2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

OK, talk about an 11th-hour development: The Hawaii Health Connector, which has been competing with Oregon and Massachusetts for the "worst exchange" award, may have actually turned the corner just in time for the final 2 weeks of the ACA enrollment push.

If this development doesn't turn out to be another false promise (Hawaii's exchange has had several "It's working NOW! Oh, wait..." moments since October), there could be up to 16,000+ people who get piled onto the Hawaii tally over the final two weeks of open enrollment:

The Hawaii Health Connector, in its final stretch of open enrollment, says it has fixed a substantial number of system glitches that have frustrated consumers and stifled enrollment.

Contributor Maurice H. provides a bit of Off-Exchange data from Oregon. He contacted Oregon's Health CO-OP and while they didn't provide exact numbers, they were willing to provide their on-exchange/off-exchange ratios:

Oregon’s Health CO-OP is not sharing specific enrollment numbers, but is happy to give you the percentages of on and off Exchange:

On – 42%  /  Off—58%

Hope that helps.

Fortunately, an article in the Oregonian by the authority on all things Cover Oregon-related, Nick Budnick, provides the other piece of the puzzle:

Policies as of March 6th / Oregon's Health CO-OP: 212

Hmmm. Well, if 212 is 42% of the co-op's total enrollments, that makes off-exchange enrollments...505 people.

OK, not exactly a huge number, but an enrollment is an enrollment...noting it...

I just posted the big announcement out of California: They broke through the 1 million mark on Friday, reaching 1,018,315 QHPs as of Saturday night. This means they've been averaging over 10,600/day in March so far.

It also means, using my projection table, that the national total, which I had predicted would cross 5 Million sometime tomorrow, should actually break the 5 million mark today.

Specifically, the national total should be running around 167% higher than February's rate (33,600/day), or around 56,300/day in March so far. 56.3K x 15 days = 844,500, added to the 4,242,325 to date, for a total of about 5.09 million. I'll assume that this is highballing a bit, so tack on an extra day or so.

Now, they may not announce it until tomorrow, but if I'm correct about this, we should actually be at somewhere around 5.09 million by the end of today (Monday, March 17th).

There we go; I originally projected California to hit 1M last Tuesday or Wednesday, but didn't realize at the time just how bad the mid-February outage had hit the exchange. It ended up taking them 2 extra days to hit the 1M mark (Friday night). Fortunately, it looks like they've bounced back nicely:

Covered California’s enrollment reached the 1-million mark late Friday. By the end of Saturday, enrollment reached 1,018,315 in the health care exchange marketplace. The figure represents the number of people applying for coverage and selecting insurance plans for themselves and their family members through the exchange.

Just as a reminder: Based on my projection model and a little big of educated guesswork on my part, I've estimated that Private Exchange QHPs should be around 4.89 Million as of today, setting things up to cross the 5 Million mark sometime on Tuesday, March 18.

If I'm correct about this, then it means:

  • The rate averaged around 44,000/day for the first half of the month
  • The rate for the second half of March will have to average at least 74,000/day in order to hit 6 Million
  • The rate for the second half of March will have to average at least 141,000/day in order to hit 7 million

Obviously, the 7M target is going to be extremely difficult to reach at this point.

Follow-up from last night's post on Saturday's HC.gov enrollment: The final number ended up being over 40,000:

Enrollment on March 15 at 2pm on the ACA website was 15,000 and counting.

UPDATED – As of 12:01 AM, March 16, 2014, Over 40,000 people signed up on healthcare.gov Saturday and made the deadline for insurance to be effective April 1, 2014.

UPDATED - As of 6:26 PM – Around 23,000 so far for today have enrolled for healthcare.  Almost 300,000 people logged into the healthcare.gov website today, Saturday, March 15, 2014.

Through Friday, I had the daily average for QHP enrollments at around 43,000 (up from the 33.7K/day in February).

Last night I assumed that the total HC.gov enrollments for Saturday (3/15) wold end up being around 32K based on the 6:30pm total of 23K.

very nice find by Twitter follower @rwhide...this post from April D. Ryan about President Obama giving a pep talk to the Healthcare.Gov team:

Enrollment on March 15 at 2pm on the ACA website was 15,000 and counting.

UPDATE to this story - as of 6:26 PM – Around 23,000 so far for today have enrolled for healthcare.  Almost 300,000 people logged into the healthcare.gov website today, Saturday, March 15, 2014.

OK, until today, I've been projecting March QHP enrollments to be around 43,000 per day (pre-Surge).

Let's see if we can break the data points above out.

23,000 as of 6:26pm (let's call it 6:30pm) is 1,243 per hour.

A straight-line projection (23K in 18.5 hours) would mean around 30,000 per day.

