The Center for Medicare and Medicaid Services (CMS) released the final initial count of enrollments for Healthcare.gov’s open enrollment period last night.
|HealthCare.gov Platform Snapshot||Week 7: Dec 9 – Dec 15||Cumulative: Nov 1-Dec 15|
|Consumers Renewing Coverage||3,403,802||6,429,271|
|Consumers on Applications Submitted||4,291,903|
Total plans purchased went down by 368,000 before the data gets cleaned up. Assuming this year looks like most other years, I expect to lose a net 50,000-100,000 more enrollments after files are reconciled. Charles Gaba has a very helpful chart that lays out the details year over year:
There are two things to note that I think tell the stories of enrollment. I am speculating wildly with little to no direct evidence but I think I have reasonably well grounded intuition.
The first story is that the renewals went up by a minuscule amount. We know that more people are being exposed to Silver Loaded and Silver Gapped deals due to Cost Sharing Reduction (CSR) subsidies having been terminated and baked into the premium structures. This is not uniform. It was a plus in North Carolina and Iowa but a big minus in Philadelphia and Phoenix.
Pricing for subsidized folks was an enrollment driver:
More states are silver-loading. Colorado and Delaware shifted from a broad-load of CSRs, meaning that CSR costs were incorporated into the premiums for all plans, to a silver load of CSR costs. North Dakota and Vermont are incorporating CSR costs into premiums for the first time. These steps will increase the value proposition for subsidized buyers.
The other story is to look at the new enrollees. This year saw a 15% decline in new enrollees.
I think this is a sign that the repeal of the individual mandate as well as increased focus on expanding eligibility for underwritten plans is working as expected.
I am speculating wildly right now.
I think that once someone shows up on Healthcare.gov, the odds of converting an account creation or even a windowshopping moment into a plan purchase is as high if not higher this year than in past years. The pricing due to CSR termination creates a lot of high value proposition deals. However the odds of someone who is potentially in the individual market for health insurance actually going to Healthcare.gov is lower this year than in prior years.
That is speculation. I think it is reasonable speculation but it is not evidence based (yet).
Overall, given the environment, this is a surprisingly strong end of the open enrollment period enrollment report for Healthcare.gov.