Health Sherpa continues to enroll ~50% of 2023 federal ACA exchange enrollees.

Disclosure: Health Sherpa is a paid sponsor of this site.

Note: This is an update of a post from a couple of weeks ago.

Enhanced Direct Enrollment:

Enhanced direct enrollment (EDE) is a new pathway for consumers to enroll in health insurance coverage through the Federally-facilitated Exchange. This pathway allows CMS to partner with the private sector to provide a more user-friendly and seamless enrollment experience for consumers by allowing them to apply for and enroll in an Exchange plan directly through an approved issuer or web-broker without the need to be redirected to HealthCare.gov or contact the Exchange Call Center.

In short, EDEs are basically a private version of HealthCare.Gov which are authorized by the federal government to hook directly into the HC.gov back end. This means that people who enroll via an EDE website are enrolling in on-exchange ACA coverage (including ACA financial subsidies as appropriate); they're just doing so via a 3rd party web interface. There's actually several dozen different EDEs, several of which have advertised on this site.

There's been some controversy over certain EDEs in the past for various reasons. However, to the best of my knowledge, those concerns don't apply to the EDEs which advertise on this site. I should also note that EDEs are only able to hook into the federal ACA exchange, which operates in 33 states this year; I don't believe they're equipped to interface with the 18 state-based exchanges.

Health Sherpa is by far the largest EDE in the ACA field, and their growth has been nothing short of extraordinary. For the 2019 Open Enrollment Period, around ~840,000 of those who enrolled in the then-38 states on the federal exchange did so via Sherpa itself or other "white label" EDE websites utilizing their platform. That's right around 10% of all HC.gov enrollees, or roughly 7.3% of all 2019 ACA Open Enrollment Period enrollees.

2020 Open Enrollment Period:

With the close of the open enrollment period in the 38 states using the federal health insurance Marketplace, HealthSherpa announced its 2020 open enrollment results.

Between November 1st and December 17th, 2019, HealthSherpa enrolled 1.2 Million people in ACA coverage - a 143% increase over the prior Open Enrollment period. Over 31,000 of these enrollees were able to take advantage of the deadline extension granted by the Centers for Medicare and Medicaid Services. In total, HealthSherpa accounted for over 14% of ACA enrollments across the 38 Federal Marketplace states.

I don't have their 2021 OEP data handy, but check out their growth for the 2022 Open Enrollment Period:

The Open Enrollment period for Plan Year 2022 is over, and HealthSherpa has helped more than 3 million people find coverage through the ACA Marketplaces – our strongest Open Enrollment to date.

...Key Enrollment Metrics, 11/1/2021 – 1/15/2022

HealthSherpa Volume

HealthSherpa policies: 2,265,719

HealthSherpa lives: 3,345,150

Top States: FL, TX, GA, NC, SC

10,255,636 people selected ACA exchange plans via the federal exchange during 2022 OEP, which means that nearly 1/3 of all federal exchange enrollments ran through their EDE network by the time OEP ended.

Even that pales by comparison to their press release a couple of weeks ago, however:

HealthSherpa Volume

  • HealthSherpa policies: 1,819,425
  • HealthSherpa lives: 2,692,749 (up 54.28% from OE22)
  • Top States: FL, TX, GA, NC, SC

...*HealthSherpa data from November 1 through December 4, 2022. Data listed represent federal marketplace states only and are accurate to +/- 5%. Comparisons represent percent change over data from November 1, 2021 through December 4, 2021.

Again, while the raw number is smaller, remember that this only included enrollments through 12/04/22. Total HealthCare.Gov enrollment as of 12/04/22 nationally was 4,862,944, so as of that point, a stunning 55.5% of all federal exchange enrollments for 2023 had run through Health Sherpa or their affiliates.

Today they issued another press release with updated numbers:

In the final push to secure 1/1/23 coverage, HealthSherpa enrollments were up nearly 23% over the previous week bringing the December 15 enrollment total to 4.2 Million people – the highest in the company’s history. While total enrollment reporting won’t be available until next month’s deadline, this milestone indicates another season of significant enrollment growth and clinches HealthSherpa’s position as the premiere ACA enrollment platform.*

HealthSherpa Volume

  • HealthSherpa policies: 2,791,832 (up 22.78% since last week)
  • HealthSherpa lives: 4,187,748 (up 22.78% since last week)
  • Top States: FL, TX, GA, NC, SC

*HealthSherpa data from November 1 through December 15, 2022. Data listed represent federal marketplace states only and are accurate to +/- 5%. Comparisons represent percent change over data from November 1, 2022 through December 11, 2022.

I don't have an apples-to-apples comparison through 12/15/21 for total federal ACA exchange enrollment available, but I can make a pretty good guesstimate:

  • According to the 2022 OEP CMS Public Use Files, a total of 9,728,956 Qualified Health Plans (QHPs) were either selected or auto-renewed as of 12/18/21
  • Of those, 2,193,923 were auto-renewals

This means that total QHP selections (either new enrollees or current enrollees actively renewing their policies) on the federal exchange through 12/15/22 were very close to 7,535,033. A small number of these were people newly selecting policies after the 12/15 deadline for January 1st coverage between 12/16 - 12/18, but I can't imagine that was more than a few tens of thousand at most. So, call it around 7.5 million total.

Assuming similar enrollment this year, that would mean 55.8% of all federal exchange enrollees so far are via HealthSherpa or one of their affiliates/partners...almost identical to my prior post on this. Even if enrollment ends up being ~10% higher (which I expect), that would still represent over 50% of the total.

This will shrink when the 18 state-based exchange enrollments are added to the mix, of course, but it could still end up somewhere north of 1/3 of all QHP selections nationally when the dust settles, which is jaw-dropping. Even if they don't enroll anyone else and total ACA enrollment ends up being 16 million (10% higher than last year), they've already enrolled over 26% of that.

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