Healthcare.gov enrollment reaches nearly 2.8M despite week 4 slowdown

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The cumulative signup total since open enrollment began on Nov. 1—nearly 2.8 million—is an increase of 30% relative to last year’s four-week cumulative total of 2.14 million. 

Healthcare.gov enrollment slowed considerably in week four of the annual signup period for Affordable Care Act plans, though the pace of plan selections continues to outstrip the prior year. 

From Nov. 19-25, a little more than 500,000 people enrolled in health plans on the federal exchange, according to the latest data from the Centers for Medicare & Medicaid Services. That's far fewer than the 800,000 who signed up the week prior, or the roughly 876,000 in week two. 

Some of the slowdown in week four is likely due to the Thanksgiving holiday, Leerink Partners analyst Ana Gupte suggested in a research note (PDF). 

However, the cumulative signup total since open enrollment began on Nov. 1—nearly 2.8 million—is still an increase of 30% relative to last year’s four-week cumulative total of 2.14 million. 

Of the total signups so far for 2018 plans, 2,062,975 are returning customers and 718,285 are new customers. Year over year, the mix of returning customers and new customers has changed little—this year it’s 74% returning and 26% new, versus 76% returning and 24% new at the same point last year. 

Enrollment so far this year has consistently beaten last year’s pace, contrary to predictions that signups would be down this year. Many factors could be fueling that trend, including increased awareness of the ACA amid Republicans’ attempt to repeal it, and a rush to sign up for plans before the open enrollment period—which is half as long as prior years—ends on Dec. 15. Affordability could also be a factor, since even though premiums have risen, those eligible for tax credits may actually end up paying a lower portion of their premiums compared to prior years.

Whatever the reason, the strong showing so far in open enrollment is good news for Centene, as it has about 15% earnings exposure to the ACA exchanges, Gupte wrote. The company, which traditionally specializes in Medicaid managed care, has expanded its footprint on the exchanges next year even as other major insurers have pulled back. 

As for Centene’s managed care peer, Molina Healthcare, the insurer expects its pricing and network models to “essentially minimize” any exchange exposure in 2017, Gupte added. Molina, which recently appointed a new CEO, is in the midst of a restructuring effort and has posted losses in the past two quarters. 

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