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5 states where new public exchange business poured in

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In the world of politics, HealthCare.gov is either a bold agent of health care system change or a demonic agent of those scoundrels in Washington.

In the world of health insurance sales, HealthCare.gov is just another distribution channel. The system handles Patient Protection and Affordable Care Act (PPACA) exchange enrollment for the states in which the U.S. Department of Health and Human Services (HHS) provides exchange services.

HHS has still not persuaded the states running state-based exchanges to report their exchange performance data in the format HHS uses for HealthCare.gov, and HHS does not make it easy to compare data for the 2014 open enrollment period with data for the 2015 open enrollment period.

But HHS has been publishing data for all states on the number of people known to have selected qualified health plan (QHP) coverage through a PPACA exchange through Feb. 22, and the number of QHP selectors in each state who are new to the exchange system.

The numbers reflect the number of people who are on track to have QHP coverage. In many cases, the plan selectors have not yet paid for coverage. HHS considers consumers to be official QHP enrollees once they have “effectuated” their coverage by making premium payments.

The second annual open enrollment period officially started Nov. 15 and ended Feb. 15. Most states offered access to broad enrollment period extensions for at least a few days, and taxpayers who say they learn about the PPACA individual mandate penalty when they file their 2014 taxes will get a special enrollment period that will last from March 15 through April 30 in most of the country.

The total number of selectors has increased about 34 percent between April 19, 2014, and Feb. 22, 2015 — after the official end of the enrollment period and before the tax season enrollment period.

Enrollment changes ranged from a decrease of 17 percent in Vermont, a state that was notoriously cold toward agents and brokers as it was setting up its state-based exchange, up to an increase of 343 percent in Massachusetts, a state that had terrible technical problems in 2014.

See also: Vermont governor’s nightmare is almost over

Aside from Massachusetts, the state with the strongest QHP selector growth was Louisiana. Insurers have attracted 186,277 residents of that state to exchange QHPs for 2015, 83 percent from the April 2014 selector total.

Exchange managers in five states — Idaho, Maryland, Massachusetts, Nevada and Oregon — are counting all 2015 QHP enrollees as new QHP selectors. 

In the other states, the percentage of QHP business coming from QHP selectors who are new to the system ranges from 14 percent in Vermont, and 26 percent in the District of Columbia, up to 75 percent in Hawaii.

In some states, the change in the percentage of business coming from “new cases,” rather than re-enrollment of existing exchange customers, may reflect the effects of technical problems that occurred last year or this year. In other states, the change may reflect fluctuations in the percentage of residents who have access to employer-sponsored coverage, or to Medicaid programs or other government health programs.

But, in some states, the change numbers may reflect how well HealthCare.gov is doing at going out for business.

For a look at the top five generators of new exchange business (excluding the states that counted all QHP selectors as new selectors), read on. 

Kids with pony

5. Texas

Total number of 2015 exchange QHP selectors: 1,295,174

Percentage of QHP selectors who are new to the exchange system: 57%

Growth in number of QHP selectors between 2014 and 2015: 64% 

See also: 10 PPACA exchanges with upmarket appeal

Bourbon Street in New Orleans

4. Louisiana

Total number of 2015 exchange QHP selectors: 186,277 

Percentage of QHP selectors who are new to the exchange system: 58%

Growth in number of QHP selectors between 2014 and 2015: 83%

See also: HHS: Florida has 1.2 million exchange plan enrollees

Charleston, South Carolina

 3. South Carolina

Total number of 2015 exchange QHP selectors: 210,331

Percentage of QHP selectors who are new to the exchange system: 58%

Growth in number of QHP selectors between 2014 and 2015: 78%

See also: Top 10 states with lower uninsured rates after PPACA [infographic] 

Map showing Minneapolis

2. Minnesota

Total number of 2015 exchange QHP selectors: 59,704

Percentage of QHP selectors who are new to the exchange system: 60%

Growth in number of QHP selectors between 2014 and 2015: 23%

See also: Minnesota PPACA exchange loses dominant carrier 

Hawaii beach

1. Hawaii

Total number of 2015 exchange QHP selectors: 12,625

Percentage of QHP selectors who are new to the exchange system:  75%

Growth in number of QHP selectors between 2014 and 2015: 47%

See also: What auditors said about Hawaii’s exchange

HHS data for all states

New HHS exchange customers

  

 

Share of 2015 enrollees who are new to the exchange

Total 2015 exchange QHP selectors

Total 2014 exchange QHP selectors

Change in total QHP selectors

Alabama 54% 171,641 97,870 75%
Alaska 52% 21,260 12,890 65%
Arizona 48% 205,666 120,071 71%
Arkansas 44% 65,684 43,446 51%
California 35% 1,412,200 1,405,102 1%
Colorado 28% 140,327 125,402 12%
Connecticut  38% 109,839 79,192 39%
Delaware 51% 25,036 14,087 78%
District of Columbia 26% 18,465 10,714 72%
Florida 55% 1,596,296 983,775 62%
Georgia 55% 541,080 316,543 71%
Hawaii 75% 12,625 8,592 47%
Idaho  100% 97,079 76,061 28%
Illinois 50% 349,487 217,492 61%
Indiana 50% 219,185 132,423 66%
Iowa 53% 45,162 29,163 55%
Kansas 52% 96,197 57,013 69%
Kentucky  26% 106,330 82,747 29%
Louisiana 58% 186,277 101,778 83%
Maine 47% 74,805 44,258 69%
Maryland 100% 120,145 67,757 77%
Massachusetts 100% 140,540 31,695 343%
Michigan 42% 341,183 272,539 25%
Minnesota 60% 59,704 48,495 23%
Mississippi 56% 104,538 61,494 70%
Missouri 52% 253,430 152,335 66%
Montana 41% 54,266 36,584 48%
Nebraska 53% 74,152 42,975 73%
Nevada 100% 73,596 45,390 62%
New Hampshire 40% 53,005 40,262 32%
New Jersey 48% 254,316 161,775 57%
New Mexico 51% 52,358 32,062 63%
New York  35% 408,841 370,451 10%
North Carolina 51% 560,357 357,584 57%
North Dakota 45% 18,171 10,597 71%
Ohio 47% 234,341 154,668 52%
Oklahoma 54% 126,115 69,221 82%
Oregon 100% 112,024 68,308 64%
Pennsylvania 41% 472,697 318,077 49%
Rhode Island  32% 31,337 28,485 10%
South Carolina 58% 210,331 118,324 78%
South Dakota 47% 21,393 13,104 63%
Tennessee 53% 231,440 151,352 53%
Texas 57% 1,205,174 733,757 64%
Utah 49% 140,612 84,601 66%
Vermont 14% 31,619 38,048 -17%
Virginia 54% 385,154 216,356 78%
Washington state 37% 160,732 163,207 -2%
West Virginia 49% 33,421 19,856 68%
Wisconsin 44% 207,349 139,815 48%
Wyoming 48% 21,092 11,970 76%

Source: ASPE May 2014 and March 2015 issue briefs. 

See also: HHS extends PPACA enrollment for some