This Just In...

“Because of the unprecedented demand and volume of consumers contacting our call center or visiting HealthCare.gov, we are extending the deadline to sign-up for January 1 coverage until 11:59pm PST December 17. Hundreds of thousands have already selected plans over the last two days and approximately 1 million consumers have left their contact information to hold their place in line. Our goal is to provide access to affordable coverage, and the additional 48 hours will give consumers an opportunity to come back and complete their enrollment for January 1 coverage. ”

--Kevin Counihan, CEO of the Health Insurance Marketplaces

Welp, you can probably throw The Graph out the window now, at least in terms of the "spike" hitting right around now. My model was based on the assumption that yes, there'd be a huge spike yesterday and today, followed by perhaps 3 million auto-renewals being tacked on all at once tomorrow/Thursday.

This is a classic "glass half full/half empty" situation.

Remember in October when I noted that up to 1.5 million current ACA exchange enrollees could have been at risk of losing their federal tax credits this year?

The short version is that about 710,000 enrollees forgot to file a tax return at all (or didn't even know they were required to do so). Another 760,000 did file their taxes, but forgot to include the extra Form 8962 which was required to reconcile their 2014 tax credits (one of those happened to be, ahem...me).

As always: I could be dead wrong here. It's entirely possible that my recent tweaking of The Graph, which projected that 1.5 million people would select exchange QHPs between 12/06 - 12/12 via HealthCare.Gov alone and continued to see the number shoot up from there for December 13th, 14th and 15th is way off the mark.

HOWEVER, assuming that both the Week Six total as well as the "spike" trend I projected turn out to be accurate, that means that these final days should be playing out something like the following:

  • Sunday, 12/13: Around 350K nationally (270K via HC.gov)
  • Monday, 12/14: Around 460K nationally (350K via HC.gov)
  • Tuesday, 12/15: Around 780K nationally (600K via HC.gov)

Yes, that's right, it's conceivable that HealthCare.Gov could see up to 600,000 people select private policies in a single 24-hour period tomorrow, plus up to another 180,000 via the various state exchanges.

A few weeks ago, I attempted to figure out at what point the cost of paying for healthcare policy premiums would start to outweigh the Shared Responsibility Mandate Penalty for not having ACA-compliant coverage for 2016. For my own experiment, I was looking purely at the "young invincible" target market: Single, childless individuals between 26-35 years old, earning between $20K - $40K. I ran "real world" checks across 10 major U.S. cities. My conclusion was that for this market in particular, signing up through the ACA exchanges was obviously the smart play up until they hit around $25,000/year in income. After that it started to become more of a judgment call depending on their circumstances and how much of a gamble with their health they're willing to take.

Last month, right at the launch of the 2016 Open Enrollment Period, HealthCare.Gov announced that they were beta-testing a couple of important new tools via a pilot program:

Beginning today, HealthCare.gov is piloting a new beta feature that allows consumers to search plans by their preferred provider or health facility. Some consumers will be part of a pilot that allows them to use the beta Doctor Lookup feature as they compare their coverage options in window shopping or when selecting a plan.

...For the first time, insurers are required to provide up-to-date information about which doctors and facilities are in their networks. Plans must also provide access to information on what medications are covered in the health plan formulary. In the coming weeks, HealthCare.gov expects to pilot the Prescription Drug Check feature, as well, which will allow consumers to search for whether a plan covers their prescription drugs.

As expected, the December Surge started in Week 5, and should really be taking off even as I type this on Wednesday of Week 6. I overshot a bit this time:

  • Week 5 Projection: 840K / Actual: 804K (over by 4.4%)
  • Cumulative Projection: 2.88M / Actual: 2.84M (over by 1.2%)

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.

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).

I have a doctor's appointment myself this afternoon which I have to leave for soon (irony!!), so the second half of my weekly analysis (state level) will have to wait until I get back, but here's the major story.

With the December 15th deadline just 1 week away and the December Surge starting to kick in, CMS decided to hold a full press conference call this morning ahead of the Week 5 HC.gov Snapshot report.

Last Thursday, as you'll recall, after an initial lower number, I made the following projection:

UPDATE 12/03/15: OK, strike that. This has been nagging at me all day. I'm bumping my HC.gov Week Five projection up further to 840,000 for 11/29 - 12/05 (2.88 million cumulatively), or around 3.77 million nationally.

