Jason Shafrin hosted the latest Health Wonk Review at The Healthcare Economist, and it’s an excellent edition. It’s mostly all about the ACA, and there are lots of different viewpoints to consider. One of my favorite posts in the HWR is from Health Affairs, written by Rick Curtis and John Graves.
Rick and John make an excellent point about how open enrollment is just the beginning of ACA enrollment. As a brokerage operating in the individual market for more than a decade, our experience is exactly in line with Rick and John’s post. In the past, there were no open enrollment periods for individual health insurance in Colorado – you could sign up at any time, as long as you were healthy enough to get through medical 
underwriting. People would enroll or switch policies for a variety of reasons, but two stand out as by far the most common: an existing policy being up for renewal (with a rate increase) and triggering them to shop around, or a change in circumstances that resulted in the loss of other coverage (leaving a job for example, or getting divorced). Those two factors will continue to drive enrollment in ACA-compliant plans long after the March 31 open enrollment deadline.
Most carriers in Colorado are letting existing policies continue until they renew in 2014. Some people have opted for early renewal if it was available, which means that there will be a flood of people entering the ACA marketplace next December when their early-renewed policies are expiring. But a lot of insureds are simply letting their policies continue into next year until their regular renewal date, which can be in any month of the year. Some will be up for renewal while open enrollment is still going on in the early part of 2014, but many will be switching from an existing plan to a new plan throughout the year, with their own open enrollment triggered by the loss of other coverage (existing plans may not continue after their renewal date in 2014 unless they are grandfathered, but grandfathered individual policies are becoming very rare). The other scenario – loss of coverage because of a job change, divorce, etc., will still be just as common in the future as it was in the past. People will still need to shop for coverage because their existing policy is ending for reasons that have nothing to do with the ACA policy cancellations.
Since non-compliant plans are not available at all after January 1 (on or off exchange), everyone who needs to purchase new policies in 2014 will be getting ACA compliant plans. And in Colorado, many of them will opt to enroll via Connect for Health Colorado. Total enrollment will continue to increase throughout the year – it will not peak at the end of March.
