Previewing the Number of Sign-Ups on HealthCare.gov

December 15 marked the end of the open enrollment period in the 39 states using HealthCare.gov, and within the next few days the Centers for Medicare and Medicaid Services (CMS) will likely release an update detailing how many people selected plans during that period. Here’s what you need to know when comparing this week’s report to enrollment for 2017:

1. The CMS data will likely only include the number of people who signed up for coverage in the 39 states that use HealthCare.gov. Of the 12.2 million consumers who signed up for marketplace plans across the country by the end of open enrollment last year, 9.2 million signed up in states using HealthCare.gov, with the remaining 3 million signing up in states with their own marketplaces.
2. The CMS data may not include people who are auto-enrolled for 2018. Each year, consumers enrolled in coverage are automatically re-enrolled for the next year if they don’t return to the marketplace and select a plan during open enrollment, or otherwise opt out of being auto-enrolled. Last year, HealthCare.gov auto-enrolled about 1.6 million people and 7.6 million people actively selected a plan. It’s unclear whether the data that CMS will release this week will include those who were auto-enrolled.
3. A lot of people can still sign up. Eleven states and the District of Columbia have their own marketplaces. Only two of these marketplaces, Vermont and Idaho, ended open enrollment on December 15. (In Idaho consumers can select plans until December 22 if they completed an application by December 15.) In seven state-based marketplaces — accounting for 26 percent of current marketplace enrollment — the open enrollment period will end in January. Moreover, many people who were negatively affected by natural disasters, such as this fall’s hurricanes, can qualify for a special enrollment period (SEP). For example, all consumers in Florida qualify to enroll with this SEP. Finally, just like in previous years, many 2017 enrollees’ plans were canceled this year, whether because their insurer left the marketplace or because it made major changes to product offerings. People in this situation are eligible to enroll in an SEP until March 1, 2018 even if they are auto-enrolled in a new plan.

Going into the 2018 open enrollment period, the Affordable Care Act (ACA) marketplaces faced headwinds from the Trump Administration: a 90 percent cut in consumer outreach, a 40 percent funding cut for “navigators” (trained consumer assistance providers), and no support from Administration staff to promote awareness about open enrollment at events. That’s on top of consumer confusion resulting from months of congressional attempts to repeal the ACA and a far shorter open enrollment period than in previous years. Despite these challenges, enrollment so far this year has been strong. Consumers clearly continue to value the opportunity to obtain health coverage in the marketplaces.