Week 1 Preview
Tomorrow, November 11, CMS is expected to release the first Open Enrollment numbers of the year for states served by HealthCare.gov. As in past years, CMS is using a standardized Sunday-to-Saturday weekly report format. Typically the initial weekly snapshot doesn’t capture a full week of enrollment, making year-over-year comparisons more complicated for “Week 1”.
This year, the “Week 1” report will include seven full days of enrollment compared to just 2 days last year. Last year, HealthCare.gov faced major technical issues on the first day of Open Enrollment — preventing an estimated 100,000 people from enrolling. Despite these issues, 177,082 people (88,541 people per day) enrolled during the “Week 1” report (2 days) of Open Enrollment. But because of the technical issues, last year’s Week 1 report should not be used for comparison with tomorrow’s numbers.
Based on the last three years, Get America Covered expects roughly 125,000–150,000 enrollments per day. For the Week 1 report, we’d expect between 875,000 and 1,050,000 enrollments if shopping behavior were similar to past years. However, there are many new factors at play this year during the Week 1 report, including the pandemic and related economic crash, the 2020 Presidential election, and today’s Supreme Court oral arguments in California v. Texas, the health care repeal lawsuit.
The pandemic has created the largest health insurance coverage losses in American history, likely increasing the number of people shopping for coverage. At the same time, the pandemic has significantly tightened the budgets of millions of people, exacerbating the persistent disconnect between the perceived cost of coverage, which is significantly higher than the actual cost for most HealthCare.gov consumers.
The ongoing attention devoted to the 2020 Presidential election is likely to have delayed some people from enrolling, or even shopping for coverage. The looming Supreme Court challenge created doubts about the future of the law in the minds of many consumers, which is also likely to have deterred some from enrolling.
Despite the historic need for millions of people to find quality, affordable coverage, CMS will not be spending a dollar more than it did last year on outreach or consumer assistance. The Trump administration cut outreach and education by 90% in 2017 — which means there hasn’t been a single television ad, one of the most effective forms of outreach, informing people of the enrollment deadline or the availability of coverage in almost 4 years. This means there is not a major effort to let people know that Open Enrollment is happening, that the deadline for 2021 coverage is December 15, or that millions of Americans have plans available with a $0 monthly premium. Without a meaningful effort by CMS to provide basic information to consumers about the availability of affordable coverage, they deny millions of newly-uninsured people the vital information they need to protect themselves, their families, and their fellow Americans during a pandemic.
In short, it’s not yet clear how consumers have weighed the unprecedented set of factors surrounding this year’s Open Enrollment. And it’s unlikely to become clearer until later in the Open Enrollment period, but we will have a better sense of how things are shaping up following tomorrow’s Week 1 report.
