An Update on Open Enrollment in the State-Based Marketplaces

The winter holiday season is in full swing and as many people are counting down to their celebrations, the health insurance marketplaces are counting down to their December enrollment deadlines to ensure consumers are covered by January 1.
To date, the marketplaces have reported steady progress on enrollment. As of November 28, CMS reported that over two million individuals selected plans in the 38 states using Healthcare.gov, inclusive of individuals who will automatically be reenrolled in their coverage in December. Enrollments in the federal marketplace states, including federally-facilitated marketplace states and states that share the federal technology platform,[1] range from 4,356 qualified health plan (QHP) selections in Alaska to 444,711 QHP selections in Florida.

State-based Marketplaces (SBMs) have different methods to count and manage enrollment, reflecting the variety of strategies in which SBMs are engaging to monitor enrollment priorities. Below, we share enrollment updates from the SBMs as they wrap-up the first month of open enrollment.
CALIFORNIA
 As of December 7, California reported that more than 78,000 new   marketplace consumers had selected QHPs through Covered California—an  average of 2,000 individuals per day since the launch of open enrollment.  Individuals renewing their enrollment will be auto-renewed, unless they revise  their plan selections prior to the end of open enrollment. After the first few weeks of open enrollment, California reported  enrollment of more than 33,000 individuals in its family dental plan offerings, new for 2016.  Learn more about dental coverage and the marketplaces in Dental Benefits and Health Insurance Marketplaces: An Update on Policy Considerations.
One draw for consumers has been Covered California’s focus on eliminating consumer confusion while shopping for health insurance. Consumer Reports recently honored Covered California on its 2015 Nice List for these efforts, including the marketplace with companies such as jetBlue, Target, and Chipotle.
COLORADO
 More than 46,000 enrollees have obtained coverage through  Connect for Health Colorado inclusive of QHP, Medicaid, and  Child Health Plan Plus (CHIP) enrollees through November 29.  Colorado reports early significant gains, resulting from the many  system improvements it implemented for this year. Colorado  also  focused on improved outreach resources, including the launch of a  new tool to connect consumers directly with brokers for  enrollment assistance. This tool yielded 622 leads within the first  week of open enrollment. Similarly, a new tool to support in-person assistance accounted for more than 800 appointments scheduled with consumers by the end of week one.
CONNECTICUT
 Connecticut reported more than 99,100 enrollments in QHPs,  inclusive of 5,400 new enrollees, as of November 17.  In addition,  nearly 24,000 individuals had been determined eligible for Medicaid  through Access Health CT. The state revamped its marketing and  outreach strategy for this open enrollment season, focusing on  reaching “community influencers,” and identifying many unique  target segments including African Americans, Polish, Asians,  French/Creole, Brazilians, and Hispanics.  To draw in broker assistance, Connecticut launched a new broker-focused mobile app that has been billed as a “game changer.” Moving into the holidays, Connecticut is partnering with many local charity initiatives to spread the news about coverage, while also supporting a cause.  This includes participating in NBC’s Joy of Sharing Food and Toy Drives and volunteering its enrollment centers as drop-off locations for the Gr8 Holiday Give benefiting Toys for Tots.
DISTRICT OF COLUMBIA
 At 5.3 percent, the District of Columbia boasts the third lowest  uninsured rate in the country after two years of marketplace  operation. Based on the most recent Census data, the District of  Columbia achieved a 20 percent drop in the rate of uninsured in  2014. For this open enrollment period, DC Health Link has  committed to a citywide call to action to “Each One, Link One” to  reach universal coverage in the District. Target populations include  African Americans, Hispanics, Asian-Pacific Islanders, LGBTQ  communities, and millennials. Enrollment campaigns encourage individuals and communities to “be the link” to coverage for the uninsured. DC Health Link officials have also been very active in community engagement and outreach work from participation in local community fests, to Spanish language Sunday masses, to posting a table at concession stands during blockbuster movies, such as the “Hunger Game’s Mockingjay Part II” the upcoming opening of “Star Wars: The Force Awakens”. DC Health Link is also experiencing benefits from system enhancements made for this year, including reductions in average call times and increased active shopping for plan renewals.
IDAHO

Idaho has successfully completed automatic renewals for all of its  86,000 QHP enrollees. Your Health Idaho (YHI) reports that this  year they are offering consumers more plan choices than ever  before, including the addition of adult dental coverage.  Additionally, YHI has trained and certified more than a thousand  agents and brokers to act as personal shoppers for consumers. In  January, agents across the state will host a Super Sign Up  Saturday for consumers.
Affordability remains a key message in Idaho and YHI is driving awareness of the tools and resources that are available to help Idahoans find the plan that is best for them and their families.
KENTUCKY
Much attention has focused on the implications of the most recent gubernatorial election on the future of kynect, Kentucky’s marketplace. Potential changes to the marketplace are unlikely to occur until next year; meanwhile open enrollment is in full swing with the marketplace. Kentucky has experienced the highest reduction in its uninsured rate of any state, with more than half a million consumers finding coverage through the marketplace. For this open enrollment period, kynect has been equipped with even more tools to assist consumers including an updated mobile app, and a new cost-calculator.  Kynect is also continuing use of its “kynect stores;” last year, one store welcomed 7,600 visitors and processed 6,000 applications. Consumers can use kynect’s “power towers” (pictured) to charge their cell phone while checking their eligibility or applying for coverage.
MARYLAND

