So, my wife and I finally got around to renewing our own ACA exchange plan the other day (yes, I'm realize how ironic it is that I've spent the past 41 days screaming at everyone else to #GetCovered while waiting until the last week to do so myself. We're a bit busy this month. Don't @ me.)
Anyway, we went through a lot of research and discussion (including assistance from fantastic folks who know more about this stuff than me like Louise Norris and David Anderson) about whether to stick with our existing Gold HMO (we have some pricey issues to deal with) or to switch to a Bronze HMO...but with a Health Savings Account.
I know very little about HSAs, but Dave and Louise suggested I look into one so we did. In our particular case, we decided to stick with the Gold plan in the end for reasons I'd rather not get into...but along the way, while researching our actual 2018 medical claims and expenses, I noticed something rather important. See if you can figure out what it is:
Deadline to Apply for Health Insurance for the 2019 Plan Year is Dec. 15
Nine in 10 Idahoans Qualify for a Tax Credit to Help Lower Monthly Premiums
BOISE, Idaho – Idahoans wanting health insurance coverage starting on January 1, only have a few days left to enroll in a plan for 2019 with Your Health Idaho, the state’s health insurance exchange. Idahoans must complete their application by midnight, December 15 in order to have coverage at the start of the new year. In response to high demand, Your Health Idaho is extending its support center hours to help customers enroll or answer any questions.
Again, I realize that doesn't mean much of anything on its own; I haven't a clue what counts as "high demand" in Idaho or how it differs from prior years. Still, it does suggest that things are running smoothly at the Idaho exchange.
It's important to note that unlike most states, Minnesota's 2019 Open Enrollment Period doesn't end on the 15th (although you do have to sign up by then in order to have coverage start on January 1st); Minnesotans still have until January 13th to enroll (anyone who enrolls after 12/15 will have their coverage kick in on February 1st instead).
With major enrollment updates from California, New York, DC and Massachusetts and especially the Week 5 update from HC.gov all rolling in over the past couple of days, I thought this would be a good point to put it all together and see where things stand just ahead of the big final push (for most states).
Here's a state-by-state breakout of confirmed QHP selections. All 39 HC.gov states as well as New York are as of 12/01, while California, Colorado and Connecticut are all as of 11/30; Rhode Island and Washington State are as of 11/28. The outliers are DC and MN (11/13 and 11/14) and Massachusetts (thru 12/04). I don't have any enrollment data from Idaho, Maryland or Vermont as of yet.
When comparing the year over year numbers, I have not corrected the HC.gov states for the missing day below, but I did add a column noting how many days worth of data are missing in each state.
As you can see, all of the HC.gov states are running behind last year as of roughly the same point in time (Florida is slightly ahead if you adjust for the missing day). As a whole, the 39 HC.gov states are down 11.3% so far.
In week three of the 2019 Open Enrollment, 773,250 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. Consequently, the cumulative totals reported in this snapshot reflect one fewer day than last year.
Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated 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.
Press Release: NY State of Health Announces 2019 Enrollment is Up in First Month of Open Enrollment Period
Dec 5, 2018
More than 930,000 Consumers Enroll in a Qualified Health Plan or the Essential Plan
December 15 is the Deadline to Enroll for January 1, 2019 Coverage
ALBANY, N.Y. (December 5, 2018) - NY State of Health, the official health plan Marketplace, today announced in the first four weeks of the 2019 open enrollment period, enrollment is outpacing last year.More than 930,000 consumers have enrolled or renewed coverage in a Qualified Health Plan or the Essential Plan for 2019. Consumers must enroll or renew by December 15, for coverage beginning January 1, 2019.
Things weren't looking great as of two weeks in: Total enrollments were down 6.8% (1,202 people) year over year as of the same date. We'll have to see whether things have picked up since then.
As with most other state-based exchanges, the numbers for both years include auto-renewals, which means the vast bulk of 2019 enrollments are likely already baked in. Last year's final tally was 19,289; DC had already reached 85% of that as of 11/13.
DC's report also includes all sorts of wonky demographic breakout data, and even closes with currently effectuated numbers for both the individual and small business (SHOP) markets. Remember, DC's SHOP market is unusually high (especially compared to the individual market) because the ACA requires all members of Congress and their staff to enroll using it if they want their 72% FEHB subsidy.
I just received another official update from the MA Health Connector...
On enrollment, as of today, we have 261,619 enrolled members for January. We have an additional 14,368 plan selections made (but unpaid) for a total of 275,994 under the CMS definitions. New enrollments for 2019 continue to trend slightly ahead of last year.
A week or so ago I noted that Massachusetts had enrolled just over 264,000 people (10,000 of whom hadn't actually paid their January premium yet...MA's exchange is one of the only states which is able to actually track payment data live, since they handle it themselves). They were up 10K over the same date in 2017, or up around 4% year over year.
I don't have a hard "thru 12/05" number for 2017 this week, but they did confirm the 276K number is still "slightly ahead", which is good.
More than 90,500 new consumers selected a plan through Nov. 30.
While plan selections are ahead of the pace set in 2016, when Covered California also delayed its marketing until after Election Day, they are slightly behind the pace set during 2017.
Roughly 1.2 million Covered California enrollees have been renewed for 2019, similar to last year’s totals.
An estimated 1.1 million uninsured Californians are eligible to enroll in Covered California or Medi-Cal. New research shows that 82 percent of uninsured consumers surveyed, who are eligible for financial assistance, do not know that they qualify.
Consumers must sign up by Dec. 15 in order to have their health insurance start on Jan. 1, 2019. Open enrollment in California continues through Jan. 15.
DENVER — More than 46,000 Coloradans selected health coverage through Connect for Health Colorado® during November, a number 6 percent ahead of the pace one year ago, according to new data released today.
“We started with a strong month but there are now only 12 days left to get coverage in place for Jan. 1,” said Connect for Health Colorado® CEO Kevin Patterson. “It is time for Coloradans who buy their own health insurance to act to protect their health and their family finances.”
During November, Connect for Health Colorado customers made 46,332 medical plan selections. The total was 43,881 medical plan selections for the comparable period in 2017.Fifteen percent of the plan selections are by customers who are new to Connect for Health Colorado and 85 percent are renewing customers.
HARTFORD — Enrollment in Access Health CT is higher this year than it was last year at this time, but time is running out.
Officials said they’ve enrolled 9.685 customers who are new to the exchange this year, and they’ve auto-enrolled more than 91,000 customers who purchased plans with them in 2018. That brings total enrollment up to 101,054 individuals as of Nov. 30.
Last year, about 90,428 individuals had enrolled by this time.
A couple of weeks ago I reported that the Washington Health Benefit Exchange reported enrolling a seemingingly astonishing 190,000 people into 2019 policies in just the first 10 days of the 2019 Open Enrollment Period. This is highly misleading, of course, because only a small fraction of these are new enrollees, and a somewhat larger portion are current enrollees actively renewing their policies.
The vast bulk of that 190K are current enrollees who are auto-renewed into 2019 policies by the exchange itself...with the option to then actively go into the system and opt to cancel their renewals if they wish. There's nothing wrong with this, and in fact more and more of the state exchanges seem to be doing it this way as they improve and streamline their software (I've confirmed that Maryland, Massachusetts, Minnesota, Rhode Island and Washington State are "front-loading" autorenewals this year, although Maryland hasn't actually reported their data yet).