Week 1: Despite the Election and Supreme Court case, HealthCare.gov Open Enrollment starts strong

Today, CMS released the first Weekly Enrollment Snapshot for the eighth Open Enrollment Period. This is our first look at enrollment in health coverage in states served by the HealthCare.gov platform following the outbreak of COVID-19. CMS announced that 818,365 people selected a plan including 174,344 new people enrolling in coverage and 645,021 renewals. Despite the election and Supreme Court case, enrollment during the first week was strong.

The pandemic has created the largest health insurance coverage losses in American history, likely increasing the number of people shopping for coverage. At the same time, the pandemic has significantly tightened the budgets of millions of people, exacerbating the persistent disconnect between the perceived cost of coverage, which is significantly higher than the actual cost for most HealthCare.gov consumers.

The ongoing attention devoted to the 2020 Presidential election is likely to have delayed some people from enrolling, or even shopping for coverage. The looming Supreme Court challenge created doubts about the future of the law in the minds of many consumers, which is also likely to have deterred some from enrolling.

In our Week 1 Preview on Tuesday, we estimated that based on enrollment trends from the past three Open Enrollments we expected between 875,000 and 1,050,000 enrollments.

We noted there were a number of critical differences between this year and last year due to COVID-19, the 2020 presidential election and the California v. Texas Supreme Court case. One additional difference that we did not highlight is that New Jersey and Pennsylvania have become State Based Marketplaces and will report enrollment separately from HealthCare.gov. Last year, New Jersey and Pennsylvania were responsible for 7.0% of total enrollment. Factoring in New Jersey and Pennsylvania, we would have expected between 815,000 and 1,000,000 enrollments to be reported today. Today’s snapshot shows enrollment within that range.

While enrollment during the first week of November was slower than last year, that’s to be expected due to the 2020 election and impact of the health care repeal lawsuit. Many entities delayed outreach efforts until after the election to avoid competing for attention. Despite the worst health coverage losses in American history, CMS is not doing any additional outreach this year to get out the word about Open Enrollment. While there may be some improvement in the weeks to come, without a robust effort to get out the word, it’s likely that these factors will have a lingering impact on enrollment this year.

It’s too soon, especially during such an extraordinary year, to draw meaningful conclusions about how the remainder of Open Enrollment will unfold, but considering all of the unique factors at play this year, this is a strong start to Open Enrollment.