2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

OE3

According to a recent Kaiser Family Foundation study, as of last spring there were still around 32.3 million uninsured people in America, broken down roughly as follows:

Three portions of the total are eligible to enroll in private policies through the ACA exchanges: "Tax Credit Eligible", "Ineligible for Financial Assistance due to ESI Offer" and "Ineligible for Financial Assistance due to Income" (22%, 15% and 12% respectively). It's important to remember that "Ineligible for Financial Assistance" means that they can enroll through the ACA exchanges, they just have to pay full price if they do so. Many of these folks will simply enroll off-exchange, directly through the insurance carriers, but there's nothing preventing them from going through the exchange instead.

As expected, Week Eight was extremely quiet; not only did the entire week take place after the (extended) deadline for January coverage, but there was also Christmas Eve and Christmas Day to contend with. Needless to say, very few people feel like enrolling in healthcare coverage on December 24th or 25th.

Last year, just 96,000 people chose to do so between 12/20 - 12/26 in the 37 states covered by HC.gov. I was expecting slightly more this year (100K even), but only 74,000 did...26% fewer than the same week in 2014. Whatever else is going on, it's safe to say that the Open Enrollment Periods are starting to become more and more "front-loaded".

I launched the "State by State" chart feature towards the end of the 2015 Open Enrollment period last time around, and it proved to be pretty popular, so I've brought it back this year.

It's important to note that I'm still missing data from some state exchanges; I have bupkis from DC, Kentucky, New York or Vermont. I also only have partial data from others (California includes new enrollees only, while several other states only have data for the first couple of weeks).

With all those caveats out of the way, here's where things stand. Just like last year:

As I noted last Tuesday, the Week Seven HC.gov Snapshot Report threw a bit of a curveball; while they did add most of the bulk auto-renewals to the total, they also stated that some unknown number had yet to be added. As far as I can tell, that number could be as low as 1...or (theoretically) as high as 680,000. My best spitball take is that it was somewhere around 150,000, which presumably have all been added to this week's report.

As for new enrollments, with Week Eight taking place a) entirely after even the extended deadline for January coverage and b) the same week as Christmas Eve and Day, I'm not expecting many to be added; perhaps 100,000 or so, for a grand total of roughly 250,000 for the week, which in turn would bring the cumulative total (for the federal exchange only) up to right around 8.50 million even.

Last week I asked "How many HC.gov auto-renewals are left to be added?" I noted that 5.86 million current exchange enrollees have been confirmed to have been renewed/re-enrolled via the federal exchange (71% of 8.25 million total), and that there could theoretically be up to 680K left to be auto-renewed, assuming that the currently-effectuated number is indeed still 9.1 million nationally:

The 9/30/15 number isn't what's relevant here; what we need to know is the December number. For that, HHS is still quite insistent that it'll end up being 9.1 million. While I was more optimistic earlier this year (I assumed it'd still be close to 9.7 million nationally as of now), it's pretty obvious that the attrition rate has indeed been higher than I figured, so I'll go with their 9.1 million.

If so, and assuming the federal-to-SBM ratio has remained the same, that suggests that as of December, HC.gov states are down to 6.54 million people as of today.

Several people have recently asked me whether I plan on adjusting my official projection of 14.7 million QHP selections (nationally) as of the end of the 2016 Open Enrollment Period.

On the one hand, the total numbers to date sound pretty impressive, and over 20 states are running well ahead of my projections so far (Massachusetts & Maryland have already hit my targets; SD, UT, RI, MT & TN are close behind). On the other hand, I'm also starting to see some worrying signs in a few large states, particularly Texas, Illinois, New Jersey and Pennsylvania.

Here's an irony for you: Take a look at what the state-by-state chart looks like when you divide it into the states which are currently above where I expected them to be right now and those which are behind (remember, 5 states aren't listed at all, since they haven't provided any data at all or only very limited in the case of California):

On top of the other big two data drops today (the Week Seven HC.gov Snapshot and the Q3 Effectuated Enrollment Report), CMS decided to really pile on the data just ahead of Christmas 

Open Enrollment Trends: Selected HealthCare.gov Statistics prior to the January 1, 2016 Coverage Deadline

Since Open Enrollment began on November 1, millions of Americans have learned about the financial help available and selected quality plans through the Marketplace for 2016. While six weeks remain before the final deadline, early consumer behavior and enrollment trends are beginning to surface. The following charts provide a preliminary analysis of plan selections ahead of the deadline for January 1 coverage through the HealthCare.gov platform.

I launched the "State by State" chart feature towards the end of the 2015 Open Enrollment period last time around, and it proved to be pretty popular, so I've brought it back this year.

It's important to note that I'm still missing data from some state exchanges; I have bupkis from DC, Idaho, Kentucky, New York and Vermont. I also only have partial data from others (California includes new enrollees only, while several other states only have data for the first couple of weeks).

With all those caveats out of the way, here's where things stand. Just like last year:

Yeesh, what a mess.

