Week 4: Thanksgiving complicates comparisons, but health plan sign-ups continue to lag

Joshua Peck
Get America Covered
2 min readNov 27, 2019

CMS released the fourth weekly enrollment snapshot today. In this snapshot, 703,556 people signed up for coverage — down 6% compared to an equivalent week last year. Cumulatively, 2,372,957 people signed up for coverage during the first 23 days of OE7. The trends of lower active renewal and stable new enrollment we’ve seen during the past two weeks appear to continue.

Week 4 sign-ups cannot be accurately compared to week 4 sign-ups last year. During both of the previous 45 day Open Enrollment periods Thanksgiving fell during Week 4. This year Thanksgiving takes place during Week 5. The Thanksgiving holiday is a historically slow period for enrollment. For this reason, we don’t make comparisons of cumulative or state by state sign-ups this week.

While imperfect, the best benchmark of relative performance for this year’s Week 4 is likely Week 3 of last year. Week 5 of last year should not be used, because there is typically a post-Thanksgiving surge in sign-ups which alters sign-up behavior. We should be able to compare Week 5 this year (next week’s report) with last year’s Week 4. For both Week 4 and Week 5 of this year, we caution against reading too much into subtle variations in performance.

513,421 people actively renewed health coverage and 190,135 new people signed up for coverage. The active renewal trend demonstrated in Week 2 and Week 3 of this year appears to continue through Week 4. Active Renewal continues to lag behind last year’s performance (down 9% this year compared to Week 3 last year). Similarly, new sign-ups remain slightly ahead of last year’s Week 3 (up 4% compared to Week 3 last year) similar to the performance we’ve seen for the past two weeks.

Bottom Line: The number of people signing up for coverage this week doesn’t give us any reason to believe there are any fundamental changes to the trends we’ve seen in past weeks — sign-ups still appear to be on track to lag behind last year’s totals.

State by State Sign-ups

Once again, CMS released sign-up data for states that use the HealthCare.gov platform. The first 23 days of OE7 can not be accurately compared to the first 24 days of OE6, because of when the Thanksgiving holiday falls in weekly snapshot calendar. As a result, we are not offering state by state comparison this week — just the totals through the end of Week 4.

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Joshua Peck
Get America Covered

Co-Founder Get America Covered, Former Chief Marketing Officer for HealthCare.gov