2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

When I posted Maryland's July enrollment update, I noted that the effectuated exchange-based QHP number had actually gone up slightly from April through July (from 125,535 to 126,346). Not much of an increase, of course, but the fact that this number increased at all was significant since it indicated that, as I expected, new additions to the exchange QHP pool thanks to the "life event" options are slightly outpacing those dropping their policies during the off-season.

Last week the MD HealthBenefit Exchange released their August report and, as I've also been expecting, the tide is now starting to turn, with "drop-outs" finally starting to outpace the new additions:

BALTIMORE (Aug. 18, 2015) -- As of Aug. 13th, 606,226 Marylanders have enrolled in quality, affordable health coverage for 2015 through Maryland’s state-based insurance marketplace.

Long-time readers (and anyone from Maryland, I presume) know that the Old Line State (I have no idea whether that nickname is actually widely used?) was among those whose 2014 ACA exchange website turned out to be a huge technical mess. Oregon and Nevada received most of the headlines because they both ended up scrapping theirs completely and moving home to HealthCare.Gov this year (to be followed by Hawaii in 2016), but along with Massachusetts, Maryland went the "Try, Try Again" route.

Not sure how this one got by me, but the Maryland Health Benefit Exchange actually released some updated enrollment numbers over a week ago:

Nearly a half-million Marylanders — 493,346 — have enrolled in quality, affordable health coverage through Maryland Health Connection for 2015.

That includes 126,346 people enrolled in private Qualified Health Plans and 367,000 enrolled in Medicaid from Nov. 15, 2014 through July 5, 2015. About 92 percent of enrollees through the state’s health insurance marketplace are receiving some form of financial assistance.

Medicaid enrollments are year-round. And while open enrollment for private health insurance for 2015 coverage ended in February, people may still enroll if they have a qualified “life event.”

The "92% receiving financial assistance" bit is slightly misleading; that's true, but only because the Medicaid enrollees are lumped in. If you're talking about QHPs only, it's more like 69% (87.2K out of 126.3K). Whether that's a good or bad thing obviously depends on your POV.

Maryland's rate request website is an exercise in frustration. At first glance, it looks very cut and dried: A full table of each health insurance company, broken out by either individual or small group market, whether the filing is for policies sold on or off the ACA exchange, and the "average % change requested", along with direct links to the actual filing documents (where, presumably, I can dig up the crucial enrollment numbers, which are vital to determining the weighted average rate requests).

Unfortunately, once you get into the actual documents...they're completely scattershot. Some companies list the number of enrollees who would be impacted by the requested rate changes; some don't. That makes it impossible to determine the market share, which in turn means there's no way of weighting the average.

Maryland is the second state to release their official, complete #ACATaxTime special enrollment period figures (Washington State ended their tax SEP on 4/17). Healthcare.Gov, DC Health Link and Covered California have released partial reports, while 3 states didn't offer the tax SEP at all, so this leaves 8 states which haven't given any #ACATaxTime numbers yet (Vermont has extended theirs even further, until the end of May).

For Maryland, here's the press release:

BALTIMORE (May 1, 2015) — More than 4,700 Marylanders took advantage of a special six week enrollment period that allowed them to enroll for health insurance to avoid an additional federal tax penalty for 2015 if they had already owed a tax penalty for lacking health coverage in 2014.

Marylanders who applied for the special enrollment period, which ran from March 15 through yesterday, attested that they owe the penalty for lacking health insurance in 2014 and that they became aware of this after the Feb. 15 close of open enrollment for 2015 coverage.

The Maryland Health Connection posted the following tweet at around noon Tuesday:

ALERT: Our call center has closed today due to the city disturbances. Find in-person help:

— MD Health Connection (@MarylandConnect) April 28, 2015

However, any impact on actual ACA enrollments should be nominal.

Maryland had 120,145 QHP selections during open enrollment. Assuming my combined #ACATaxTime + "normal" Off-Season enrollment rate estimate of roughly 10,500 people per day nationally (through Thursday the 30th, anyway) is accurate, MD's share of this should be roughly 1% of this, or around 108 people per day at the moment. Even then, only around 1/3 of the total would be specifically for the tax season special enrollment period (the others would presumably just be delayed by a few days).

Hmmm...the headline looks bad, but when you read further it's clearly a matter of perspective more than anything else:

Maryland's health insurance exchange improperly billed the federal government $28.4 million, a Department of Health and Human Services audit reported Friday.

An inspector general's probe found a lack of oversight and internal controls, not criminal wrongdoing, was the cause of the exchange's problems since the marketplace opened in 2013.

I'm expecting final official #OE2 enrollment reports from Massachusetts and Minnesota later today, but otherwise have to catch up on a bunch of my actual day job work. Here's three quick things to note:

MARYLAND: The Maryland Health Connection has released a big slideshow PDF with a mountain of demographic info. The only gripe I have is that it only runs through 2/15, so doesn't include the extra folks who signed up during the #ACAOvertime period. Data nerds, rejoice!!

