“While exchange enrollment will meet the Administration’s modest 10 million person goal, it does appear that growth in this market has slowed,” said Caroline Pearson, senior vice president at Avalere. “Efforts to expand participation in the long-term will be important to sustain robust plan participation and support continued improvement in the risk pool.”
While data from state-based exchanges are not yet available, Avalere estimates that total enrollment across these states is around 3.1 million. As such, nationwide exchange sign-ups at the end of open enrollment are estimated to be around 12.7 million.
In 2014 and 2015, total exchange enrollment fell about 20 percent between the end of the open enrollment period and the end of the calendar year. This attrition occurs for a number of reasons. First, some people select a plan but never pay their first month’s premium. Other people complete their enrollment but stop paying premiums and drop out of coverage during the year. While a third group exits the exchange markets if they get a job that offers insurance or become eligible for other sources of coverage, like Medicaid, because of change in income, among other reasons.
Based on this historic rate of attrition, Avalere estimates 2016 year-end enrollment will be roughly 10.2 million, just above the Administration’s 2016 year-end goal of 10 million people covered in exchanges. Based on the data released today, it appears that this goal is achievable, though enrollment will fall significantly short of the Congressional Budget Office’s current estimate of 13 million effectuated enrollees—i.e., those paying premiums throughout the entire course of their coverage.