As I note every week, between Rhode Island's tiny population, tinier ACA exchange numbers and especially their decision to "front-load" autorenewals of all current enrollees ahead of the 12/23 deadline for January coverage, their official QHP selection tally is only going up a few hundred per week. Week Three is no diffferent:

PROVIDENCE – HealthSource RI (HSRI) has released certain enrollment, demographic and volume data through Saturday, November 21, 2015, for Open Enrollment.

INDIVIDUAL AND FAMILY ENROLLMENT As of November 21, 2015:

31,012 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.

Nearly all of these individuals are current HSRI enrollees that have been autorenewed into a 2016 plan. 920 individuals have selected a plan for 2016 coverage, and are new to HSRI this year or returning after being enrolled with HSRI at some point during a prior year.

Me on Monday:

Last year, during the third week of Open Enrollment, 618,548 people selected QHPs via the federal exchange (HealthCare.Gov). This year, I'm pretty sure that right around 500,000 people selected QHPs during the third week.

CMS, just moments ago:

Health Insurance Marketplace Open Enrollment Snapshot Week 3: November 15 – November 21, 2015

During the third week of Open Enrollment, consumers continued to explore their health insurance options by reaching out to a call center representative at 1-800-318-2596, attending enrollment events in their local communities, or visitingHealthCare.gov or CuidadoDeSalud.gov. There are about three weeks remaining ahead of the December 15 deadline.

My latest exclusive piece for healthinsurance.org is mainly a quick reminder that the tax penalty for not having ACA-compliant heatlhcare coverage in 2016 is up to 7x as high as it was for 2014, depending on your income and situation.

The Carrot refers to the federal tax credits available to more than 8 out of 10 of those who enroll; the Stick is the increasing Shared Responsibility Tax Penalty, aka the Individual Mandate tax.

I've been quick to crow about improving national support for the ACA in the past, so it would be disingenous of me to ignore it when there's a negative development:

Views on Obamacare have taken a negative shift, according to a November Kaiser Family Foundation poll released Tuesday.

Forty-five percent of Americans now say they have a negative view of the Affordable Care Act, while 38 percent have a positive view. This represents a reversal from earlier this year when, for the first time in three years, a greater number of Americans were in favor of the law than against it.

In October, a KFF poll found opinion evenly split on the law at 42 percent. The foundation's September poll showed a more narrow divide, with a 41 percent favorable to 45 percent unfavorable rating. A KFF survey conducted in August showed opinion skewed more favorably, with 44 percent of Americans stating they had a positive view and 41 percent stating they had a negative one.

From an email I received today:

FROM: (name)
Organization: Sinclair Broadcast Group

Mr. Gaba,

I am working on an article about UnitedHealth Group saying it may drop out of Affordable Care Act exchanges in 2017. I am trying to get a sense of how significant this and other recent news surrounding the law really are. I see you have written several posts about these developments. If you are interested and available to talk about that on the phone for a few minutes today, please let me know. Thank you.

(name)

My response:

Dear (name)--

I appreciate your interest.

Unfortunately, I couldn’t help but notice that your organization is the same one which produced and broadcast the anti-John Kerry propaganda film “Stolen Honor: Wounds That Never Heal” [ie, part of the infamous "Swift Boating" smear] in 2004.

...and various reporters will breathlessly report about how this is 20% lower than the same third week during last year's Open Enrollment Period, and OMG THIS MEANS OBAMACARE IS FAILING!!!

Yep, it's true: Last year, during the third week of Open Enrollment, 618,548 people selected QHPs via the federal exchange (HealthCare.Gov). This year, I'm pretty sure that right around 500,000 people selected QHPs during the third week.

However, here's what you have to keep in mind: The first week was 17% higher this year than last (543K vs. 462K). The second week was a whopping 77% higher than last year! (535K vs. 303K).

Why the massive discrepancies? Simple: The calendar. Last year, Open Enrollment started on November 15th. The second week was also Thanksgiving week, which meant that enrollments dropped off to practically zilch for that Thursday and Friday.

This year, Open Enrollment started 2 weeks earlier, on November 1st. That means two important differences:

Presented Without Comment:

U.S. adults are slightly more likely to say it is the responsibility of the federal government to ensure all Americans have health insurance coverage (51%) than to say it is not the government's responsibility (47%). The percentage who believe the government has that obligation is up six percentage points from 2014. This year marks the first time since 2008 that a majority of Americans say the government is responsible for making sure all citizens have health insurance.

Hat tip to someone named "Chuck" (no last name or organization given) for the tip.

Yet Another Post® about UnitedHealthcare, I'm afraid. Healthcare pundits/reporters have found last week's United announcement extremely oddly-timed, especially given that they were giving a very positive outlook for the ACA exchanges just a month earlier.

In short: UHC sat out the ACA exchanges in 2014, dove into half the states head first for 2015, expanded into another 11 states for 2016...but then suddenly announced that they "may" drop out of the exchanges completely in 2017? Furthermore, they made this announcement a month after painting a glowing outlook in their official quarterly report and did so in the middle of the 2016 open enrollment period? Something doesn't sound right here.

Well, today I've learned another tidbit which seems odd to me, although it's possible that there's nothing amiss here:

Over at Inside Health Policy, Amy Lotven takes a deeper look at one part of last week's UnitedHealthcare announcement which slipped by a lot of people:

United Notes Customer Churn As It Mulls Exiting Exchanges

...United in a Thursday morning call said it is seeing a high number of people who are purchasing exchange plans, receiving services, and then dropping their policies. Aetna, which last month announced it would scale back its offerings in 2016, also recently said is has seen an increased number of enrollees coming in and out of the exchange, especially through the special enrollment periods.

...Aetna Chief Financial Officer Shawn Guertin made similar comments in a Nov. 10 investors meeting at Credit Suisse. The phenomena that really we're seeing now is a lot more people coming in and out of the system, and in particular people coming in during a Special Enrollment Period and then staying for only a few months and dropping, is really part of what's draining the system, Guertin said.

After UnitedHealthcare freaked everyone in the health insurance investor community out (along with enrollees, politicians, healthcare reporters/pundits, etc.) with their Thursday morning announcement that they might drop off the ACA exchanges in 2017, just 2 years after entering the exchanges and just 1 month after painting a rosy picture of the situation, several other major players in the individual market decided to calm everyone the hell down:

U.S. health insurers Aetna Inc and Anthem Inc on Friday sought to reassure investors that their Obamacare businesses had not worsened after UnitedHealth Group Inc warned of mounting losses in that sector.

Aetna and Anthem said their individual insurance businesses, which include the plans created by President Barack Obama's national healthcare reform law, had performed in line with projections through October. Both backed their earnings forecasts for 2015.

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