Now that we have a couple of weeks worth of hard enrollment data under our belt, it's time to start trying to break the numbers out by state and category (that is, Active Renewals, Auto-Renewals and most importantly new Enrollees). This is trickier than it sounds for several reasons:
HealthCare.Gov hasn't started breaking out their numbers across the 39 states which utilize their platform yet. For them, I had to base my estimates on what portion of the 39-state total each state had in the first 12 days last year (via CMS's Public Use File). I'm assuming the ratios within HC.gov are roughly the same this year.
Five of the state-based exchanges haven't released any enrollment data yet (CO, DC, ID, NY and VT)
The other seven state-based exchanges have released some hard data, but none of their thru-dates match up with the federal exchange (11/11).
Even then, some state exchanges have only released the number of new enrollees, not renewals (CA, WA and--I think--MD), while others have already baked in passive/auto-renewals (MN, RI), which means their renewal numbers may actually decrease over time as some who were auto-renewed already change their minds.
In addition, in those states which included auto-renewals (MN, RI), I don't know the breakout between active and passive renewal, so I had to take a guess.
With all that in mind, here's where things stand to the best of my calculations. Again, while the subsets within each category are estimates, the totals include confirmed QHP selections only. I suspect the actual total to date is well over 3 million as of 11/15/17:
More than 91,000 Minnesotans have Enrolled in Private Health Plans through MNsure for 2018
November 15, 2017
ST. PAUL, Minn.—Today, MNsure announced 91,623 Minnesotans have enrolled in private health plan coverage for 2018 through MNsure.
The numbers reported include new consumers, renewing consumers who have come back and shopped for a new plan for 2018, and renewing consumers who are continuing their previous plan for 2018.
"Our first two weeks have gone very smoothly," said CEO Allison O'Toole. "MNsure's enrollment is looking strong out of the gate. This year, we renewed twice as many people into coverage than last year, and we're also seeing a steady stream of new consumers."
As I've been saying for months now, trying to predict not just the final number but the pattern of enrollments in ACA exchange policies for the 2018 Open Enrollment Period is a fool's errand given all the batcrap insanity surrounding the ACA this go around; this would be the case even without the actual enrollment period being slashed in half.
Things were looking pretty dicey for two of Montana's three insurance carriers participating on the individual market the past few days. One of the three, Blue Cross Blue Shield, saw the writing on the wall regarding Cost Sharing Reductions (CSR) likely being cut off and filed a hefty 23% rate hike request with the state insurance department. The other two, however (PacificSource and the Montana Health Co-Op, one of a handful of ACA-created cooperatives stll around), assumed that the CSR payments would still be around next year and only filed single-digit rate increases.
I'm not going to speculate as to the reasons why they both did so when it was patently obvious that having the CSRs cut off was a distinct possibility, although I seem to recall the CEO of the Montana Co-Op said something about their hands being tied since CSR reimbursement payments are legally required, after all. Basically, it sounds like he was genuinely trying to avoid passing on any more additional costs to their enrollees than they had to.
HealthSherpa is a California-based technology company focused on connecting individuals with health coverage. The site was initially developed as an alternative to research plans from Healthcare.gov, and now provides individual health, dental and vision benefits to both part-time employees and retirees. As of February 2017, over 800,000 people have been enrolled in individual health coverage through HealthSherpa.
First, I want to clarify that I'm not shilling for HealthSherpa here. They aren't paying me for this post. I have no idea whether their customer service is awesome or sucks or anything like that.
Having said that, they are a pretty good resource for getting a feel for what the big picture situation is regarding open enrollment trends each year, and they have provided me with some internal data which they've OK'd me to share publicly.
It's important to note that all of the data here refers to exchange-based enrollments only. They reiterated to me that their individual market enrollments are on-exchange only:
However, what you're looking at is, in fact, a visual breakout of the state-by-state proportions of total Qualified Health Plan selections on the ACA exchange throughout the 2017 Open Enrollment Period, which ran from Nov. 1, 2016 - Jan. 31, 2017. The data comes from the official Public Use Files from the Centers for Medicare and Medicaid. As you can see, most states follow a fairly obvious trend because 39 of them are run through the federal exchange at HealthCare.Gov.
Since all 39 are administered, entered into the system and reported the same way, the only variances between them are their relative population size: Large states are thicker, small states are thinner throughout the entire enrollment period as you'd expect.
UPDATE: To clarify, just like with Covered California's "6,000 on day one" notice, Washington State's 4,550 new enrollees in 8 days don't include renewals/re-enrollments of current enrollees. Last year WA had 10,265 QHP selections total in the first 5 days and 21,665 in the first 12, so assuming a similar number of renewals each year, their total 8-day tally this year is likely around 13,000 + 4,550 = 17,500)
Every year, I painstakingly patch together Open Enrollment Period data from both the weekly (or bi-weekly, last year) snapshot reports for HealthCare.Gov as well as the dozen or so state-based exchanges to compile The Graph. Usually it's kind of bumpy and scattershot because the numbers for some of the state exchanges are released at (and through) seemingly random times. This means that the curve of the graph is usually a bit bumpy and skewed as I try my best to catch up.
Then, at some point the following year, CMS always compiles the data and posts it to a Public Use File (PUF) in a much more comprehensive, organized fashion. I knew this, and have used the PUF for prior years many times to analyze different demographics (income, age, metal level, financial aid, etc).
HOWEVER, what I didn't realize until tonight is that the same PUF also breaks out the enrollments by week in a nice, even fashion. This allowed me to more accurately recompile the enrollment graphs for both 2016 and 2017 at both the federal (HC.gov) and national (HC.gov + SBMs) level.
Weekly Enrollment Snapshot: Week One: Week 1, Nov 1-4, 2017
In week one of Open Enrollment for 2018, 601,462 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. Consequently, week one was only four days long this year - from Wednesday to Saturday.
Every week during Open Enrollment, the Centers for Medicare and Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchanges, the State Partnership Exchanges, and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.
ALBANY, NY (November 8, 2017) – NY State of Health, the state’s official health plan Marketplace, today announced a new partnership with ride sharing companies Lyft and Uber. Through the partnership, Lyft and Uber will reach more than 200,000 drivers throughout New York State urging them to visit the Marketplace to shop for and enroll in quality, affordable health insurance. NY State of Health will work directly with Lyft and Uber to promote coverage options and enrollment opportunities for drivers through an email campaign, In-App notifications and in-person education on coverage options.
...Statewide, in fact, growth is up 100 percent since last year, according to Betsy Plunkett, a deputy director for the Maryland Health Benefit Exchange. First-time enrollment is up 15 percent, with changes to existing plans up 270 percent. Overall, 10,420 people enrolled in the first week compared to 5,212 in 2016, she said.
In Rhode Island, enrollment this year is five times higher in the first week than it was last year, said Zach Sherman, the director of HealthSource R.I. An early outreach campaign by the state seems to have paid off with more than 500 people enrolling, compared to 109 people in the first week last year.
I've received a hard number direct from the exchange: It's actually 604 new enrollees through 11/07, versus 126 new enrollees in the first 7 days last year.
"We realize it's a shorter period so we have to get people in the door quicker," said Andrew Ratner, chief marketing officer for Maryland Health Benefit Exchange, which runs the marketplace.
Sign-ups have been brisk so far, with more than 5,000 people picking plans in the first two days, nearly twice as many as last year. The Maryland Health Connection website, which usually closes at 11 p.m., had to stay open an hour later on Wednesday because 300 people were still online. Maryland currently has about 120,000 Obamacare enrollees.