The Centers for Medicare & Medicaid Services (CMS) today released the Health Insurance Exchanges 2019 Open Enrollment Report. With the Trump Administration’s focus on making healthcare more affordable, the report confirms another successful open enrollment period coinciding with a stabilization of premiums after years of substantial increases. Specifically, the report shows plan selections in Exchange plans in the 50 states and D.C. remained steady at 11.4 million. This represents a minimal decline of around 300,000 plan selections from the same time last year. Also, as outlined in the report, average total premiums for plans selected through HealthCare.gov dropped by 1.5 percent from the prior year, the first decline since the Exchanges began operations in 2014.
When people say “oh the shutdown only affects government workers,” remind them that IT requires maintenance. GOV websites that help businesses are going offline by the dozens per week https://t.co/1wGeTgsCyypic.twitter.com/sYmBwTYFSq
How many government servers were not patched in the past month? How many applications and website frameworks were not updated? How many pentests were postponed? How many logs were not examined for intruders?
Imagine if your private company simply stopped having employees show up for a month. The government is no different and the impact is larger than all but the most massive private sector orgs
That should mean that the average HC.gov premium is around $600 or so per month in 2018. The 3.5% surcharge hasn't changed for 2018, which means the federal exchange should take in something like $252/year per enrollee. Total enrollment in HC.gov plans was down 5% this year, so I'll assume average effectuated enrollment will be as well...somewhere around7.13 million per month. That means ~$1.8 billion in HC.gov revenue directly from the premium surcharge.
As I warned back on December 19th when CMS released the Week 7 HealthCare.Gov Enrollment Snapshot Report, the final, official enrollment tally for the 2019 Open Enrollment Period was almost certain to end up slightly lower than the Week 7 cumulative numbers indicated. There are several reasons for this: Some people who were auto-renewed contact HC.gov to cancel their 2019 renewals, while others had their enrollments involuntarily denied or otherwise cancelled due to problems with verifying their identity, address or legal residency status.
So, how likely is HC.gov to reach last year's total in the final week? Well...not very likely, but let's do the math anyway. Again, this is for the 39 states hosted by HC.gov only; it does NOT include the 12 state-based exchanges, which are mostly AHEAD of last year so far.
Last year, 8,743,642 people selected QHPs via HC.gov total:
4,580,782 actively re-enrolled
1,702,429 were auto-reenrolled
2,460,431 were new enrollees
Of those 8.74 million total, there are likely around 6.16 million currently enrolled as of December
Last year, 97% of those still enrolled as of December re-enrolled (actively or passively). If that holds true this year, that'll be around 5.97 million total renewals
That means HC.gov would need 2.77 million new enrollees total
Fire up the Wayback Machine, Peabody, and take us to September 2015:
AP's NEW "HC.gov Security Flaws" story attacks problems FIXED UP TO A YEAR AGO.
Last night I posted what seemed, at first, to be a merely-amusing (if a bit depressing) story about a Florida news station website accidentally (?) reposting a year-old AP newswire story about potential security vulnerabilities at Healthcare.Gov:
WASHINGTON -- The government's own watchdogs tried to hack into HealthCare.gov earlier this year and found what they termed a critical vulnerability - but also came away with respect for some of the health insurance site's security features.
Those are among the conclusions of a report released Tuesday by the Health and Human Services Department inspector general, who focuses on health care fraud.
I just received the following from a healthcare broker, who I trust from past communication exchanges, who wishes to remain anonymous. I'm presenting it as sent, with the only changes being breaking it out into paragraphs for readability & with their state's identifying information removed.
According to this article from last May, the total budget for operating HealthCare.Gov, the federal ACA marketplace/exchange which covers 39 states,was around $2.1 billion in 2016. Donald Trump proposed slashing the budget down by about 20% to $1.7 billion in 2017.
Where does that money come from? Well, HealthCare.Gov, the federal ACA marketplace/exchange which covers 39 states, is not funded out of the general federal budget. Instead, it's funded by assessing a 3.5% premium surcharge on policies sold on it.
OK, that's not quite true; the 3.5% only applies to the 34 states which are fully operated by the federal exchange; there are 5 states (Arkansas, Kentucky, Nevada, New Mexico and Oregon) which have their own exchange operations but "piggyback" on HC.gov's technical platform; those states were charged just 1.5% of premiums in 2017 and 2.0% for 2018. However, those 5 states combined only make up around 5% of all HC.gov enrollments, so the lower fees only knock perhaps 2% off the total user fee revenue.
UPDATE: OK, it looks like the big HealthCare.Gov Final Surge Report is gonna be released sometime Thursday morning. Unfortunately, I have a can't-miss meeting in the morning as well, so there's a good chance that after sitting at my desk and constantly refreshing/checking email all day today, I may ironically end up missing the big reveal and not being able to post about it for an hour or so after it comes out.
UPDATE 12/21/17: As of 2:00pm, still nothing. Speculation now brewing that they may be hoping to bury the report at 4:59pm on the Friday before Christmas. Hoping to be proven wrong.
UPDATE 2:35pm: h/t to Adam Sacarny for the head's up:
Exchange open enrollment for 2018 coverage ended w/ approx 8.8M people enrolling in coverage. Great job to the @CMSGov team for the work you did to make this the smoothest experience for consumers to date. We take pride in providing great customer service.
