Massachusetts: Over 264K QHP selections to date, up 4% year over year so far

I just received an official 2019 ACA Open Enrollment Period report from the Massachusetts Health Connector...

As of today, we have 254,177 enrolled for January 1. That is up about 10,000 from last year's 244,308 at the same date. When you include people with plans selected but not paid, we are at 264,118.

The high number is again explained by the fact that Massachusetts, like several other state-based exchanges, front-loads their auto-renewals. 254K / 244K = around a 4% increase year over year, which is solid and right in line with other state-based exchanges to date...while the federal exchange (HC.gov) continues to lag around 11% behind last year. On the other hand, HC.gov doesn't front-load auto-renewals, so it's a bit of an apples to oranges comparison.

Massachusetts is the one of only two states which handles ACA exchange policy premium payments themselves instead of letting the insurance carriers deal with it (the other state which does this is Rhode Island, I believe; Washington State did for the first three years of ACA Open Enrollment but stopped that a couple of years back). This means the MA exchange is one of only two who has real-time data on not just how many people select policies but how many actually pay their first monthly premium.

While the lower number is the one which really counts for purposes of calculating actual subsidies paid out by the federal government as well as the individual market risk pool, for purposes of "how many people signed up during Open Enrollment" it's still the larger number which counts, so that's the one I'm going with at the moment.

On the other hand, it is worth noting that Massachusetts is showing a remarkably high payment rate--over 96% of January enrollees have already paid their first premium over a month before the 2019 policies are effectuated! That's amazing. For comparison, the typical payment rate in 2014 was around 88% nationally, which has climbed to around 90% overall since then. Due to front-loading, some folks will inevitably go back in and cancel their policies before the dust settles...but with 96% of them having paid for January already, that number will likely be pretty small.

In any event, last year's final, official (paid) QHP selection total was 267,260 people as of 1/23/18, which means the Bay State is already 95% of the way to last year's tally with nearly two full months left to go.