January 10th was the last time that the Centers for Medicare & Medicaid Services (CMS) issued a detailed 2022 Open Enrollment Snapshot report which broke out 2022 ACA enrollment across every state.
As of 1/10/22, it had already reached an all-time record of nearly 14.9 million people (13.8 million via Qualified Health Plans, or QHPs, and another million or so who have enrolled in Basic Health Plans (BHPs) in Minnesota and New York specifically).
A few days later, CMS issued another update just ahead of the official January 15th OEP deadline (in most states) which updated the top line QHP tally to over 14.2 million. They broke this out by "over 10 million" enrollees on the federal exchange (HealthCare.Gov), plus another 4.2 million or more in the 18 states which operate their own ACA exchanges.
Tack on the 1.0M BHPs and that's at least 15.2 million nationally.
On Monday morning, the Centers for Medicare & Medicaid Services (CMS) reported that total 2022 ACA Open Enrollment had reached an all-time high of 13.8 mllion people selecting Qualified Health Plans (QHPs) via the federal & state-based ACA exchanges. In addition, over a million more Americans had enrolled in the ACA's "Basic Health Plan" (BHP) programs in Minnesota & New York. Combined, this means that the 2022 ACA Open Enrollment Period (OEP) had enrolled nearly 14.9 million people as of late December.
In my blog post/analysis about this report, I concluded:
The big question now is how many more new enrollees will be added by January 15th (final deadline in 44 states), January 23rd (Massachusetts) or January 31st (CA, DC, NJ, NY & RI)? (Idaho is the only state which had their final deadline for 2022 Open Enrollment back in December).
The Centers for Medicare & Medicaid Services (CMS) reports that 13.8 million Americans have signed up for or were automatically re-enrolled in 2022 individual market health insurance coverage through the Marketplaces since the start of the 2022 Marketplace Open Enrollment Period (OEP) on November 1. This includes 9.7 million plan selections in the 33 states using the HealthCare.gov for the 2022 plan year, through December 15, 2021, the deadline for January 1 coverage.
That would put the national final QHP total at somewhere between 12.9 - 13.2 million people nationally as of January 31st, 2022; call it around 13.1 million.
...I completely forgot to mention BASIC HEALTH PLAN (BHP) enrollment in New York and Minnesota. It totalled 975,337 people during the 2021 OEP (883,451 in New York, 91,886 in Minnesota)...I'm willing to bet total BHP enrollment across both states will end up perhaps 10% higher year over year, which would put it at around 1.1 million.
When you add that to my QHP projection above, you get a grand total of perhaps 14.1 million QHPs + BHPs combined.
If this projection had proven accurate, it would have meant total ACA exchange enrollment was up ~9 - 10% year over year, which would have been impressive but not stellar.
Now that we have two weeks worth of 2022 Open Enrollment data under our belt (well...for 33 states, anyway), I thought this would be a good time for me to try and put together a spitball estimate of how many Americans are likely to enroll in ACA exchange coverage during the 2022 Open Enrollment Period (OEP).
There's really two main numbers to try and project: How many current enrollees will renew/re-enroll for 2022 (whether actively or automatically); and how many new enrollees will jump into the ACA exchanges?
For each of these, due to how the data is reported, I have to further break the states out between those using the federal ACA exchange (HealthCare.Gov) and those which operate their own state-based ACA exchanges (Covered California, NY State of Health, etc.) This is further complicated by the fact that three states (Kentucky, Maine and New Mexico) switched from the federal exchange to their own state-based exchange starting with the 2022 OEP.
It's been nearly a month since I posted my final estimate of the official national and state-level tally for the 2021 Open Enrollment Period (OEP). At the time, I pegged the final total at just barely over 12.0 million QHP selections nationally...the first time an ACA OEP had hit that threshold since the end of the Obama Administration (this seems fitting for obvious reasons).
Earlier today, the Centers for Medicare & Medicaid (CMS) issued the official 2021 OEP report, as well as the accompanying Public Use Files (PUFs) which break the data out in all sorts of ways. Let's dig in!
A couple of weeks ago, I used the COVID Special Enrollment Period (SEP) data I had for HealthCare.Gov through the end of March, combined with limited SEP data from some state-based ACA exchanges, to extrapolate out a rough estimate of how many new Qualified Health Plan (QHP) selections may have happened since the new "Spring 2021 Special Enrollment Period" was launched on February 15th, 2021.
At the time, I estimated that perhaps 15,800 people per day on average had newly enrolled in ACA exchange policies as of the end of March, or roughly 710,000 nationally. This included the 528,000 confirmed enrollees via HealthCare.Gov, plus another 183,000 or so via the 15 state-based exchanges.
A couple of weeks ago, I used the limited COVID Special Enrollment Period (SEP) data I had for HealthCare.Gov from the last two weeks of February, plus some limited SEP data from a handful of state-based ACA exchanges, to extrapolate out a rough estimate of how many new Qualified Health Plan (QHP) selections may have happened nationally.
At the time, I estimated that perhaps 18,500 people were enrolling per day nationally the final two weeks of February, and that IF that pace remained the same throughout the entire month of March, it would amount to upwards of 832,000 new people enrolling by the end of March (666,000 via HealthCare.Gov, plus another 166,000 via the 15 state-based exchanges).
It's important to note that this wasn't a hard estimate--I was pretty sure that the actual enrollment pace would slow down somewhat after the inital surge, at least until expanded subsidies via the American Rescue Plan (ARP) were officially available in most states, which didn't happen until April 1st.
UPDATE 3/16/21:Health Source Rhode Island just released their 2021 OEP report as well; they ended up down around 8% y/y. With that, I now have either the final official enrollment numbers or at least close approximations for all 50 states + DC. The table, graph and text below have been updated accordingly.
With New York State of Health releasing their 2021 Open Enrollment Report data (w/some caveats), I now have official (or semi-official) enrollment data for 49 states and the District of Columbia. The odd man out is Rhode Island...which also happens to be one of the smallest states with the smallest number of ACA enrollments; last year they enrolled around 34,600 people.
There's a few caveats:
New York's QHP tally included enrollments through 2/28; the official CMS report will likely cut them off as of 1/31.
The numbers for DC, Idaho, Rhode Island and Vermont are estimates...it's possible that the official numbers for each will be slightly lower.
At the very worst, the official CMS 2021 OEP report will come in at something like 11.98 million or so.
UPDATE 3/16/21: With Rhode Island added, the semi-official tally comes in at just over 12.0 million (12,005,270 QHP selections total). Again, it could drop slightly below that if my estimates for a handful of states are off, but it should be damned close to it.
At the time, HealthCare.Gov had reported 206,000 Qualified Health Plan (QHP) selections as of February 28th. I also had some partial COVID SEP data from a handful of the state-based ACA exchanges, as of various dates. I had 225,000 QHPs confirmed nationally.
At the time, I concluded that based on the enrollment pace of the first few weeks...
As noted above, Medicaid expansion states have only increased average SEP enrollment by around 2/3 as much as Non-expansion states. Since all 15 state-based exchanges have expanded Medicaid, this suggests that the 206K via HC.gov probably represents more like 80% of the total, meaning perhaps 258,000 nationally (~168,000 more than average).
