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Consumer fear about the future of the Affordable Care Act public exchange system may be driving early sales of 2018 public exchange plans through the roof. took in 2018 plan selection information for an average of about 150,000 people per day during the first four days of the open enrollment period for 2018, according to the Centers for Medicare and Medicaid Services (CMS).

That’s up about 79% from an average of 84,000 per day during the first 12 days of the open enrollment period for 2016, according to a comparison of the new data with data CMS posted about a year ago.

(Related: Open Enrollment 2018 Crawls Into Open)

Plan selection activity for returning users has increased 83%, to about 116,000 per day.

Activity for users that are new to the exchange plan system has increased 67%, to 34,000 per day.

The new CMS figures suggest that the website might be working better than the call centers, or that the website might have an easier time increasing volume than the call centers do: The average daily user count has increased 70%, year-over-year, to 643,000. The average daily number of call center users has increased just 27%, to 132,000.

State-Based Exchange Programs

The new CMS report does not give exchange plan activity data for the state-based exchange programs., an ACA exchange activity tracking service, is reporting that early state-based exchange activity appears to be strong. In Maryland, for example, daily plan selection activity has been about twice as high as it was early in the fourth open enrollment period.

A open enrollment video (Image: CMS/YouTube)

A open enrollment video (Image: CMS/YouTube)

Managers of, a health insurance web broker, reported last week that its first-day application activity for 2018 was double the level of activity it recorded for the first day of the fourth annual ACA open enrollment period.

The ACA Public Exchange System

When Democrats were drafting the legislation that created the Affordable Care Act, they developed the ACA public exchange system to give consumers a mostly web-based system for shopping for health plans on an apples-to-apples basis.

A public exchange program offers health insurance plans from private health coverage issuers.

Some states have set up their own state-run ACA public exchange programs.

The U.S. Department of Health and Human Services, the parent of CMS, had CMS set up to provide exchange account setup and administration services for states that are unwilling or unable to provide those services. is now handling exchange plan applications for 39 states.

Exchange managers, insurers and state regulators developed an “open enrollment period” system, or limits on when people can buy individual major medical coverage without having what the government considers a good reason to do so, to discourage people from waiting until they get sick to pay for coverage.

The idea is that consumers will rush to buy coverage during the open enrollment period, to avoid getting stuck with medical bills they can’t pay, and an inability to buy health insurance, at other times of the year.

The open enrollment period for 2018 started Nov. 1 and is set to end Dec. 15 in most of the country.

The current open enrollment period is the fifth conducted under Affordable Care Act individual major medical coverage rules. managers and managers of the state-based exchange programs often report on the number of people who have selected plans, rather than on plan sales, because users of most exchange programs have several weeks to “effectuate” their coverage by making their first premium payments. In the past, exchange managers have reported that about 85% of the people who select plans go on to effectuate their coverage.

—Read Web Broker Reports Strong Individual Health Activity on ThinkAdvisor.

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