Healthcare.Gov

So, how likely is HC.gov to reach last year's total in the final week? Well...not very likely, but let's do the math anyway. Again, this is for the 39 states hosted by HC.gov only; it does NOT include the 12 state-based exchanges, which are mostly AHEAD of last year so far.

  • Last year, 8,743,642 people selected QHPs via HC.gov total:
    •  4,580,782 actively re-enrolled
    • 1,702,429 were auto-reenrolled
    • 2,460,431 were new enrollees
  • Of those 8.74 million total, there are likely around 6.16 million currently enrolled as of December
  • Last year, 97% of those still enrolled as of December re-enrolled (actively or passively). If that holds true this year, that'll be around 5.97 million total renewals
  • That means HC.gov would need 2.77 million new enrollees total

So, where did things stand as of 12/08?

Right alongside the 2019 Public Use Files being posted, HealthCare.Gov is now open for people to window shop for 2019 ACA individual market healthcare policies.

Remember, HC.gov only hosts the ACA marketplace for 39 states; 12 states operate their own marketplace websites, and most of those have been open for window shopping for several weeks now. In fact, Covered California has allowed people to actually sign up for 2019 since October 15th.

Fire up the Wayback Machine, Peabody, and take us to September 2015:

AP's NEW "HC.gov Security Flaws" story attacks problems FIXED UP TO A YEAR AGO.

Last night I posted what seemed, at first, to be a merely-amusing (if a bit depressing) story about a Florida news station website accidentally (?) reposting a year-old AP newswire story about potential security vulnerabilities at Healthcare.Gov:

"Critical" flaw found in HealthCare.gov security

WASHINGTON -- The government's own watchdogs tried to hack into HealthCare.gov earlier this year and found what they termed a critical vulnerability - but also came away with respect for some of the health insurance site's security features.

Those are among the conclusions of a report released Tuesday by the Health and Human Services Department inspector general, who focuses on health care fraud.

PLEASE NOTE IMPORTANT UPDATES BELOW.

I just received the following from a healthcare broker, who I trust from past communication exchanges, who wishes to remain anonymous. I'm presenting it as sent, with the only changes being breaking it out into paragraphs for readability & with their state's identifying information removed.

Glossery:

According to this article from last May, the total budget for operating HealthCare.Gov, the federal ACA marketplace/exchange which covers 39 states,was around $2.1 billion in 2016. Donald Trump proposed slashing the budget down by about 20% to $1.7 billion in 2017.

Where does that money come from? Well, HealthCare.Gov, the federal ACA marketplace/exchange which covers 39 states, is not funded out of the general federal budget. Instead, it's funded by assessing a 3.5% premium surcharge on policies sold on it.

OK, that's not quite true; the 3.5% only applies to the 34 states which are fully operated by the federal exchange; there are 5 states (Arkansas, Kentucky, Nevada, New Mexico and Oregon) which have their own exchange operations but "piggyback" on HC.gov's technical platform; those states were charged just 1.5% of premiums in 2017 and 2.0% for 2018. However, those 5 states combined only make up around 5% of all HC.gov enrollments, so the lower fees only knock perhaps 2% off the total user fee revenue.

UPDATE: OK, it looks like the big HealthCare.Gov Final Surge Report is gonna be released sometime Thursday morning. Unfortunately, I have a can't-miss meeting in the morning as well, so there's a good chance that after sitting at my desk and constantly refreshing/checking email all day today, I may ironically end up missing the big reveal and not being able to post about it for an hour or so after it comes out.

UPDATE 12/21/17: As of 2:00pm, still nothing. Speculation now brewing that they may be hoping to bury the report at 4:59pm on the Friday before Christmas. Hoping to be proven wrong.

UPDATE 2:35pm: h/t to Adam Sacarny for the head's up:

Exchange open enrollment for 2018 coverage ended w/ approx 8.8M people enrolling in coverage. Great job to the @CMSGov team for the work you did to make this the smoothest experience for consumers to date. We take pride in providing great customer service.

OK, here it is: OE5 data for HealthCare.Gov for the 2nd-to-last week:

UPDATE: Minor updates out of New York and Washington State added later today have nudged the official national QHP selection tally over the 7.0 million mark. All numbers below have been updated to include these additions.

UPDATE 12/14/17: With the latest update from California, the confirmed national QHP selection total has now officially broken 7.1 million.

Week 6, Dec 3- Dec 9, 2017

In week six of Open Enrollment for 2018, 1,073,921 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday.

