

The final number of plan selections associated with enrollment activity during a reporting period may change due to plan modifications or cancellations. In addition, the weekly snapshot only reports new plan selections and active plan renewals and does not report the number of consumers who have paid premiums to effectuate their enrollment.

As a reminder, New Jersey and Pennsylvania transitioned to their own State-based Exchange platforms for 2021, thus they are not on the HealthCare.gov platform for 2021 coverage. Those two states accounted for 578,251 plan selections or 7% of all plan selections during the 2020 Open Enrollment Period. These enrollees’ selections will not appear in our figures until we announce the State-based Exchange plan selections.

It's a bit tricky to compare the first weekly report against the previous year because the snapshot reports run Sunday - Saturday. Last year Nov. 1st fell on a Friday, so "Week 1" was actually only 2 days; "Week 2" included the following 7 days, for 9 days total; and "Week 3" included just 16 days total.

With the third week included, I can compare 21 days in OEP 2021 vs. 23 days in OEP 2020, which is still apples to oranges but a lot closer. So far the 2021 season is running 9.9% higher than last year on a daily basis:

  • First 21 days of OEP 2021: 113,358 QHP selections/day (2,380,527 total)
  • First 23 days of OEP 2020: 103,172 QHP selections/day (2,372,957 total)

Keep in mind, however, that this is if you include Pennsylvania and New Jersey! Those two states enrolled a total of 102,210 people in the first 16 days last year, so it's actually:

  • First 21 days of OEP 2021: 113,358 QHP selections/day (2,380,527 total)
  • First 23 days of OEP 2020 (w/out NJ/PA): 96,837 QHP selections/day (2,227,273 total)

...or 17.1% higher per day than last year, which is fantastic, especially under the circumstances (the pandemic, the looming Supreme Court decision and the ongoing coup attempt by Donald Trump to overthrow the election results).

It's also important to note the breakout between current enrollees actively renewing their policies and new consumers enrolling.

Last year, in the first 23 days, it was a 74% / 26% split between the two. This year, for the first 21 days it's split 78/22. It's too early to say whether that means much, of course; the ratios could easily shift as we go forward.

In addition, with the Week Three report, CMS has also started breaking enrollment out by state for the 36 states hosted via HC.gov. I've included last year's "Week 4" (23 day) numbers for comparison, and have adjusted them to account for the 2 missing days this year to get an idea of how each state is performing year over year so far:

As you can see, on a per-day average basis, 35 out of 36 states are outperforming last year so far. The highest increase is North Dakota, which is up 35% year over year; I'm assuming their worst-in-the-nation COVID-19 crisis has something to do with that (although South Dakota is "only" up 15.5% vs. last year).

The only state underperforming last year so far is Kentucky. I don't have any insight about what's causing that other than perhaps some confusion about the status of the kynect state-based exchange...kynect is fully back in operation next year (assuming the ACA surives at all), but this year Kentucky residents are still enrolling via HealthCare.Gov.