Washington State


Time: D H M S

A week or so ago, the Washington exchange released their November numbers, reporting 123,000 QHP selections through 11/30.

Yesterday they issued a mid-December update; the total number is now up to over 150,000:

The upcoming deadline coincides with the biggest surge in sign-ups seen during the current enrollment period. Since the start of the month more than 27,000 customers have selected plans for coverage starting Jan. 1, bringing the total number of those selecting coverage since the start of open enrollment to over 150,000.

OK, this is a bit of a downer on an otherwise extremely positive day, but given my recent obsession with trying to track down the number of people still currently enrolled in effectuated policies for 2015, it seems worth making note of.

Remember, the official exchange effectuation figure as of 6/30/15 was 9.95 million people.

Back in early November, I cobbled together the effectuated enrollment data from 8 different state-based exchanges, and concluded that the numbers stayed relatively from the end of June through the end of September. With Massachusetts included, the numbers were actually higher, and even without MA included (special case) it was only down a nominal amount. With only 8 states representing a small percentage of the national population, however, there was no way of knowing how representative this was.

Hot off the presses...

Washington Healthplanfinder Sees 123,000 Select Qualified Health Plans in First Month of Open Enrollment

The Washington Health Benefit Exchange today announced that more than 123,000 residents have selected Qualified Health Plans for 2016 coverage since the launch of the third open enrollment period on Nov. 1. Approximately 112,000 customers renewed plan selections from the previous year, with automatic renewals accounting for more than 84,000 of the 123,209 plans selected through December 1.

All residents who qualify must select a Qualified Health Plan throughwahealthplanfinder.org by December 23 to receive coverage by Jan. 1, 2016. Data collected from the first two open enrollment periods indicate a significant increase in sign-ups as the Dec. 23 deadline approaches. Open enrollment runs through Jan. 31, 2016.

Fresh on top of the Covered California data drop, the Washington Health Benefit Exchange (the 3rd-largest state-based exchange after California and New York) has published an updated, detailed enrollment report:

The Washington Health Benefit Exchange, which operates the state’s insurance marketplace,Washington Healthplanfinder, today announced over 1.5 million Washingtonians accessed health coverage through wahealthplanfinder.org from Oct. 1, 2014 through Sept. 30, 2015.

The announcement was part of a new Health Coverage Enrollment Report that includes an updated enrollment total of 152,517 individuals in private health plans – called Qualified Health Plans (QHPs) – as well as executed enrollment for more than 1.4 million Washington Apple Health (Medicaid) eligible enrollees.

When I updated my #OE3 state-level enrollment projections yesterday, I came across this official projection for #OE3 from Your Health Idaho's Sept. 18th board meeting minutes:

Rep. Rusche asked what our target enrollment is for this cycle and what barriers we see in making those targets. Mr. Kelly said the team is focused on the 80% goal of 92,000 as our enrollment target.Premium increases are a potential barrier. Net premium is a relatively small increase for most consumers, and each consumer will experience something different depending Page 5 of 14 on their plan, their location, their carrier, etc. We feel that while the premiums are increasing the relatively small net premium increase will mitigate this barrier to a large degree.

When I asked for clarification, they informed me that:

We currently have 86,659 effectuated enrollments with Your Health Idaho, as of September 15. The 92,000 would also refer to effectuated enrollments.


In today's speech at the Howard University College of Medicine, HHS Secretary Sylvia Burwell started ramping things up for the 2016 Open Enrollment Season (which I'm gonna designate #ACA2016 unless someone else comes up with something better) by dropping some data points.

Among these was this one: 

Almost half of the uninsured individuals who are likely eligible for Marketplace plans are between the ages of 18 and 34.

This is really important, because only about 28% of those who enrolled in exchange-based policies this year fall into the 18-34 range, which is a problem from an actuarial/risk pool perspective. Younger people are generally healthier, so the insurance companies prefer to have a higher percentage of them in their risk pools in order to help keep premiums/deductibles from increasing too quickly.

If "almost half" of the 10.5 million uninsured people eligible for the ACA exchanges are in the 18-34 range, that's roughly 5 million young adults who the exchanges need to target.

Way back in early June, Washington State reported that the overall average requested individual market rate increases for 2016 came in at 5.4%, which is pretty darned good.

Just now, the state insurance commissioner reported that the approved weighted average increase next year will be even lower: Just 4.2%:

OLYMPIA, Wash. –The Office of the Insurance Commissioner has approved 136 individual health plans from 12 insurers who will offer them to the Exchange, Wahealthplanfinder, for sale in 2016. The Washington Health Benefit Exchange Board is scheduled to certify the approved insurers and their plans at its board meeting later today.  

The companies requested an average rate change of 5.4 percent, but 4.2 percent was approved.

