Industry News

HHS Lowers 2015 Exchange Open Enrollment Estimates

HHS announced their projections for individual enrollment in the public exchanges. The overwhelming majority of the enrollments will occur during the Open Enrollment Period (Nov 15 – Feb 15). The projections are significantly lower than prior government projections and third-party estimates. The notable points:

  • Over 8 million people purchased exchange coverage during the last open enrollment
  • As of October, 7.1 million people are enrolled. Note this figure presumably reflects both attrition and qualifying event enrollees.
  • HHS expects to retain 5.9 million of the 7.1 million currently enrolled in 2015. This is a 17% turnover rate.
  • HHS estimates that 9.0 to 9.9 million people will sustain coverage in 2015. Note this statistic does not seem to be Open Enrollment elections. I.e.: It should be compared to the 7.1 million figure for 2014 and not the 8 million figure.
  • The 2015 coverage estimates would imply a net gain of 1.9 – 2.8 million people (5.9 million retained membership and 3.1 – 4 million new enrollees)
  • In April, the CBO estimated 13 million people would be insured by exchange coverage in 2015
  • The same CBO report estimated a sustained enrollment of 25 million in exchange coverage by 2017
  • HHS expects coverage to ramp-up over a 3-5 year period and plateau between 2017 and 2019.
  • 15 million people were eligible to purchase exchange coverage in 2014
  • 8-12 million people are currently covered by individual off-exchange coverage


HHS frames the issue brief that would lead the careless reader to think that the enrollment projection should correlate to Open Enrollment enrollment. However, the actual statistical range of 9.0 to 9.9 million refers to “effectuated” enrollment in context. If the 2015 experience is any indication, 11.5% of the Open Enrollment signups will terminate coverage soon thereafter. Unless they get to the high end of their estimate during Open Enrollment, they will miss their goal for “effectuated” enrollment during the 2015 calendar year. Something tells us the bait and switch was intentional.


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