Oof. Regular readers know that I've compiled plenty of evidence showing that while the 39 states run through the federal exchange (HC.gov) showed a ~5% enrollment drop this year, the state exchanges have been showing an overall net increase of roughly 2% over 2016. Rhode Island, however, is the odd man out on this front, as shown in this email I just received (not up on their website yet):
Despite facing a unique set of challenges this open enrollment, 29,420 individuals selected 2017 coverage through HealthSource RI during open enrollment period (November 1, 2016 – January 31, 2017). As of January 31, 27,395 of those individuals paid, and are therefore confirmed, in 2017 coverage. We do anticipate these number will change as payments are made through the February 23 payment deadline and also as HealthSource RI remedies account issues incurred during the open enrollment period. It is difficult to point to one clear cause for this year-over-year drop in enrollment, but we believe several factors might have played a role:
As i noted last week, with all renewing enrollees accounted for, Rhode Island's ACA exchange is likely to come up short not only of my pre-election projection (40,000 enrollees), but will likely see a drop from last year's 34,670 QHP selections. They had only hit 29,312 QHPs as of Christmas Eve, and have only tacked on another 580 people since then:
INDIVIDUAL AND FAMILY ENROLLMENT • As of December 31, 2016
Rhode Island is one of three states (along with Washington and Massachusetts) which allowed people to enroll for January coverage as late as December 23rd. RI's numbers have also included auto-renewals for some time now, so today's report includes everyone whose 2017 policies will kick off effective this Sunday, January 1st:
INDIVIDUAL AND FAMILY ENROLLMENT • As of December 24, 2016
Last week, the Rhode Island exchange reported 27,555 QHP enrollees as of 12/10, a tiny increase over the prior week mainly due to auto-renewed enrollees dropping out, cancelling out most of the increase.
I've been posting so many stories about the ugly implications of the ACA being repealed that it's kind of nice to get back to actually reporting on the number of people enrolling for ACA coverage again (hey, it's right there in the title of this site and everything...)
Rhode Island, which issued regular weekly enrollment reports last year, has been unusually silent so far this year...until today:
HealthSource RI (HSRI) has released certain enrollment, demographic and volume data through Saturday, December 3, 2016 for Open Enrollment.
INDIVIDUAL/FAMILY ENROLLMENT As of December 3, 2016
Rhode Island, in addition to being one of the smallest states, is also one of the first states I crunched the rate hike numbers for back in late May. It was actually pretty easy to run a weighted average hike request since there are only 2 carriers even operating on the individual market next year: Blue Cross Blue Shield of RI and Neighborhood Health Plan (UnitedHealthcare is dropping out of the RI indy market entirely, but only has about 1,400 people enrolled to begin with).
Anyway, BCBS was asking for a 9% increase, while Neighborhood is among the very few carriers to actually request a rate decrease...of around 5%. As a result, Rhode Island has the honor of having the lowest average rate hike request of all 50 states (+DC) next year...a mere 3.6% overall, which is awesome.
Better yet, they're also making sure to include both the gross enrollment and net effectuated enrollment numbers. If every state exchange (and especially HealthCare.Gov, of course) were to do this, I'd be a very happy man indeed. In the meantime, I'll have to settle for RI's regular updates, although extrapolating anything nationally from a single state with just over 1 million people is a bit tricky.
Once the dust settled on the 2014 and 2015 Open Enrollment periods, only a handful of state exchanges bothered continuing to report off-season exchange enrollments, but I was able to extrapolate those numbers pretty accurately nationwide: Around 7,500 people per day were still signing up via Special Enrollment Periods throughout the summer/fall of 2014, and around 8,500 per day did so last year (not including the time-limited #ACATaxTime SEP from mid-March through the end of April 2015).
This year, that number is expected to drop somewhat due to HHS supposedly cracking down on SEPs in both variety and eligibility verification, but I still wouldn't be surprised if at least, say, 6,000 people per day end up signing up between now and next November (or around 1.6 million total, give or take).
PROVIDENCE – HealthSource RI (HSRI) has released certain enrollment, demographic and volume data through Saturday, January 31, 2016 for Open Enrollment.
INDIVIDUAL AND FAMILY ENROLLMENT • As of January 31, 2016:
34,670 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.
The majority of these individuals are 2015 HSRI enrollees that were auto-renewed into a 2016 plan.
7,538 of the 34,670 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.
32,286* of the 34,670 individuals are enrolled in 2016 coverage through HSRI, and have paid their first month’s premium.
*The number of paid enrollments is expected to increase as individuals pay for March coverage through the February 23 payment deadline.
Aside from HealthCare.Gov itself, the Rhode Island exchange is the only state-based exchange which provides weekly updates on a consistent basis. In addition, RI's updates cover the exact same 7-day periods as HC.gov's Snapshot reports, so they can often act as a bit of a harbinger of the larger report to come the following day. However, RI is also a tiny state with an even tinier ACA exchange population, in the 30K - 40K range, so it may be pointless to try and extrapolate nationally.
As I've noted before, aside from HealthCare.Gov itself, the Rhode Island exchange is the only state-based exchange which provides weekly updates on a consistent basis (the other exchanges range from no updates at all to monthly to a "whenever they feel like it" schedule). In addition, RI's updates cover the exact same 7-day periods as HC.gov's Snapshot reports, so they can often act as a bit of a harbinger of the larger report to come the following day.
On the other hand, Rhode Island is also a very tiny state, with enrollment numbers in the 30-40,000 range, so I have to be careful about extrapolating out to the federal exchange, which covers 38 states and likely has over 9 million people enrolled by now.
Until this year, most of the ACA exchanges, including HealthCare.Gov, would simply report how many people selected QHPs through the exchange, whether paid up or not. There's nothing wrong with this as long as it's made clear at some point how many people actually paid their premiums and had their policies effectuated; the argument over this issue was the entire basis of the infamous "But how many have PAID???" fuss back in 2014. It was such a Big Deal that the Republicans on the House Energy & Commerce Committee even published the results on a laughably garbage-filled "survey" they had sent out to a portion of the insurance carriers.