State Exchange Enrollment Widely Variable Compared to Projections

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New Avalere analysis finds that while nationwide exchange enrollment has reached 55 percent of projections, state progress varies dramatically.

In total, enrollment grew by 1.1 million in January, a 50 percent increase over 2013 year-end totals. In 15 states, enrollment exceeds 60 percent of those expected to enroll in 2014.

“The latest data shows that exchange enrollment continues to rebound following early technological problems, although progress is uneven across states,” said Caroline Pearson, Vice President at Avalere. “The question remains if the final enrollment surge at the end of March will make up the ground lost in October and November.”

Several states with state-based exchanges continue to lead the way in meeting enrollment expectations, including California and Washington. Meanwhile, state-based exchanges in Massachusetts, DC, and Hawaii continue to lag behind. Interestingly, enrollment in Oregon is average (52 percent), despite delayed launch of their online webportal.

States using infrastructure outpaced state-operated exchanges in January. Idaho and North Carolina lead the way among federally-operated states, while Arkansas and Iowa have enrolled less than 20 percent and 30 percent respectively.

Methodology and Notes

Avalere’s analysis incorporates the HHS enrollment figures released on February 12, 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.

* Note: Projected exchange distribution from the Avalere model includes Medicaid enrollees through state premium assistance programs in Arkansas, Iowa, and Pennsylvania.

For more information about exchange enrollment, contact Caroline Pearson at

View Avalere’s full press release attached.

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