In nearly every state, the official "enrollment number" used in the HHS Dept's ASPE reports has been the number of QHP selections completed...whether or not the enrollee actually pays their first monthly premium. Naturally, this led to a lot of fuss and bother about "How many have PAID???" last year (and this year as well, though to a lesser extent). In the end, the answer in 2014 turned out to be roughly 88%, with an additional 4% or so gradually dropping their policies over the course of the year and another 5% dropping theirs once the 2015 season opened up. In 2015, so far it looks like the 1st-month-paid percent is a bit higher, more like 90%.

Most news outlets mushed the two figures (non-payments and attrition) together, but I keep them separate, and Washington State is one reason why. Unlike most states, the Washington ACA exchange only reports their exchange policies after the first monthly premium has been paid. As a result, while their official numbers seemed a bit weak back in February (160,732 vs. their stated goal of 230,000), the silver lining is that it was also a "cleaner" figure; I didn't have to lop off 10% of the total, since WA "pre-purged" it for me.

Yesterday I posted about Healthcare.Gov's new "Rate Review" tool, and how, while it's very handy for seeing which comapanies are trying to jack up their premium rates by more than 10% next year (and allowing public comment on them), it's essentially useless for trying to calculate the overall average rate increase in a given state (or in some cases, even for a given company in that state).

I used Connecticut as an example: The actual statewide, weighted average increase request is around 7.7%, but if you only use the Rate Review database as your source it makes it look like it's over 18%.

Here's an even better example: Washington State.

Thanks to Rebecca Stob for the heads up.

On the one hand, Washington State, like Oregon, has a nifty, easy-to-use web-based searchable database for their 2016 rate request filings, yay!

On the other hand, when you get into the details, some of it can be pretty confusing stuff. In 2014, there were 8 companies approved for the WA exchange. For 2015, there were 10 companies, plus 2 more which didn't make the cut. For 2016, a total of 17 companies/subsidiaries have requested approval to sell on the individual market. There's no guarantee that all 17 will be approved to sell in the state, but I'm assuming they all will be for the time being.

There's actually 18 listings, however, because Lifewise split their policies into two entries...one of which is "grandfathered" policies only, and is therefore not relevant for the table below...although this does answer the question "how many people are sill enrolled in Grandfathered policies in Washington State?" The answer appears to be just 15,677 people...out of 343,348 total in the individual market, or only 4.5% of the total.

Earlier today I posted updated exchange enrollment numbers out of Washington State; as of 4/17, ACA exchange QHPs were up to 170,000 currently enrolled out of about 177K paid enrollments and perhaps 200K total selections.

This evening, another piece of the puzzle is filled in : OFF-exchange QHPs in WA:

The office of the state insurance commissioner estimated 170,000 people bought private insurance outside the state marketplace during the open enrollment period. That’s about the same as last year.

Well, now. After all my dead ends, that was remarkably...simple and to the point.

This Just In...

Washington Healthplanfinder Enrolls 170,000 in Qualified Health Plans; 16,000 Enroll through Spring Special Enrollment Period
Enrollment Continues for Residents with Qualifying Life Events


OLYMPIA, Wash. – Washington Healthplanfinder today announced that 170,101 Washingtonians have currently signed up for a Qualified Health Plan or renewed their health coverage through www.wahealthplanfinder.org. Of the total number of Qualified Health Plan enrollees, more than 16,000 enrolled during the spring special enrollment period.

The spring special enrollment period, which ran from Feb. 17 to April 17, was previously available to Washingtonians who recently became aware of the tax penalty for not having health insurance or were unable to complete their applications due to technical issues by the Feb. 15 deadline.

In the midst of a pretty quiet week data-wise, the Washingotn HealthPlanFinder had a pleasant surprise: An extremely comprehensive enrollment report which breaks down their 2015 numbers every which way possible and, of particular importance to me, also includes data up through March 9th (as opposed to the Feb. 21st cut-off of most of the other state exchanges).

As an additional bonus, the accompanying press release also brings the QHP enrollment numbers even further up to date...right up through March 25th, I think (the PR doesn't specify the exact date of that number, but it's a few thousand higher than the enrollment report so I'm assuming it includes the 16 extra days).

First up: The top-of-the-fold numbers:

Washington Healthplanfinder Enrolls 165,000 in Qualified Health Plans; Annual Enrollment Report Released

Special Enrollment Opportunity Still Available through April 17

FOR IMMEDIATE RELEASE: March 26, 2015, 10:00 am PST

Now that the King v. Burwell Supreme Court oral arguments are out of the way (with radio silence expected until they announce the decision sometime in June) , the next Big Development to keep an eye on ACA-wise is...Tax Season! There will be plenty of stories about how many people have to pay back some/all of their 2014 tax credits, how many will receive additional tax credits...and, most germane to this site, how many additional people enroll via the exchanges to avoid having to pay (most) of the higher tax penalty next year for not being covered in 2015 during the Tax Filing Season Special Enrollment Period (SEP), or #ACATaxTime as I prefer to call it.