Near-Doubling my Week One Estimate: 410K as of 11/21/14

I've been thinking about this a lot over the weekend. My prior estimate of QHP enrollments through the first week of the 2015 Open Enrollment period (enrollments being defined as "number of covered lives via plans selected, whether the first premium has been paid yet or not") stood at 212,000 "or more". I included the "or more" because some of the state data was not only partial, but only covered a single insurance company within that state. In addition, in some cases the data I have only covers renewals or new enrollments as opposed to both.

Of course, my assumption is still that the vast majority of renewals will come via auto-renewal, which wouldn't actually happen until after December 15th (I'm not sure if the official records at HC.gov and most state exchanges will suddenly jump up dramatically, or if they'll be grouped separately or what). However, the early data out of Vermont, at least--where over 3,000 people out of less than 38,000 total last year have already renewed--suggests that a lot of people are getting their renewals out of the way early after all (presumably to scratch it off the list before Thanksgiving?)

As for the "single company in a state" factor, 3 states now fall into that category: Illinois, Nevada and Oregon. Illinois has 8 companies operating on their exchange...and the one I have data for so far, Land of Lincoln, is a pretty small player. Nevada only has 4 companies, of which the CO-OP I have info for has around 1/3 of the total share for the state. Finally, the CO-OP in Oregon only had a tiny fraction of the state-wide exchange market last year, but is off to a great start so far this time around.

I should also reiterate that all enrollments in not only Oregon and Nevada, but Maryland, Massachusetts and Rhode Island as well, are technically "new" as opposed to renewals, due to the technical overhauls of the first 4 and a policy decision by the last one. Again, this doesn't mean that the totals in these states will be any higher, but it does make them more likely to "front load" enrollments as opposed to waiting until the 15th to automatically renew, since there won't be any auto-renewals in these states.

In other words, even if these 5 states don't end up getting a single new person and only "re-enroll" say, 90% of their existing numbers, that should still mean a good 200,000+ will have to renew manually between 11/15/14 - 12/15/14 or lose their coverage. Many of them will wait until close to the 15th just like the other 45 states +DC, of course, but that still makes it more likely that there's been an early "mini-surge" as well.

With all of the above in mind, I'm raising my Week One estimate from 212K up to 410,000 QHP enrollments as of 11/21/14.

I should stress, again, that none of this changes my total projection of around 12.0 million QHPs by 2/15/15, just the distribution of those enrollments throughout the 3 month period.