Week In Washington: Open Enrollment Updates and News of Note

December 12, 2018

With ACA Open Enrollment drawing to a close in a little more than a week in most states, a quick summary of where things stand:

  • Healthcare.Gov States- Overall enrollment is down about 10.5% , which would be on track for about a decrease of about 800,000 enrollees, according to Josh Peck. There’s a sharp difference between returning enrollment (only down 9%) and new enrollments (down 18%). Josh has a good chart of how each Healthcare.gov state is doing (only Florida is currently on track to have as many enrollees as last year).
  • State-Based Exchange States- States that operate their own Exchange are having remarkably more success. According to Charles Gabba, who does a great job aggregating how states are doing for enrollment, NY, WA, MA, and RI all are exceedinglast year’s open enrollment so far. California and DC are down, but far less than the average Healthcare.gov state. As a reminder many State-Based Exchanges have enrollment deadlines after December 15th so we may not know the final totals until January or even February. SBEs tend to spend far more on outreach than the Healthcare.gov states.

What’s Doing with Congress?

I get a number of questions of what is doing with HIT fee or other potential lame duck Congressional actions. Generally, Congress has shut down this week in respect to President Bush’s passing. Next week news should percolate out.

Provider Consolidation

The influential progressive think tank, Center for American Progress (CAP), released a report on the impact of provider consolidation on health care costs and policies to address the problem. CAP is very influential among Democratic thinkers and its possible some of their ideas will be incorporated into the 2020 candidate platforms.

HHS Releases Ideas on Reforming Healthcare

On the other end of the political spectrum, the Trump Administration released a broad policy report for how it thinks the government should improve the American health care system. Previously, ideas that the Administration has endorsed have crept into regulations. In essence it’s best to think of this as what the Administration would like to do, rather than what it is doing.