By February 17, Connect for Health Colorado had enrolled 79,779 people in private health insurance plans, and another 128,219 in Medicaid. Prior to the start of open enrollment, CMS published monthly enrollment targets for each state – based on those numbers, Colorado’s target for the end of February was 73,600 people enrolled in private plans. The exchange was already more than 6,000 people above the February target with 11 days left in the month, and reported that enrollment was continuing briskly. At this pace, the exchange will almost certainly meet or exceed its total private plan enrollment target of 92,000 people by the end of March.
It’s important to note however, that the CMS state targets were little more than guesses in most cases. Colorado was not one of the ten states that submitted its own target, and CMS set the other 40 state targets in order to accommodate the total enrollment target of 7 million nationwide (that has since been revised down to 6 million). ACA Signups (an excellent resource for ACA questions) has a great post about this topic, and Charles Gaba explains that a better target might be 14% of the uninsured population, since 7 million is roughly 14% of the total uninsured population in the US prior to open enrollment (and if we adjust this based on the recent revision of the national target down to 6 million, we end up with 12%) EDIT, 3/10/14: Be sure to check out the comment below this article from Brainwrap. He’s adding more details to the original calculations he used in the ACA signups post, and clarifies some of the numbers a bit more.
In 2012, Kaiser Family Foundation pegged Colorado’s uninsured population at 746,500 people. 14% of that is 104,510 people. If we go with 12%, we get a total target of 89,580 people. Given that Colorado had enrolled nearly 80,000 with six weeks to go, I’d say that the 12% target will almost certainly be surpassed by the end of March. And it’s quite possible that the 14% target could be too (it would require 25,000 people enrolling in six weeks, but there is likely to be extremely high enrollment volume in the latter part of March, and the application process is working smoothly now – it’s certainly feasible).
It’s still unknown exactly how many of the 208,000 total enrollments (Medicaid plus private plans) that Connect for Health Colorado had completed by 2/17 were for people who were previously uninsured. We’ve had a good mix of both – people who were switching from old plans to new ACA-compliant coverage, as well as people who were previously uninsured. Again, ACA Signups has some good insight into this, noting that enrollment in February in NY (only one state, but it’s a huge one) was overwhelmingly people who were previously uninsured. We’ve passed the point where people are enrolling after having an old policy terminated for non-compliance, so it’s quite likely that the enrollments at this point are largely from the uninsured population.
When it comes to total enrollment in ACA compliant plans, we also have to keep in mind that there’s a robust off-exchange market for individual health insurance too. In Colorado, several of the big name carriers are offering health insurance off-exchange, although there’s no state-wide tracking system for determining how many people have enrolled in new plans outside of the exchange. In terms of the previously uninsured population, the vast majority are likely to be enrolling through the exchange, since that’s where the premium tax credits are available. In 2008, only 3.6% of the uninsured population in Colorado had incomes above 400% of poverty level (the upper limit for subsidy eligibility), meaning that most of the uninsured population is eligible for either premium tax credits or Medicaid. But the off-exchange market is no doubt doing a brisk business replacing old non-compliant health insurance policies for people who do not qualify for tax credits and choose to shop off-exchange (the plans are ACA compliant either way).
I like knowing that our brokerage has been a part of Colorado’s enrollment success. Kudos to the exchange staff, Colorado Medicaid, navigators and brokers across the state. I can’t wait to see what our state’s official uninsured rate drops to for 2014. We’ve certainly made a big dent, and it will only get better over the next few years.