The Final Countdown: Can We Enroll 7 Million?

March 12, 2014

It’s that time again – we’ve got data on California’s enrollment through the end of February.

A total of 868,936 people have enrolled in Covered California, with 88% receiving premium assistance. In Medi-Cal, 1,136,000 individuals were determined eligible, a figure that does not include the 823,000 who were enrolled in Medi-Cal through January via the LIHP transition, Express Lane enrollment, and sign-ups directly through county social services. Together, more than 2.8 million are now enrolled in coverage through Medi-Cal and Covered California.

Nationally, 4.4 million people have been deemed eligible for Medicaid or CHIP and 4.2 million people have selected a plan through the Exchanges, although it is unclear how many of these individuals paid their first premium. February enrollment was slower than in January, but still close to a million people signed up in the short month. Whether or not we’ll reach the national goal of enrolling 7 million (or 6 million, per the CBO) in the Exchanges is not clear. We’ve got a ways to go to get there, but given the intense response to the December 31 deadline, the March 31 end of open enrollment could bring a surge even fiercer.

While California is still leading the states in enrollment by far, other states have picked up steam. Florida is up to 442,000 Exchange enrollments and Washington has determined nearly 629,000 people eligible for Medicaid and CHIP. More effort is needed in states like Texas that have large uninsured populations, but relatively low enrollment (just 295,000 people have selected a plan – less than 40% of those who applied and were found eligible). While enrolling hundreds of thousands of people in health plans is no easy task under any set of circumstances, it is clear that the support of the governor, state elected officials, and localities enhances implementation and boosts enrollment.

The available data shows that most enrollment trends are staying constant. The proportion of enrollees in the young invincible category remains at 25% nationally and at 26% in California. Applicants continue to choose Silver and some Bronze coverage.


Fun facts:

  • Californians are more likely than the rest of the country on average to enroll with premium assistance (88% vs. 83%)
  • More than 19 million calls have been placed to Exchange call centers nationally
  • Enrollees in states operating their own Exchanges are less likely to select a Silver plan than those living in states participating in the federally run Exchange (58% vs. 67%)
  • 55% of enrollees are female nationally, compared to 53% in California
  • 91% of the 27,000 people who have selected a catastrophic plan through the federal Exchange (the data isn’t available in California at this time) are between ages 18 and 34
  • 544,000 people have purchased standalone dental plans, which are not available in California this year

The federal briefs on enrollment are available here and here. This time next month we should have a peek at the FINAL enrollment numbers for the first open enrollment period (more folks will come in through special enrollment and through Medi-Cal throughout the year). It’s the final countdown…


80s jams optional.