Old n' Busted: 22M ACA enrollments; New Hotness: 23M+?

In mid-December, I posted an update to my 2024 ACA Open Enrollment Period projections in which I upgraded my prior estimate of 18.5 million QHPs + BHPs combined to more than 19 million total.

A few days later, based on a press release from the Centers for Medicare & Medicaid Services (CMS) announcing over 15.3 million QHPs via the federal exchange alone, I updated my projection significantly more, to around 20.7 million QHPs (Qualified Health Plans) and 1.3 million BHPs (Basic Health Plans), or roughly 22 million total.

CMS's press release states that they won't be posting the next detailed/state-by-state enrollment breakout until January 10th, so aside from a handful of minor SBM updates here and there, there hasn't been much to report on the enrollment front since then...until this:

Excited to share that @healthsherpas has now enrolled over 7 million lives for Plan Year 2024, with over 62% of people paying nothing for coverage!

— George Kalogeropoulos (@GeorgeK_HS) January 4, 2024

As I've noted before, Health Sherpa (full disclosure: they're a sponsor of this site) is by far the largest Enhanced Direct Enrollment (EDE) partner for the ACA's federal health insurance marketplace. Between them and their affiliates/partners, they enroll a huge portion of ACA enrollees every Open Enrollment Period (OEP)...and in fact in their last blog post they said they had enrolled 6.1 million people so far this OEP out of the 15.3 million total noted by CMS, or around 40% of all federal exchange enrollees as of 12/15/23.

Now their CEO says that another 900,000+ people have enrolled via Sherpa & their affiliates since the initial December 15th deadline.

If accurate (and assuming a nominal number of last-minute cancellations/terminations), this means that at least 16.2 million people have selected QHPs via the federal ACA exchange...and that's only if every single one of them did so via Health Sherpa. Obviously that isn't the case; assuming the same 40% portion noted above, that would mean over 2.25 million additional enrollees since 12/15...and even that still doesn't include the 4.6 million additional enrollees I've confirmed to date via the 19 state-based ACA exchanges. That's somewhere between 20.8M - 22.1M QHP selections to date.

Add to this the 1.3 million BHP enrollees in Minnesota & New York (I've confirmed this via both states latest enrollment reports) and the range is between 22.1M - 23.4M QHPs + BHPs combined.

And again, that still doesn't include most of the state-based exchange enrollees since mid to late December, nor does it include any of the additional enrollees in any state from now through the end of Open Enrollment, which ranges anywhere from January 15th to January 31st depending on the state.

How many could that be? Well, last year 577,000 additional people enrolled nationally between January 1st & 31st...and again. Throw in the assorted missing state exchange data from December and it's at least 600K.

In short, using Sherpa's 7M figure and their historic proportional market share as a guide, we could now be looking at anywhere from 21.4 - 22.7 million QHPs, for a grand total of somewhere between 22.7 - 24.0M QHPs+BHPs combined by the time the dust settles in every state on January 1st. I'll stick with 23M for the moment just in case...