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.
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.
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.
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.
I've received confirmation from CMS that this "in line by midnight" grace period ONLY applies to those who CALL THE FEDERAL EXCHANGE at 1-800-318-2596and 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.
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:
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.
On September 26, 2013, just 5 days before the disastrous initial launch of HealthCare.Gov (as well as ugly rollouts of many of the state-based exchanges), President Obama gave a speech pumping up the impending start of the first Open Enrollment Period at Prince Geroge's Community College.
At one point in the speech, he touted how easy and handy the website would be to use:
Starting on Tuesday, every American can visit HealthCare.gov to find out what’s called the insurance marketplace for your state. Here in Maryland, I actually think it's called MarylandHealthConnection.gov. (Applause.) MarylandHealthConnection.gov. But if you go to HealthCare.gov, you can look and they'll tell you where to go. They'll link to your state.
Now, this is real simple. It’s a website where you can compare and purchase affordable health insurance plans, side-by-side, the same way you shop for a plane ticket on Kayak -- (laughter) -- same way you shop for a TV on Amazon. You just go on and you start looking, and here are all the options.
(note: I'm live updating as I type this stuff, so keep checking back, I'll be adding more updates/analysis over the next hour)
Wow! OK, I'm back from my kid's field trip (nature center; they learned about how animals handle the winter via hibernation, migration & adaptation...learned about fossils...went on the nature trail to look for animal tracks...and even dissected owl pellets, hooray!!). Of all the days to miss a major HHS/CMS conference call, this was a big one. I'm furiously poring over the HHS Dept's ASPE January Enrollment Report which, as I expected this morning, was just released less than two hours ago.
So what about this week? Well, it should play out very much the same: Practically all QHP selections going forward should be for new additions, and we have New Year's Eve and Day included. Sure enough, last year there were just 103K added to HC.gov from 12/27 - 01/02...slightly more than Christmas week.
Assuming this year follows a similar pattern, there should be roughly 80,000 people tacked onto the HC.gov total for Week 9, bringing the cumulative total up to just over 8.6 million.
If this does happen, then yes, I'll have to seriously re-evaluate my current 14.7 million OE3 projection...because that will suggest that the final 5 weeks are gonna play out a good 20% lower than my expectations.
And if that's the case, then instead of another 3.5 million new folks signing up, it'll only be around 2.8 million...bringing a grand total of right around 14.0 million even.
As expected, Week Eight was extremely quiet; not only did the entire week take place after the (extended) deadline for January coverage, but there was also Christmas Eve and Christmas Day to contend with. Needless to say, very few people feel like enrolling in healthcare coverage on December 24th or 25th.
Last year, just 96,000 people chose to do so between 12/20 - 12/26 in the 37 states covered by HC.gov. I was expecting slightly more this year (100K even), but only 74,000 did...26% fewer than the same week in 2014. Whatever else is going on, it's safe to say that the Open Enrollment Periods are starting to become more and more "front-loaded".