Maryland has enrolled 36,483 individuals in qualified health plans  through Maryland Health Connection through Dec. 6, and an  additional 130,505 in Medicaid for a total of 166,988 individuals  since open enrollment for 2016 began on Nov. 1. An additional  100,000 individuals who enrolled for 2015 are eligible for “passive  renewal” into their same or comparable plans in January. Like  California and Idaho, Maryland is offering adult dental for the first  time and 9,853 have enrolled in a dental plan for 2016 as of Dec. 6.  A “Health Yeah!” marketing campaign was launched to help drive more young people to enroll. The Maryland Health Benefit exchange has also launched the “BATphone” (Broker Assistance Transfer) that enables “warm handoffs” of a customer from the call center to a participating broker. The pilot program has resulted in 490 enrollments from 887 calls so far.
MASSACHUSETTS
 Massachusetts has reported a much smoother enrollment  process with 2,645 eligibility determinations reported through  the Health Connector after (approximately) the first two weeks  of the enrollment season. Expanded in-person service centers  have been a key part of consumer assistance, serving more than  800 customers at the time of their report. Also noted were  improvements to the Connector’s call centers, which have reduced both wait times and total call times in this year. This is in part likely attributed to extended call center hours and increased call center staffing implemented for this year.

MINNESOTA
Minnesota reports 23,181 enrollments through MNsure, as of November 17, inclusive of 6,864 QHP enrollees, 11,226 enrollees in Medical Assistance (Minnesota’s Medicaid program), and 5,091 enrollees in MinnesotaCare (Minnesota’s Basic Health Plan). In addition, 363 Minnesotans have enrolled in a qualified dental plan. Responding to high growth in premium rates, MNsure has strongly encouraged consumers to take advantage of the tax-credits and cost saving reductions available to consumers through MNsure. MNsure reports that more than 70 percent of customers have qualified for financial assistance so far this open enrollment season, a 20 percent increase over previous enrollment years Beyond implementation of new plan comparison tools and increased call center staff to support consumers, MNsure has also touted the importance of local partnership to reach consumers, such as connections with local brokers for personal assistance to connecting with programs that assist specific populations, such as those with mental illness.
NEW YORK
 Aiming for a “Marvel-ous” open enrollment season-New York  included Marvel comic charters as spokespeople during a  statewide mall tour—the state’s coverage strategy is focused on  achieving a statewide goal of one-million fewer uninsured  individuals by the end of 2016.  Beyond its statewide mall tour, NY  State of Health has partnered with pharmacies to host over 100  educational events across the state. In the spirit of the holidays, the  marketplace partnered with Equinox, a local non-profit serving  homeless, behavioral health, and domestic abuse populations, to share Thanksgiving meals while also sharing information about coverage availability.

RHODE ISLAND
 As of November 28, HealthSource RI reports 31,238 QHP  enrollments, with over 85 percent of enrollees qualifying for  financial assistance. Addressing limitations imposed by  reductions in the marketplace’s budget, HealthSource RI is  focused on continuing to improve consumer service for marketplace customers, including a ramp-up of call center staff and encouragement for consumers to use various tools available through the marketplace website.
VERMONT
After two weeks of open enrollment, Vermont has completed automatic processing of over 18,000 QHP renewals. Last year, the state conducted renewals manually—a process not completed until more than three months into open enrollment. Vermont’s efforts leading up to open enrollment concentrated on system improvements to ensure smoother experiences for consumers such as new self-service features that enable customers to complete changes and updates online, rather than through the call center. Officials anticipate a “surge” in enrollments during this year, and while the state is still working out some fixes, it has committed that “we owe [it] to Vermonters” to fix any problems found.
WASHINGTON
On November 19, Washington reported approximatley 150,000 QHP enrollees through the Washington Healthplanfinder, putting the state within 90 percent of its projected enrollment figure of 165,000 individuals by the end of the enrollment period. Washington has identified three Cs important for consumer consideration when selecting plans: cost, coverage, and convenience, encouraging consumers to spend some time shopping its “new, better, and more affordable” options. Washington is also encouraging consumer education about coverage through the “know your plan” resources available on the Healthplanfinder website. The Healthplanfinder is also hosting a series of Facebook “office hours” to enable consumers to get real time responses to questions from enrollment specialists.
Enrollment deadlines are December 15 for most marketplaces (December 23 in Massachusetts, Rhode Island,  and Washington) to receive coverage by January 1.  This report reflects a point-in-time summary; we encourage you to stay tuned for more analyses throughout open enrollment as states continue to report on their progress.
[1] FFM: Federally-facilitated marketplace states; SPM: state-partnership marketplace states; SBM-FP: state-based marketplace states using the federal technology platform.