Here's the actual numbers, released by CMS just moments ago:

I've decided to start breaking out my official weekly projections for the upcoming week out separately from my analysis of the previous week; this way I'll have a "clean" entry to link to for all projections.

As I noted this afternoon, I came in 6.3% under for Week Four, making me exactly 1% under the actual cumulative total for the first 4 weeks:

  • Week 4 Projection: 370K / Actual: 395K
  • Cumulative Projection: 2.02 Million / 2.04 Million

Based on this, I'm once again bumping up my Week Five projection a bit, from 600K even to 670K for 11/29 - 12/05. If accurate, that will bring the grand HC.gov total up to 2.71 Million as of Saturday, December 5th. It should also bring the national total up to roughly 3.56 Million.

UPDATE 12/03/15: OK, strike that. This has been nagging at me all day. I'm bumping HC.gov Week Five projection up further to 840,000 for 11/29 - 12/05 (2.88 million cumulatively), or around 3.77 million nationally.

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, starting today.

I couldn't start doing this earlier because this is the first week that CMS has broken out the HealthCare.Gov QHP numbers by state. Now that they've started doing so, I have cumulative numbers for enough states for a chart like this to make sense.

It's important to note that I'm still missing data from some state exchanges; I have bupkis from DC, Idaho, Kentucky, New York, Vermont and Washington. 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 two states (Connecticut and Rhode Island) where I have the opposite situation--they've jumped the gun and 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).

Some Guy, 11/25/15:

I still expect the current week to drop substantially due to it being Thanksgiving week. Note that last year the number dropped about 35% during Thanksgiving week before skyrocketing again the week after that; a similar drop this year would bring it down to around 330K for Week Four...although I'm gonna adjust my Week 4 projection upwards to 370K given the higher-than-expected results for Week Three.

CMS, moments ago:

Health Insurance Marketplace Open Enrollment Snapshot - Week 4 • November 22 – November 28, 2015

NOTE: The Weekly HealthCare.Gov Snapshot Reports are normally released at around 1:00pm on Wednesdays. I have a 1:00pm meeting today, so the odds are that I won't be able to write up a response/analysis of the weekly HC.gov numbers until late this afternoon.

THEREFORE, the following assumes that my estimate of appx. 370,000 QHP selections via HealthCare.Gov from 11/22 - 11/28 turns out to be accurate. Obviously if the number is significantly higher or lower than that, I'll have to tweak some of this.

OK, assuming this is correct:

Hmmmm...over at Investor's Business Daily, Jed Graham looks at HealthCare.Gov's 3rd Weekly Snapshot report from a different angle: If you set aside renewals of current enrollees, how are things looking in terms of new additions?

As I noted in my detailed 2016 OE3 projection breakdown, nationally the HHS Dept. is projecting around 8.1 million renewals, plus around 4.5 million new additions, for a total of roughly 12.6 million QHP selections (expected to then dwindle down to roughly 10.0 million still enrolled/paying by the end of next year. In contrast, I'm more optimistic: I projected around 9.0 million renewals, plus 5.7 million new additions.

Today was a big day for enrollment updates. Not only did the Week Two Big One come out (HealthCare.Gov, which covers 38 states in one shot), but there were also official state-level updates from Rhode Island, Minnesota and California (although the CA update is partial, only covering new enrollees, not renewals of currently-enrolled individuals). In addition, there's also the recent updates from Maryland and Colorado.

Plug 'em all in ad you have the following: 1.17 million QHP selections confirmed nationally from 43 states out of around 1.76 million estimated nationally to date.

Some Guy, 11/12/15:

By my reckoning, total national QHP selections should hit around 1.33 million by the end of Week Two, of which around 1.07 million should be via HealthCare.Gov. I the expect around 1.9 million in Week Three, around 2.4 million by Thanksgiving, and then start ramping up to around 6.3 million by the 12/15 deadline for most states.

CMS Dept., just moments ago:

Health Insurance Marketplace Open Enrollment Snapshot: Week 2: November 8 – November 14, 2015

The second week of Open Enrollment for Marketplace coverage saw millions more Americans exploring their health insurance options by calling the call center, attending enrollment events, or visiting HealthCare.gov or CuidadoDeSalud.gov.