Nationwide Exchange Enrollment Tracking Toward 5.4M by the End of March

New Avalere analysis finds that exchange enrollment is on track to reach 5.4 million by the end of March when open enrollment is set to end. That number falls short of current Congressional Budget Office (CBO) estimates that six million people will enroll in exchanges in 2014.

“The Administration is conducting aggressive outreach in March in an effort to boost enrollment.  However, success of exchanges in 2014 will depend less on the size of the market and more on the risk profile of enrollees,” said Caroline Pearson, Vice President at Avalere Health.

The federal government announced yesterday that 4.2 million individuals had enrolled in exchanges through February. By comparison, when the Medicare Part D program began in 2006, 22 percent of voluntary enrollees signed-up in the final month of coverage. If exchanges follow the same pattern, we would project that 1.2M people would enroll in coverage in the month of March.

At the state level, exchange progress remains highly variable compared to state-specific enrollment projections for 2014. In both January and February, enrollment in federally-run exchanges increased faster than enrollment in state-based exchanges, as federal exchanges recovered from early setbacks caused by Healthcare.gov. California, Florida, Idaho, North Carolina, and Washington lead the states in terms of enrollment, having enrolled more than the number of people expected to sign-up for exchange coverage in 2014. Meanwhile, the state-based exchanges of Hawaii, DC, and Massachusetts—each of which have struggled with website IT problems—trail the nation in enrollment relative to projections.

“In recent months, enrollment in federally-run exchanges has caught-up to the initial enrollment surge in many state-based exchanges.  The federal marketplaces have been fixed and now surpass some states in terms of ease of consumer access, eligibility and functionality,” said Dan Mendelson, CEO of Avalere Health.

Download the full release below.

Methodology:

Avalere’s analysis incorporates the HHS enrollment figures released on March 11, 2014 as well as updated state-specific tracking from publically available resources. Enrollment projections are based on Avalere’s enrollment projections for year-end 2014, assuming smooth implementation across states (i.e., stable participation rates), applied to the CBO’s February enrollment projection of 6 million.

Avalere Health reviewed monthly enrollment numbers for individuals who voluntarily enrolled in Medicare stand-alone prescription drug plans (PDPs) and aligned the milestones of the Part D initial open enrollment period with those of the initial open enrollment period for exchanges. We then applied the trajectory of voluntary enrollment in Part D to the February exchange enrollment numbers to project total exchange enrollment at the end of March 2014. Medicare Part D open enrollment ran from November 15, 2005 to May 15, 2006. Exchange open enrollment runs from October 1, 2013 to March 31, 2014.

Avalere’s analysis incorporates the HHS enrollment figures released on March 11, 2014 as well as updated state-specific tracking from publically-available resources. Enrollment projections are based on Avalere’s projections for enrollment distribution by state at the end of 2014 applied to the CBO’s February enrollment projection of 6 million.   This approach assumes smooth implementation across states; that is, eligible populations take up coverage at similar rates across states.

For more information on Avalere's work on exchanges, email Caroline Pearson.

View the full Avalere press release attached.

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