Anyone who's followed me either here at ACASignups.net or over at Twitter over the past eight months knows that no one has been sounding the alarm louder or more frequently than me about both the real and potential sabotage of the ACA being carried out (or at least attempted) by the GOP in general and Donald Trump/Tom Price specifically. Hell, back in July, I even warned of a half-dozen things to look out for, several of which have since already been proven true:

This brings me to the main point of this entry: This is likely just the beginning. I'm not going to say that any or all of the following will happen--it's possible that Trump/Price/Verma will show some level of restraint--but I wouldn't be at all surprised to see any or all of these happen during this fall's Open Enrollment Period (which runs from Nov. 1st - Dec. 15th, by the way):

NOTE: The original focus of this diary was on the deliberate sabotage by the Trump Administration/HHS Dept. under Tom Price of the individual insurance market in general and HealthCare.Gov in particular, but the screen shot mentioned in passing in the diary below is actually far more important and disturbing the more I think about it than I had originally thought.

As noted below, it's an anonymous note sent to me on Thursday. Since it was sent I’ve confirmed the identity of the sender. This doesn’t prove that their specific claim is true, but there’s absolutely no reason I can think of for this person to risk their job and reputation by lying about this issue, and it matches everything else in the diary.

Several professional journalists have since contacted me and I’ve gotten them in touch with the sender. Stay tuned, this could be a big deal.

via Gawker, November 2013:

Only Six People Signed Up on Healthcare.gov's First Day

UPDATE 2/07/17: Over at Balloon Juice, David Anderson (aka 'Richard Mayhew') tackled the "last-minute sabotage" issue from a completely different angle, using actual statistical analysis methodology (remember, I'm not a statistician regardless of what everyone thinks)...and came to the exact same conclusion I did:

2017 using my known flawed data was running .96% behind 2016 on the January 14th inclusive update.  2017 ended up running 5.25% behind 2016 on Healthcare.gov states.  The increment (using favorable to the null hypothesis data) slowdown in pace that can be attributed to Trump Administration actions is 5.25-.96 or 4.29% of enrollment was lost due to the executive order and other Trump administration actions such as shutting down some outreach and advertising in the last eleven days of enrollment.

IMPORTANT UPDATE:

I've received confirmation from CMS that this "in line by midnight" grace period ONLY applies to those who CALL THE FEDERAL EXCHANGE at 1-800-318-2596​ and LEAVE THEIR CONTACT INFORMATION.

In other words, it does NOT appear to apply to those who are using the website application/enrollment process only; you have to CALL HC.gov and leave your number to qualify.

Every Open Enrollment Period to date, most of the ACA exchanges have ended up offering some sort of deadline extension and/or "in line by midnight" overtime grace period to allow people who started the enrollment process by the deadline additional time to wrap up their paperwork and complete the process.

Each year, this overtime period has shrunk:

OK, for the first time this Open Enrollment Period, my expections were off base...significantly. The past two years, HHS was posting "weekly snapshot" reports of enrollments at the federal exchange (HC.gov). This year they switched to 2-week reports, but today they decided to issue a special "week-plus" version which covers enrollments through the (extended) 12/19 deadline for coverage starting January 1st.

As I noted last Friday, based on the massive surge in enrollments (a record-breaking 670,000 people) on the final original deadline day (12/15), I bumped up my estimates for the 4-day extension period from my original 6 million or so up to an even 7 million (assuming 250K/day). However, I later realized that two of those days fell over the weekend, when enrollments drop off substantially (and since the original deadline had already passed, even the extended deadline wouldn't make much difference weekend-wise). I pulled back my projection somewhat to 6.75 million.

However, it turns out I was still overestimating, although the numbers are still pretty impressive:

On Wednesday, CMS's Week 5/6 Snapshot report confirmed 4,015,709 QHP selections via the federal exchange (HC.gov), but also noted that "over 700,000" additional ACA enrollments came in on Monday and Tuesday. About an hour ago, President Obama confirmed a 1-day record-breaking 670,000 people signed up yesterday alone. A press release from the HHS Dept. was also just released stating:

  • On Monday, over 325,000 Americans selected plans on HealthCare.gov. On Tuesday, over 380,000 Americans selected plans on HealthCare.gov. This marked two of the biggest days in HealthCare.gov history.

Unfortunately, there's no hard numbers for Sunday or Wednesday, but I have a pretty good idea where they fell:

Some guy, 5:12pm last night:

So, how about my projections? Well, for today specifically (12/15), I've been assuming roughly 700,000 QHP selections nationally (540K via HC.gov plus 160K via the dozen state exchanges), bringing the cumulative total up to 7.70 million nationally.

HC.gov's one-day enrollment record was set exactly a year ago today (12/15/15), when they enrolled 600,000 people in a single 24-hour period. I've been assuming that fewer people would enroll today specifically this year, if only because so many current enrollees have been actively renewing earlier than in the past; I figured this would've taken some of the heat off of the final day, so I knocked 10% off of the top.

Instead, it looks like I may have underestimated today's haul. The federal exchange could conceivably hit 700K today, and the national tally could potentially hit 800K or so. Then again, if they announce a deadline extension, some of that might spill over into the weekend.

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