— Emily Gee (@EmilyG_DC) December 21, 2017
This is preliminary data.
I think The 8.8 million is referring to Healthcare.gov enrollments. If this is the case, there is an outside chance that total enrollment will be flat or slightly above 2017 enrollment as the state based markets (Covered California, New York, Massachusetts Health Connector etc) come in with later deadline dates and more active marketing.
I am happily surprised. A few reporters had asked me for an enrollment guess at various points this fall and the only answer I could give them was “Somewhere between 1 and 20 million”. For some odd reason, they never ran that quote.
The Exchanges had a lot of headwinds for enrollment:
- Strategic Messaging Environment (“It’s dead, Obamacare is Dead….)
- Decrease in federally funded outreach
- Headlines of large price increases for non-subsidized plans
- Short open enrollment period (this is not a bad idea just one more barrier to access)
Bronze plans are now much cheaper than Silver plans. Bronze plans in 2017 for this carrier were priced as if they were about 10 actuarial value points less comprehensive benchmark. In 2018, Bronze plans are priced as if they are 30 actuarial values points less comprehensive than the benchmark plan. A pair of 40 year olds earning $32,000 now could buy a Gold plan for $1 month. Bronze plans will be extremely inexpensive up to the edge of the subsidy income range. Lower net of subsidy costs will bring in more people.
CMS also made it easier for brokers and third party vendors to sell on-Exchange subsidized plans which helped as Healthsherpa.com reported a record open enrollment. This probably helped as well as an increase in insurer advertising.
— WesleyanMediaProject (@wesmediaproject) December 13, 2017
The biggest take-away in my opinion is that pricing matters. Ineffective sabotage by terminating CSR payments after all insurers could survive till the end of the year and almost all had filed rates to protect themselves from CSR termination in 2018 made subsidized pricing far more attractive to healthy buyers than otherwise would have happened. If there was either effective CSR sabotage (termination of payments in May or June) or no dispute on CSR, enrollment would have been much lower.