END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

OE5

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.

Having said that, the 2nd Weekly Snapshot Enrollment Report for HealthCare.Gov came out this morning and the enrollment period continues to defy expectations:

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:

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.

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.

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.

Press release from MNsure, Minnesota's ACA exchange:

MNsure update on first week of open enrollment

ST. PAUL—MNsure CEO, Allison O’Toole, issued the following statement recapping the first full week of open enrollment:

“The first seven days of this year’s open enrollment period have gone smoothly. We are off to a strong start and doing a steady business of enrolling Minnesotans in health care coverage. Market disruptions last year— including a large jump in premiums, a major carrier pulling out of the market, the first year of enrollment caps as well as other factors—drove large numbers of consumers to our doors in the first few days of last year’s enrollment period. This year, we are seeing a much steadier flow of traffic to the website that is more in line with what we would expect. Call wait times have been consistently low throughout this first week.”

This year, MNsure renewed more people into coverage than ever before. Open enrollment figures will be released next Wednesday at MNsure’s public board meeting.

Over the past week or so I've seen or been sent several screen shots along these lines:

My plan went from $1500/mo to $2500/mo. $30,000/yr before copays and deductibles. Very affordable stuff.... pic.twitter.com/uurZFVDw7T

— Mark Gallagher (@MJGRealtor) November 1, 2017

If you click on the image to see the full-size version, the key part is this:

Your new premium:

(sigh) OK, I wasn't planning on doing week-by-week estimates/projections given how batcrap insane this Open Enrollment Period is (not just in terms of the sabotage efforts and repeal lunacy, but also due to the time window being slashed in half for most states). In the end, however, my inner data geek got the better of me, so here we are.

Today is November 7th. The 2018 Open Enrollment Period's first week ends at midnight tonight. Here's what we know so far:

UPDATE: A couple more state numbers have come in this afternoon:

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