State exchange winners and losers from open enrollment round two

Congratulations, states and insurers: You survived another round of open enrollment. Yes, you suffered some battle wounds, but this rollout went smoother than the first.

For starters, nearly 11.7 million Americans enrolled in a plan through the state and federal marketplaces from Nov. 15, 2014 to Feb. 15, 2015. This enrollment success perhaps is thanks to the lack of technical glitches on state-run exchanges, as well as continued outreach and campaign efforts aimed to pique consumers' interest.

But not every state got its happy ending. FierceHealthPayer rounded up the winners and losers from this past open enrollment period to examine just how the nation fared.


After a pretty disastrous first enrollment period that signed up only 67,757 consumers--the exchange faced so many issues it ended up letting insurers directly handle payments--Maryland redeemed itself by enrolling 120,145 residents (which include consumers who selected or were automatically re-enrolled) through the state's new-and-improved exchange, according to data from the Department of Health and Human Services (HHS).

"We knew a change needed to be made, so we adopted Connecticut's exchange's technology and platform, which proved to be successful," Carolyn Quattrocki, executive director at Maryland Health Connection, recently said during a panel at the America's Health Insurance Plans (AHIP) Policy Conference in the District of Columbia. "We've realized the marketplace is more than a website. Ultimately, it's a business. We're still figuring out ways to become more sustainable and retain consumers by meeting their expectations.

Unfortunately, the picture isn't entirely rosy: Maryland may owe the federal government more than $28 million in misappropriated funding for its state exchange.

FierceHealthPayer award: The Comeback Kid


For many, Connecticut offers a glimmer of hope that state-run exchanges can succeed. The state enrolled 79,192 residents during the first open enrollment period and increased that number to 109,839 residents this past open enrollment period, noted HHS.

Additionally, 77 percent of Connecticut consumers who purchased plans through the state's exchange qualified for a tax credit. Here's how HHS broke down the final numbers for 2015: 35,698 residents under the age of 35 enrolled in a plan, with 27,789 of them young adults ages 18 to 34.

FierceHealthPayer award: Most Outstanding Performance


The only way for Vermont to go in 2015 was up. During round one, technical problems on the state's exchange prevented many consumers from being able to pay for their chosen health plan, and the state enrolled only 38,048 residents.

Unfortunately, round two wasn't much better. After experiencing technical glitches yet again, this time preventing consumers from completing their applications, the state signed up only 31,619 residents, according to HHS.

If the state's lack of sign ups wasn't enough, in non-enrollment-figure-news, Gov. Peter Shumlin (D) announced in December he was pulling the plug for now on the state's unique plan for creating a single-payer healthcare system by 2017. However, this merely is a "small speed bump" for the state, FierceHealthPayer previously reported.

FierceHealthPayer award: Worst In Show


Year one appeared to be too much for Oregon's state exchange. After enrolling 68,308 consumers amid technical issues that prohibited consumers from enrolling in one sitting, and despite receiving millions of federal dollars to jumpstart building the site, Cover Oregon decided to make the switch to for the second open enrollment period.

Still, not all problems were solved after changing platforms. Consumers who previously enrolled were forced to go through the entire process again, while five of the 16 insurers selling plans on Cover Oregon had to incorporate a new computer interface that worked with the federal exchange, FierceHealthPayer previously reported. All told, the state enrolled 112,024 residents during round two.

FierceHealthPayer award: Third Time's the Charm?


The past two enrollment periods have proven interesting for Colorado. During the first enrollment period, the state enrolled 125,402 residents via Connect for Health Colorado. The state was able to decrease its uninsured rate to 11 percent last year.

During this most recent enrollment period, the state upped the ante by enrolling 140,327 residents and offering 176 health plans to consumers.

Thanks to an increase in choices for consumers, round two should have been a breeze. However, offering so many plans overwhelmed the Colorado exchange. Then there was market disruption. One carrier dropped prices 15 percent to 20 percent mere weeks before enrollment began; others scrambled to drop prices statewide. "Combined with renewals, we thought a crash would happen," Gary Drews, interim CEO at Connect for Health Colorado, said during the AHIP panel.

FierceHealthPayer award: Hot and Cold