Week 3: Another Strong Week for Enrollment

CMS announced another record week for people signing up for coverage during Open Enrollment at HealthCare.gov, with cumulative sign-ups up 34% overall and total daily sign-ups up 42% compared to the equivalent time period last year. Once again, there continues to be a significant improvement in early enrollment from previous years across the board — more new people enrolling, more people returning, more completed applications, more calls, and more website visits.

Keep in mind that the cumulative data CMS released today is for 18 days of enrollment this year compared to 26 days for OE3 and 19 days for OE4. See the table below for a daily comparison. This week, we’ve also included a week-by-week comparison, as well as, graphs that show the progress being made for all sign-ups, for new enrollments and for returning consumers.

Here’s our take from Get America Covered:

Another week of record-breaking enrollment numbers shows that there continues to be strong demand for affordable health insurance through the ACA marketplaces. Average daily new consumer enrollment is 45% higher and returning consumer enrollment is 41% higher than last year. Because of the shortened enrollment period, even more new people will need to sign up in the final three weeks for a comparable number to sign up this year as signed up last year.

Technically, this is the halfway point between November 1st and the December 15 deadline; however, because enrollment ramps up as we get closer to the deadline, the halfway point for enrollments will be around December 4. Last year 2.95 million had enrolled by December 4th out of the 6.1 million total who enrolled through December 17.

Historically, the week of Thanksgiving is one of the slower weeks for sign-ups as people spend time with their friends and family. Starting next Monday, enrollments should continue to ramp up ahead of the December 15 deadline. The administration’s decision to significantly cut advertising will play out during these final three weeks.

Get America Covered believes there are two competing forces at play this year:

  1. Higher availability of low-cost plans: About 4.5 million uninsured people have access to $0 health plans — far more people than ever before. We believe this is a major factor in the elevated enrollment this year. HealthSherpa reports that 1 in 4 of their customers has enrolled in a plan that costs $10 or less.
  2. Cuts to outreach and consumer confusion: The administration cut funding for outreach by 90%, navigators and assisters by 41%, and made decisions that have created significant consumer confusion. Once again, the impact of these decisions by the Trump’s administration will be most acute in the final weeks of Open Enrollment.

Week 3: Cumulative Totals and Daily Averages

NOTE: Last year, CMS released bi-weekly snapshots instead of weekly. Cumulative numbers for OE4 use total weekly enrollment from the Public Use Files and new and returning enrollment is derived from the new\returning split in the corresponding biweekly snapshot.
NOTE: Last year, CMS released bi-weekly snapshots instead of weekly.

Open Enrollment 5: Weekly Comparison

NOTE: Keep in mind that Week 1 during OE5 was only 4 days, compared to 5 days for OE4 and 7 days for OE3. Last year, CMS released bi-weekly snapshots instead of weekly. Cumulative numbers for OE4 use total weekly enrollment from the Public Use Files and new and returning enrollment is derived from the new\returning split in the corresponding biweekly snapshot.

In each of the following graphs the blue line tracks cumulative enrollment by week during the 5th Open Enrollment Period (OE5) and the orange line during the 4th Open Enrollment (OE4). We have a graph for Total, New and Returning enrollment. For each data point, we’ve included the change over the equivalent week during the previous year.

Graph 1: Cumulative Returning Enrollment by Week OE4 vs OE5

* Week 1 was one day shorter in OE5

The schedule for returning enrollment this year is essentially the same (even though the experience for returning consumers will not be) — so the increases we are seeing in active renewal are substantial. For that reason, returning enrollment continues to track ahead of last year — likely the result of anxious consumers motivated to get coverage and the availability of more affordable plans for most consumers.

Graph 2: Cumulative New Enrollment by Week OE4 vs OE5

* Week 1 was one day shorter in OE5

The schedule for new enrollment is very different this year — it’s half the length. When evaluating new enrollments, more new enrollments need to happen each week to stay on pace with last year. The first two weeks showed strong new enrollment. Today’s snapshot once again shows much higher enrollment than last year, but given the shortened enrollment period, we need to do even better than we did last year.

Graph 3: Cumulative Total Enrollment by Week OE4 vs OE5

* Week 1 was one day shorter in OE5

All three graphs show how strong the first, second and third week of Open Enrollment were this year (Note: the first week this year was a day shorter so the increase over last year is actually larger than depicted). The most important weeks of Open Enrollment are still ahead of us, so we’ll continue to watch this closely.

State by State Comparison

This week CMS released state data for the first time. We compared the first 18 days of OE5 to the first 19 days of OE4 using the weekly data from the Public Use Files.

Every single state shows enrollment growth over last year.

Total sign-ups are up by at least 47% and as much as 72% compared to last year in the top 10 states: Maine, Wyoming, Texas, North Dakota, Mississippi, Iowa, Nebraska, Alaska, Illinois and New Hampshire.