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Regulation and Compliance > State Regulation

Some QHP pipes are faster than others

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Some of the public exchanges seem to having much better luck than others at convincing commercial plan applicants to actually choose commercial plans.

The federal – and many state exchanges – have had trouble getting their enrollment sites to work at all. And many of successful applicants are on track to get Medicaid or other public health coverage.

But what about the consumers who’ve navigated the eligibility process for commercial qualified health plans?

Most of the exchanges aren’t yet reporting figures for actual paid enrollment, in part because the first premium payments aren’t due yet. And two locally run exchanges – in the District of Columbia and Massachusetts – have no QHP selection data in the latest report.

But the percentage of eligible QHP applicants in the other states who got far enough along in the process between Oct. 1 and Nov. 30 to choose a QHP ranges from 1 percent in Oregon up to 50 percent in Maryland. Both of those exchanges are state-based.

All state exchanges combined report that 29 percent of their 781,875 eligible QHP applicants had picked QHPs by the end of November.

In the HHS-run exchanges, the percentage of eligible QHP applicants who’d signed up for QHPs by Nov. 30 ranged from 6 percent in Iowa and Mississippi to 14 percent in Montana. 

The average QHP applicant conversion rate for all 1.5 million HHS exchange QHP applicants was 9 percent.

The conversion rates could reflect factors such as how well an exchange enrollment system works, how well the QHP issuers’ own systems work, the percentage of qualified QHP applicants that are eligible for Patient Protection and Affordable Care Act subsidies, how clear and comprehensive the QHP information on the website is, and the performance of the issuers’ off-exchange marketing programs.

Some exchanges in low-population states and states that have had a hard time getting many consumers through QHP eligibility screening have high QHP conversion rates. Maryland, for example, had approved only 7,465 QHP applicants by Nov. 30, but half of those applicants have already signed up for QHPs.

In the state-based exchange states with at least 50,000 approved QHP applicants, California ranked first, with a conversion rate of 47 percent, and Washington ranked second, with a conversion rate of 30 percent.

Colorado made it past the 50,000 QHP applicant approval cut-off, with 60,508 approvals, but it’s had a conversion rate of just 16 percent.

Among the federal exchanges, three states – Florida, Pennsylvania and Texas – have more than 100,000 approved QHP applicants. Florida had a 9 percent QHP applicant conversion rate, Pennsylvania a 12 percent conversion rate and Texas an 8 percent conversion rate.

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