OE5

A week ago I noted that total Idaho exchange enrollments had reached around 87,000 people as of 11/30. Today Your Health Idaho confirmed that they're "nearing 90,000" enrollments for 2018, which is about where they expected it to be at this point. They also noted that call volume and web traffic are still ahead of last year.

Not much else to say other than ID has reached about 90% of their highest enrollment tally (they had 101,073 QHP selections in 2016 and 100,082 last year) with a week left to go. Last year they had enrolled 91,509 people as of December 10th, but of course the final deadline is a week from today instead of January 31st this time around, so they'd need to add another 10,000 over the next week to match last year's tally.

A small update out of Connecticut today; AccessHealthCT last reported just over 90,000 QHP selections as of November 30th, with 11,000 current enrollees who hadn't selected a 2018 policy yet. Today they've updated that to 92,041 QHPs as of this morning, leaving 9,380 left to renew.

This means they added 1,613 more people in the past week, but the pool of current enrollees dropped by 1,675, which means that at least a small number have actively cancelled their policies altogether. Looked at another way, the number of new enrollees has increased by 3,211 (from 11,749 to 14,960), which means that, again, a couple thousand current enrollees who either actively (or were passively) auto-renewed have since gone back into the system and changed their mind and cancelled their 2018 plans. This is normal, especially for the states which "front-load" auto-renewals before the December deadline passes.

Eureka! I've finally acquired fairly up-to-date Open Enrollment data for the last blank state on my list: Vermont. The exchange representative kept it simple for me:

Vermont’s net plan selections as of December 2, 2017:

• 25,559 renewing individuals
• 1,335 new individuals (including those previously, but not currently, enrolled)
• 26,892 total individuals

Last year Vermont ended OE4 with 30,682 QHP selections total, so they were up to around 88% of that total as of Saturday with 13 days left to go.

When NY State of Health released their first Open Enrollment update a week or so ago, they reported over 140,000 QHP selections in the first 28 days (up 13% vs. the same point last year) and 700,000 BHP enrollees (which is 5% more than they enrolled in all of last year's open enrollment period).

Today they've issued another update:

• Enrollment in Qualified Health Plans and Essential Plan Reaches Nearly 900,000
• December 15th is the Deadline to Enroll for January Coverage
• New Yorkers Urged to Enroll Now

ALBANY, N.Y. (December 7, 2017) - NY State of Health, the state’s official health plan Marketplace, today announced enrollment in Qualified Health Plans (QHP) and the Essential Plan have reached nearly 900,000—continuing to outpace enrollment at the same point last year by 13 percent.

I've just been sent a link to the first official update on ACA exchange enrollment in DC. It includes a whole mess of demographic data (click below for full-size version), but the main takeaway is near the top: 18,740 QHP selections as of December 5th (compared against December 8th of last year). With auto-renewals included, this year's tally is about 2% shy vs. last year, but again, those extra 3 days make a bigger difference than you might think, especially as we approach the mid-December deadline.

It's important to remember that DC, along with California and New York, is sticking with the full 3-month Open Enrollment Period this year, so residents will still have another 6 weeks after 12/15 to sign up for coverage starting in either February or March.

Excellent news out of Massachusetts! I haven't posted any updates from the Bay State since 11/15, when they reported enrollments were up 40% year over year, but today they've given me very comprehensive and up-to-date numbers:

As of Dec. 6, we had a total of 259,815 plan selections and enrollments. This includes auto renewal of existing members. Of that, 26,074 are people who are new for 2018.

For comparison sake, for Dec. 6, 2016, we were at 244,845, and 25,746 for the new. These numbers also includes auto renewal, of course.

Obviously when you throw auto-renewals into the mix, the percentage increase drops substantially, but they're still up 6% over last year (nearly 15,000 people), and new enrolles are up about 1%.

OK, today saw two major 2018 Open Enrollment Period data updates out of HealthCare.Gov and Covered California, plus a minor one out of Maryland.

As I reported this morning, the HC.gov Week 5 Snapshot report came in much lower than I expected this week, at just 823K vs. the 1.2 million I was anticipating; as a result, the HC.gov section of The Graph (in green below) has finally reverted back to my original projection line with a total of 3.6 million as of December 2nd. If it follows my trendline this week, HC.gov should tack on another 1.2 million for a total of 4.8 million by Saturday night, December 9th, ahead of what should be the Big Final Week Surge.

Then, about half an hour ago, Covered California issued THEIR big enrollment press release: Around 1.2 million renewals (active + passive combined), plus 102,000 new enrollees, as of November 30th.

Covered California has released another 2018 Open Enrollment Update report...and thankfully, they finally included their renewal numbers as well as the new additions:

Covered California’s Open Enrollment Continues at a Brisk Pace with New Data Showing Most Consumers Who Renewed and Enrolled in November will Pay Less in 2018

More than 102,000 new consumers selected a plan during the first month of open enrollment, a 28 percent increase over the same time period last year.

After being way off in my initial HC.gov projections the first and second weeks of the 2018 Open Enrollment Period, I recalibrated and was dead on target for Weeks 3 and 4: As of November 25th, just shy of 2.8 million people had selected Qualified Health Plans (QHPs) through the federal exchange.

As I had predicted, there were a bunch of eye-roll-inducing headlines about how enrollments had dropped off a cliff, etc etc, which completely ignored the fact that it was Thanksgiving week, and that a 35%+ drop-off is typical for the holiday weekend. Whatever.

For the post-Thanksgiving week, however, ACA enrollments typically roar back to life, and this year was no exception...although not by nearly as much as I was hoping:

I've written a LOT about Silver Loading, the Silver Switcharoo and the bizzare policy pricing many people will find on the ACA exchanges this year due to two actions:

• First, Donald Trump officially pulling the plug on CSR reimbursement payments to insurance carriers, and...
• Second, the response to the CSR cut-off by some very clever state insurance departments, ACA exchange boards and individual market insurance carriers.

The gist of Silver Loading/Silver Switcharoo is that across roughly 40 states, subsidized enrolles may find themselves eligible for dirt-cheap (or even zero-premium) Bronze plans...as well as bargain-priced Gold plans which may cost the same or even less than Silver plans.