Between the success of my new QHP enrollment projection model and today's confirmation that at least some sort of "March Surge" has indeed started, I'm confident enough to add a new feature to The Graph: Estimate of Unsorted Exhange QHPs.

This new addition represents my personal estimate of the number of exchange QHP enrollments which have already been completed as of today, in addition to the ones which I've actually documented and sourced. Due to this addition, I'll be updating the chart daily going forward.

For instance, as of today, March 15, I've actually documented 4.47 million QHP enrollments. However, that only includes data through 3/01 for most states plus data since 3/01 for a dozen or so state-run exhanges. Obviously there have been additional enrollments in the other 35+ states that I just haven't documented/broken out by state yet.

From today's Detroit News, strong anecdotal evidence that Michigan, at least, is already seeing a spike in enrollment activity. The article also notes something that I didn't realize: I knew that anyone enrolling between 3/16-3/31 wouldn't have their policy coverage kick in until May 1st (and I've written about this several times), but I didn't realize that those who do so would have to apply for an exemption from the IRS next year:

Health insurers and advocates are expecting a surge in enrollment for insurance plans Saturday, the deadline to guarantee coverage beginning on April 1.

OK, now that we're prepping for the Big Home Stretch, I've added three new features to the Enrollment Projection chart:

  • March Surge Factor: Even if my formula for existing March data proves accurate, that only tells me how many March enrollments there would be if the daily rate doesn't change going forward. Obviously this is not likely to be the case; by all expectations, there should be a large end-of-month spike/surge that kicks in any day now. I haven't actually filled this in yet, I'm just prepping the spreadsheet for it. I'll be adding the Surge Factor starting on Monday.
  • Projected Daily Average: This measures my estimate of the QHP enrollment daily average throughout March so far. This is handy for helping estimate things like...
  • Projected Date for 5 Million QHPs: We should currently be at around 44K/day, which means we should hit the 5 Million mark sometime on Tuesday, March 18th.

No official update, but an article in yesterday's Coloradoan.com gives the Private QHP number as 93,000 as of Thursday, up 5,234 from 87,766 as of March 8th:

WASHINGTON — At least 100,000 Coloradans are expected to sign up for private health insurance on Connect for Health Colorado by March 31, according to the head of the state’s online health exchange.

With 93,000 people enrolled as of Thursday, “we are really exceeding our expectations,” Patty Fontneau, CEO of Connect for Health Colorado, told reporters in a conference call arranged by Families USA, a health care consumer advocate.

OK, I already had Kentucky down with 60K QHPs / 240K Medicaid; just just straightens the numbers out precisely:

300,290 Kentuckians are enrolled in new health coverage through @kynectky. 239,453 in Medicaid, 60,837 purchased private insurance. #ACA

— Joe Sonka (@joesonka) March 14, 2014

Hmm...Last week Maryland finally reported their Paid/Unpaid numbers (54% paid); this week they didn't for whatever reason. Anyway, their total QHPs are up from 38,070 to 40,693, an increase of 2,623 since March 1st.

On the Medicaid side, they've decided to bundle together the 96K PAC transferees with the "normal" new Medicaid enrollees for whatever reason. Subtracting out the PAC number gives 97,781 through March 11th, a very impressive 37% (26,332) gain since Feb. 25th.

From October 1, 2013, through March 8, 2014, there have been more than a million unique visitors to the Maryland Health Connection website. 186,268 Marylanders have created identity- verified accounts. Through March 8, 40,693 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

As of March 11, 193,670 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage.

UPDATE: CNBC Reports that 2 additional states (well, one state, Minnesota, as well as DC, anyway) have released their paid/unpaid data; the chart has been updated below, which changes...nothing really; Minnesota is at 90% while DC is at 75%, and Vermont's paid rate has apparently fallen from 85 to 59%...between the three they seem to have cancelled each other out.

I've written about the "But How Many Have PAID???" issue many times before, but going into the final stretch, I wanted to explain my reasoning as clearly as possible.

The following chart only includes states which have broken out Paid vs. Unpaid Enrollments. If you only use these 9 states as a guideline, it looks like the paid rate is around 80%:

Connecticut continues to Do It Right®. Not only have they broken their own combined goal by 60%, they're also now 37% past their fair share of the CBO's original 7 million QHP figure. The exchange's CEO is quoted in the article as saying that CT doesn't expect to see much of a "March surge", but that isn't too concerning to me--they're already doing fantastic, so any enrollment rate increase wouldn't be as dramatic by comparison anyway.

Oh, yeah--and 92% of all of their enrollees to date are paid up, even more impressive considering that this should include people whose policies don't even start until April.

In Connecticut, 160,580 people have enrolled in coverage through Access Health CT, surpassing the exchange's self-imposed goal of 100,000 people. Counihan said roughly 62,000 of those who enrolled signed up for one of three private health plans represented on the exchange. Most of the remainder signed up for some form of Medicaid.

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