As I expected, the Week Seven numbers were a bit confusing due to a) the deadline surge; b) the 2-day extension of the deadline and especially c) the auto-renewal factor. While "the vast majority" of auto-renewals (2.28 million of them) were already added to the Week Seven total, CMS says that there are still "some" auto-renewals yet to be added. I wasn't expecting them to spill auto-renewals over into the following week, so things are kind of messy this week.

In addition, while these won't impact the federal exchange numbers, several state-based exchanges (Maryland, Massachusetts, Minnesota, New York, Rhode Island and Washington State) have/had January deadlines later than the 12/17 one on the federal exchange and some other states, so there's a lot of bumpy numbers going into Week Eight.

Hmmm...here's my official projection from last week:

Update 12/18/15: Not really an update so much as a clarification: I'm guessing active QHP selections for this week via HC.gov could run anywhere between 1.0 - 2.0 million, plus another 2.5 - 3.5 million automatic renewals, for a weekly total of between 3.5 - 5.5 million.

Today's actual report:

Health Insurance Marketplace Open Enrollment Snapshot - Week 7 • December 13 - December 19, 2015

Some Guy, 12/16:

Nationally, my rough guess for this week is something close to the following:

  • Sunday, 12/13: 360K nationally (270K HC.gov)
  • Monday, 12/14: 460K nationally (350K HC.gov)
  • Tuesday, 12/15: 780K nationally (600K HC.gov)
  • Wednesday, 12/16: 1.80M* nationally* (1.40M HC.gov) (*400K active + 1.40M auto-renewals?)
  • Thursday, 12/17: 2.10M* nationally (1.60M HC.gov) (*400K active + 1.70M auto-renewals?)
  • Friday, 12/18: 80K nationally (60K HC.gov)
  • Saturday, 12/19: 70K nationally (50K HC.gov)
  • Weekly Total: 5.65M nationally (4.33M HC.gov)
  • Cumulative Total: 11.30M nationally (8.50M HC.gov)

Remember that HC.gov generally represents about 3/4 of national enrollments, so for Wednesday and Thursday, I assumed around 300K active selections per day for the federal exchange.

The Kaiser Family Foundation just released their latest monthly healthcare tracking poll, and the results are forehead-slappingly depressing:

The Affordable Care Act’s third open enrollment period will end on Jan. 31, but the latest Kaiser Health Tracking Poll finds that only a small share of people without health insurance realize it.

Just 7 percent of the uninsured correctly identify January as the deadline to enroll; another 20 percent say the deadline is at the end of 2015, while everyone else either says they don’t know, gives another date or says the deadline has already passed.

As expected, the December Surge ramped up in Week Six, although I overestimated the curve somewhat:

  • Week 6 Projection: 1.50 Million / Actual: 1.33 Million (over by 13%)
  • Cumulative Projection: 4.34 Million / Actual: 4.17 Million (over by 4%)

Given the crazy developments of the past day or so, combined with the auto-renewal factor, things are kind of fuzzy this week. I'm gonna hold tight and assume roughly 4.3 million QHPs including auto-renewals will be added to the mix by Saturday, bringing HC.gov up to a total of 8.5 million by Saturday, December 19th.

However, there's a major caveat here: I have no idea how many auto-renewals will be added, so I could easily be off by as much as a half a million or so this week.

Update 12/18/15: Not really an update so much as a clarification: I'm guessing active QHP selections for this week via HC.gov could run anywhere between 1.0 - 2.0 million, plus another 2.5 - 3.5 million automatic renewals, for a weekly total of between 3.5 - 5.5 million.

REMEMBER, as always, that this only includes the 38 states included on the federal exchange; when you throw in the other 13 running their own exchanges, the grand total (assuming I'm in the ballpark) should be roughly 11.3 million QHPs nationally by the end of the week.

I launched the "State by State" chart feature towards the end of the 2015 Open Enrollment period last time around, and it proved to be pretty popular, so I've brought it back this year.

It's important to note that I'm still missing data from some state exchanges; I have bupkis from DC, Idaho, Kentucky, New York and Vermont. I also only have partial data from others (California includes new enrollees only, while several other states only have data for the first couple of weeks).

In addition, there are three states (Connecticut, Rhode Island and Washington State) where I have the opposite situation--they've front-loaded their autorenewals of current enrollees, with the understanding that those folks can still drop their coverage or switch to a different policy between now and December 15th (CT) or December 23rd (RI & WA).

With all those caveats out of the way, here's where things stand. Just like last year:

Some Guy, 12/09/15:

I'm sticking to my guns for Week 6, projecting an even 1.5 million QHP selections via HealthCare.Gov, bringing the grand total to 4.34 million as of 12/12.

REMEMBER, as always, that this only includes the 38 states included on the federal exchange; when you throw in the other 13 running their own exchanges, the grand total by the 12th should be roughly 5.76 million QHPs nationally.

OK, I got a bit ahead of myself this week:

More than 1.3 million consumers signed-up for health coverage through the HealthCare.gov platform between December 6 and December 12, the last full week before the deadline for January 1 coverage, bringing the total number of plan selections made since Open Enrollment began on November 1 to 4.17 million consumers.  Approximately 500,000 were new consumers, for a cumulative total of about 1.5 million new consumers since the beginning of Open Enrollment.

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