November 16, 2017

Are this year's exchange enrollments setting a record pace—or lagging behind? It's complicated.

Daily Briefing

    Nearly 1.5 million U.S. residents signed up for health insurance through the federal exchange during the first 11 days of the current open enrollment season, according to CMS data released Wednesday.

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    The open enrollment period for the 2018 coverage year runs from Nov. 1 through Dec. 15—about half as long as previous open enrollment periods.

    In a break with past open enrollment periods, HHS did not project in advance how many U.S. residents would enroll in exchange coverage. S&P Global Ratings, however, projected between 10.6 million and 11.4 million U.S. residents will sign up for exchange plans during the current open enrollment period, representing a 7% to 13% decline from the 2017 open enrollment period.

    Sign-up data

    The data released Wednesday include sign-ups from Nov. 1 to Nov. 11 in the 39 states that use the federal exchange for enrollment. The data do not indicate whether individuals paid their first month's premiums, a step that effectively completes the enrollment process.

    CMS said that as of Nov. 11, 1,478,250 U.S. residents had selected a federal exchange plan. Of those individuals:

    • 345,719 were new customers; and
    • 1,132,531 were returning customers.

    According to CMS, 876,788 individuals signed up for coverage from Sunday, Nov. 5 to Saturday, Nov. 11, during the second week of open enrollment. 

    Meanwhile, CMS said the call center had received 1,284,263 calls as of Nov. 11. HealthCare.gov had seen more than 5,788,238 users, according to CMS.

    Discussion

    Observers have offered different interpretations of the enrollment tallies.

    Some observers have noted that federal exchange sign-ups during the first two enrollment weeks outpaced by about 500,000 the number of sign-ups during the same period last year.

    Politico reports that more people might be signing up because of a surge of attention around Republicans' efforts to repeal the Affordable Care Act this year. Kathy Hempstead, who oversees coverage programs at the Robert Wood Johnson Foundation, said, "All that negative publicity has been helpful."

    But Axios reports that comparing this year's weekly sign-up tallies to previous years' weekly sign-up tallies may be misleading. Since this open enrollment period is half the length of last year's, the country is already about one-third of the way through the enrollment period. 

    Caroline Pearson, senior vice president for policy and strategy at Avalere Health, said a more appropriate point of comparison would be the point at which last year's open enrollment period was one-third complete. By that standard, this year's numbers are actually about 25% lower than last year's, Axios reports.

    That said, Pearson noted that it ied thate president for policy and strategy at Avalere Health, said s difficult to make direct comparisons between open enrollment years while the open enrollment period is underway because sign-ups usually spike at the end (Hellmann, The Hill, 11/15; AP/Sacramento Bee, 11/15; CMS release, 11/15; Eilperin, "PowerPost," Washington Post, 11/15; Baker, "Vitals," Axios, 11/16; Demko, Politico, 11/15).

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