Week 5: Enrollment at HealthCare.gov is on track to fall by 800,000 for 2019

Today, CMS released the enrollment snapshot for Week 5 of the sixth Open Enrollment period. The gap in enrollment between this year and last year has increased once again. The bigger concern is that new enrollment continues to lag behind last year. Overall, enrollment at HealthCare.gov is on track to fall by 800,000.

While active renewal is cumulatively down 9% compared to last year’s total, this year’s renewals during week 5 performed similarly to last year’s week 5. The number of people renewing is stronger than earlier weeks in open enrollment, but active renewal this year needs to outpace last year in the final two weeks to catch up.

New enrollment is down 18% compared to the same week last year. This is the fifth consecutive week where new enrollment has underperformed compared to last year. Given this trend, it’s very unlikely that new enrollment will match last year’s total. Lagging new enrollment is likely the result of multiple factors. Two important factors that impact new enrollment in particular are 1) Lack of marketing 2) Less media coverage this year. According to KFF Health Tracking Poll, only 24% of the those buying their own coverage are aware of the deadline to enroll. The number who simply said they didn’t know the deadline increased from 53 percent last October to 61 percent last month. Other factors such as the shortened enrollment period, the administration’s efforts to promote short-term plans, the cost of plans,, and the and the $0 individual mandate penalty (though the KFF poll found that almost 7 in 10 Americans are unaware of the zeroing out of the penalty) are also likely to be contributing.

While there are just two more weeks of enrollment, last year, the fifth enrollment snapshot was the halfway point (48%) for new enrollment and active renewal in the federal exchange — similar to prior Open Enrollments. It we assume that the Week 5 snapshot represents 48% of enrollment this year, overall enrollment on the federal marketplace is on track to fall by about 800,000 this year. While the pace of both renewal and new enrollment will increase significantly in the final days, it’s unlikely at this point that federal enrollment will be in a position to exceed or even match last year’s enrollment totals.

State-by-State Comparison

Florida is the only state with enrollment on pace with last year. Every other state, continues to show slower enrollment compared last year. The ten states showing the greatest enrollment decline since last year are: Virginia (due to the state expanding Medicaid), Missouri, Louisiana, West Virginia, Pennsylvania, Maine, New Hampshire, Illinois, Arizona and Tennessee.