Tuesday, August 10, 2021

Total marketplace enrollment likely approaches 13 million

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Axios reports that Vice President Harris will announce today that more than 2.5 million people have signed up for marketplace coverage during the emergency Special Enrollment Period that began on February 15 and ends on August 15. (Yesterday, Charles Gaba estimated 2.57 million total SEP enrollments as of July 31.) [Update: CMS's SEP report through July 31 is out and cites the 2.5 million total.]

Just for fun, let's take a stab on where total marketplace enrollment likely stands right now. 

We know that effectuated enrollment totaled 11,290,546 in February, and that about 2.5 million additional enrollees have been logged since then. The wild card is disenrollments during those months. To estimate them, our best hints come from monthly enrollment tallies in 2020, recorded in the effectuated enrollment snapshot for February 2021.

Here's what we know about monthly enrollment in 2020, February through July.

Effectuated enrollment, February                          10,592,901
SEP enrollment, Feb. 15-July 31 (estimated)             994,350 (SBM SEPs estimated; 713k in hc.gov*)
Effectuated enrollment, July                               10,506,231
Disenrollments, Feb-July   (estimated)                    1,081,000 (estimated)

SEP signups this year exceed last year's total by about 1.6 million. To estimate disenrollments from February through July this year, let's take last year's total disenrollments, plus 5% of this year's excess SEP enrollments (78,000). That yields this estimate for enrollment as of July 31 of this year:

Effectuated enrollment, February                         11,290,546                   
SEP enrollment, Feb. 15 - July 31                          2,555,229
Disenrollments, Feb-July (estimated)                     1,159,000
Effectuated enrollment, July (estimated)          12,687,000

To the extent that this estimate is on target, it shows a 21% year-over-year increase for on-exchange enrollment -- and 2020's total was the previous high. In 2016, the peak year for initial plan selections as of the end of Open Enrollment, effectuated enrollment in July (p. 14 here) was 10,106,430. The current (estimated) total is 25% above that mark.  

Eternal caveat: in 2017-2018, the off-exchange (unsubsidized) market cratered, dropping from about 5 million in 2016 to a little over 2 million in 2019. The off-exchange market should now be shedding enrollees, as the American Rescue Plan removed the income cap on subsidy eligibility, rendering the vast majority of prospective enrollees subsidy-eligible. Individual market enrollment is thus probably not at an all-time high, though it's getting close.


Update: As noted above, CMS released a report on SEP enrollment after I first posted today. In addition, earlier I mistook total SEPs in HealthCare.gov states in 2020 for total SEPs in all states, a number CMS did not report, though today, for 2021, CMS offered a rounded SBM SEP total of 723,000. To estimate total SEPs for 2020, I estimated SBM enrollments at the same percentage of hc.gov enrollments as in 2021, which added about 250,000 to the 2020 SEP total and so to the disenrollment total. On the other hand, the CMS report added 55,000 to the current SEP total. My initial post estimated current enrollment at about 12.85 million.

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