This Just In from Maryland...


Special Enrollment Period will run March 15 through April 30

BALTIMORE (Feb. 25, 2015) — Maryland Health Connection is allowing consumers who owe a tax penalty for not having health coverage in 2014 to still enroll for 2015 coverage through a special enrollment period that will run March 15 through April 30.

Consumers who owe or have paid a tax penalty for not having coverage in 2014 would pay a higher penalty for this year if they also did not enroll for 2015. The open enrollment period to buy a Qualified Health Plan for 2015 ended Feb. 15.

The special enrollment period is for Marylanders who must pay the penalty for lacking health insurance in 2014 and who attest that they became aware of the penalty during this income tax filing season after the Feb. 15 close of open enrollment for 2015 coverage.

Holy Smokes.

264,000 Marylanders enrolled through Maryland Health Connection for 2015
Qualified Health Plan enrollments top 119,000
Enrollments “in the pipeline” can be completed by Feb. 28

264,245 Marylanders enrolled through Maryland Health Connection from Nov. 15, 2014 to Feb. 15, 2015. That includes 119,096 people enrolled in private Qualified Health Plans (QHP) and 145,149 enrolled in Medicaid.

Due to high demand during the final weekend of open enrollment, Maryland Health Benefit Exchange is allowing people who started an application at or contacted the call center by Feb. 15 to complete the process by Feb. 28. Figures for open enrollment will be revised after Feb . 28 to account for those completed enrollments.

Now that's a last-minute extension...


BALTIMORE (Feb. 15, 2015) — Due to high demand during this final weekend of open enrollment for 2015, Maryland Health Connection is allowing people to complete their enrollments until Feb. 28, 2015. Marylanders need to have started an enrollment application at or have contacted the call center at 855-642-8572 before midnight Sunday, Feb. 15 to be able to complete the process by Feb. 28.

After midnight Sunday, will include the message: "Open enrollment for 2015 has ended. If you began to enroll by the February 15 deadline but were not successful, please check the box below and you may go ahead and complete your enrollment. You must finish your enrollment no later than February 28. … [ ] I started an application or called the call center to enroll by the February 15 deadline but was not able to complete my enrollment.”

This is something of an exclusive: I've received official notice from the Maryland Health Connection exchange that as of last night, their enrollment totals stood at:

  • 107,586 QHP selections
  • 132,392 Medicaid/CHIP enrollees
  • 239,978  Total

How's this compare vs. prior weeks?

Not as dramatic of a surge as some other states, but then again, with today's update, Maryland is already 2% higher than my target number (105K), which was in turn 19% higher than the HHS Dept's target number (88K), which itself was 30% higher than their 2014 total (67,757).

A couple of weeks ago, Maryland blew past the HHS Dept's target for the state (88K QHPs) and hit 94K as of 1/22. I noted that they were on their way towards easily hitting my personal, higher target of 105K by 2/15.

In response, a few days ago I went through all 50 states (+DC) and adjusted my own projections, lowering them in 9 states while bumping them up in 26 others, including Maryland. I tacked another 10K onto MD to 115,000 QHP selections. (Note that I'm leaving my original projections in the actual spreadsheets to avoid confusion; the revisions are more just to confirm that I recognized where the trendlines would be and where my earlier logic fails were).

Just now, the MD exchange announced that they've already broken the 100K QHP mark:

A week or so ago, Maryland broke the official HHS target for 2015 (88K) with 91,137 QHP enrollments. Today, they're reporting:

As of Jan. 22, 185,199 Marylanders have enrolled in quality, affordable health coverage for calendar year 2015, since the 90-day open enrollment period began Nov. 15. That includes 93,806 people enrolled in private Qualified Health Plans (QHP) and 91,393 people enrolled in Medicaid.

As of Jan. 21, the total number of Medicaid and MCHP enrollment is 1,281,999. Compared to Dec. 31, 2013, the net change in Medicaid enrollment as of Jan. 21, 2015 is +241,337. This figure takes into account that individuals lose Medicaid coverage because of changes in household, age and income, as well as redeterminations.

OK, that's 2,669 in 11 days, or 242/day. This is down substantially from the prior week or so, but it includes the days leading up to and following the 1/15 deadline for February coverage (when they'd drop off again), so that doesn't really mean much.

TODAY, January 15th, is the deadline for anyone who wants to enroll in a private insurance policy for coverage starting on February 1st in most states (or to switch to a different policy if you have one but want to make a change starting in February).

After that, of course, we'll have the big February 15th deadline (for March 1st coverage), which will also be a big deal because it'll be the last chance many (not all) uninsured people have to get coverage before the door slams closed until next fall.

Remember, the penalty in 2016 for not having health insurance in 2015 is considerably higher than it was for 2014: Instead of 1% of your taxable income (or $95/person in your household, whichever is higher), the fee this year is 2% of your income or $325 per person.