END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

2018 Open Enrollment Quick Links


Me, just under a month ago:

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.

Here's the Wikipedia entry for HealthSherpa:

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:

Just taking a moment to pat myself on the back. Here's my final estimate of the average unsubsidized 2018 premium increases nationally, along with a rough breakout of the reasons for the increase:

With the 2018 Open Enrollment Period coming up just 5 days from now, it's time to put this to bed: After 6 months of painstaking research and analysis, I've compiled a comprehensive analysis of the weighted average rate changes for unsubsidized ACA-compliant individual market policies in 2018, including both the on- and off-exchange markets. It's already been confirmed by a different analysis by healthcare consulting firm Avalere Health, which used a completely different methodology to arrive at the exact same conclusion: The national average increase is between 29-30%, ranging from as low as a 22% average premium drop in Alaska (thanks to their successful reinsurance program) to as high as a painful 58% increase in Virginia.

At first glance, the graph below strongly resembles the Pictured Rocks National Lakeshore attraction in Munising, Michigan, which my family visited over the summer. It's truly gorgeous.

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)

Washington Healthplanfinder Traffic, New Enrollment Surges In First Week

State’s online health insurance marketplace saw a 24 percent rise in site visits, more than 50 percent increase in new enrollees

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.

Working on this so check back frequently for updates...

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.

As I noted Wednesday morning, the Congressional Budget Office released an report with updated estimates of what they figure the budget and healthcare coverage impact of repealing the ACA's Individual Mandate Penalty would be over the next decade. Their conclusions?

The Results of CBO and JCT’s Analysis CBO and JCT estimate that repealing that mandate starting in 2019—and making no other changes to current law—would have the following effects:

New York State of Health posted this press release today...

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.

This is just an update to an existing Washington Post story, but it looks like the Maryland exchange is issuing near-daily updates (which is awesome in my view):

...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.

OK, that headline is a bit of clickbait, I admit.

Rhode Island is a tiny state, so any number change is gonna look pretty outsized, but this is still an eye-opener:

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.

 

...it's that the ~35% of the public who still support Donald Trump won't get the joke.

(sigh)

But..whatever. So be it. There's 38 days left for most states. Go to HealthCare.Gov and sign up today. 

Last July I posted:

Several regular commenters here at ACA Signups have been wondering why the Congressional Budget Office keeps using March 2016 as the "baseline" for projecting the net impact on healthcare coverage numbers under the GOP's Trumpcare bills (the House's AHCA and the Senate's BCRAP), as opposed to the more recent January 2017 baseline. After all, according to the March 2016 baseline, the CBO was projecting that under the ACA, the total individual market would have 25 million people as of 2026 (18 million on the exchanges plus another 7 million off-exchange), whereas under the January 2017 baseline, their projections are for the individual market to only be 20 million as of 2027 (13 million on the exchanges plus 7 million off-exchange). Taken at face value, this would seem to suggest a 5 million enrollee discrepancy. This drumbeat has been taken up more recently by GOP Senators, particularly Wisconsin Senator Ron Johnson.

As I noted a few days ago, Maryland was the first state to issue Day One numbers, and they were pretty impressive, a 70% increase year over year.

Well, apparently they've increased the pace since then:

"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.

...and again in Day Three:

via Juliet Eilperin of the Washington Post:

That same day in Connecticut [Wednesday, Nov. 1st], 1,596 residents enrolled in qualified health plans on the state exchange while another 2,293 people either completed Medicaid applications or determined that they were eligible for that program. Access Health CT CEO Jim Wadleigh said in a statement that the state’s call center and website experienced a 15 percent increase in volume compared to opening day last year.

Not much to add here; last year the first enrollment number I had for Connecticut didn't show up until halfway through November (about 16,000 selections in 15 days), but that doesn't give me much to compare with for the first day only. Still, the 15% traffic increase is a good thing.

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