SBMs

I just realized that while I've broken out state-level 2021 Open Enrollment data between Medicaid expansion & nonexpansion states, I haven't posted the state-level 2021 vs. 2020 data in a single table yet, so I'm rectifying that today. Note that this still only includes partial data for 5 states (CA, DC, MA, NJ & WA) and no data at all for 3 others (NY, RI, VT).

For that matter, Open Enrollment is still ongoing in either 5 or 6 states (Maryland depends on your POV...they ended OEP in December but re-launched it a few weeks ago in response to the COVID-19 pandemic).

While the data below is incomplete, this seems like a good time to see where things stand given that President Biden is widely expected to announce a re-launch of Open Enrollment tomorrow.

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Way back in October 2013, when the first ACA Open Enrollment Period (OEP) launched, there were infamously massive technical problems with the federal exchange (HealthCare.Gov) as well as some of the state-based exchanges (such as those in Massachusetts, Maryland, Oregon, Nevada and Hawaii).

Over the next few years, some of those exchange websites were replaced with brand-new ones (MA & MD). Some of the states scrapped theirs altogether and moved onto the mothership at HC.gov (OR, HI & NV, although Nevada has since split back off onto their own exchange again, and seems to have gotten it right this time).

UPDATE 2/24/20: California and New York have come out with their final, official enrollment numbers, as have Vermont,Rhode Island and the District of Columbia, although the latter three are estimates on my part due to the way they're reporting their enrollment data:

California and New York have both released updated 2020 Open Enrollment numbers, so I figured I'd update my spreadsheet one more time before the final data is released. This time I've included a smaller secondary table at the bottom which adjusts the Federal and State-based exchange numbers for Nevada.

OFFICIALLY, HealthCare.Gov enrollment is down nearly 128,000 people this year, but that's not fair because Nevada broke off of HC.gov onto their own full state-based exchange platform this year. When you adjust for that, HC.gov is only down 119,000 people for the remaining 38 states. Meanwhile, the state-based exchanges are officially down 2,900 at the moment, but again, with Nevada joining them, they're actually down around 8,900.people.

That leaves the missing enrollment data from five states. Rhode Island and Vermont haven't released any data...I'm assuming they'll both be very close to last year (call it at least 33,000 and 24,000 respectively). I'm assuming New York + DC will be good for perhaps 3,000 more enrollees combined in their final days. And California will likely tack on another 30,000 or so in their final 2 days of Open Enrollment.

The FINAL 2020 Open Enrollment Period data for the 38 states hosted by HealthCare.Gov was released yesterday, shaving around 17,000 enrollees off of the semi-final report issued before Christmas. In addition, final 2020 OEP numbers have now been released by Idaho, Maryland, Minnesota, Nevada and Washington State.

Incomplete numbers have been released for California, Colorado, Connecticut, the District of Columbia, Massachusetts and New York, all of which still have ongoing Open Enrollment, and I'm still waiting on any enrollment data for Rhode Island or Vermont.

With all that in mind, here's a state-by-state breakout showing where things stand as of today, Jaunary 9th. The states have been sorted from worst-performing to best, although obviously the 8 states with partial or no data are misleading (vice-versa for the bar graph).

The lastest 2020 Open Enrollment Period data was released last week by most of the exchanges, including HealthCare.Gov, Covered California, Connect for Health Colorado, Access Health CT, Maryland Health Connection and the Washington HealthPlan Finder. When combined with the existing data from the MA Health Connector, MNsure, New York State of Health and the brand-new Nevada Health Link, we should now have over 95% of the total 2020 Open Enrollment QHP selections locked in.

As I've noted several times recently, the "break off of HealthCare.Gov & establish your own state-based ACA exchange" train continues to pick up steam, with the following states having committed to either firing up their own, separate exchange website platform or at the very least going halfway by establishing their own exchange entity (which includes a board of directors, their own marketing/outreach budget, the ability to dictate which plans are allowed onto the exchange and so forth) if they haven't already done so.

I noted yesterday that Virginia is the latest state to consider jumping onboard the State-Based Exchange train, joining Nevada, New Mexico, New Jersey, Pennsylvania, Maine and possibly Oregon in making the move. Every time I've mentioned Oregon, however, I've had to put a bit of an asterisk on it because I wasn't quite sure whether or not their shift back to their own full tech platform was still a go or not.

Like Nevada, Oregon did have their own full exchange once upon a time. Back in the first ACA Open Enrollment Period from 2013-2014, both states were among those which ran their own exchange websites. Nevada's was developed by Xerox; Oregon's was developed by Oracle.

UPDATE: Arrrrgh!!! Literally moments after I went live with this, Hannah Recht pointed out to me that the Washington Health Benefit Exchange has (unofficially) posted their (rough) final 2018 enrollment numbers via an internal slideshow presentation. The table and all numbers below have been updated to reflect the additional 8,800 enrollees added in WA over the final few days of its enrollment period.

UPDATE 1/22/18: Covered California has just issued a major update to their enrollment data, adding another 122,000 QHP selections to the national tally. Everything below has been updated to include this.

UPDATE 1/28/18: The deadline for Massachusetts has passed and they've posted their final numbers. Everything below has been updated to reflect this update.

OK. The Big News that everyone's waiting on this week regarding the 2018 Open Enrollment Period will come on Wednesday. That's when CMS will presumably post the Week 7 Snapshot Report for HealthCare.Gov, which covers 39 states. Wednesdays are also usually when Covered California, the largest state-based exchange, posts their updates as well.

That leaves the other 11 smaller state-based marketplaces (SBMs), of which only one, Colorado, has posted an update so far this week. As it happens, however, that was an impressive update: Colorado's total enrollments to date now stand at 149,000 people, about 7% ahead of last year. With CO added to the mix, I've now confirmed exactly 2,522,078 QHP selections across those 12 SBMs...which means the SBMs have already broken my personal final QHP projection of 2.5 million as of January 31st.

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