(Image: Centers for Medicare and Medicaid Services)

HealthCare.gov may have suffered its first year-over-year drop in activity volume during the fifth week of the open enrollment period for individual health insurance for 2018. 

The Centers for Medicare and Medicaid Services (CMS), the federal agency that runs the web-based health insurance supermarket program, says 823,180 people chose coverage through the system during the week that ended Saturday.

Those people were on track to have a private coverage purchased through HealthCare.gov in place starting Jan. 1, 2018.

(Related: HealthCare.gov Posts 7.6% Growth for Weeks 3 and 4)

The system has received plan selection information for a total of 3.6 million people.

Because CMS reported activity data for the open enrollment period for 2017 every two weeks, making year-over-year comparisons is difficult. 


An Affordable Care Act exchange is a web-based system that sells individual and small-group health coverage from private insurers.

The U.S. Department of Health and Human Services set up HealthCare.gov to provide ACA exchange account setup and administration services for states that are unwilling or unable to provide those services.

CMS gives families that select coverage several weeks to “effectuate” their coverage, or put it into effect, by making their first premium payments. Because much of the coverage chosen through HealthCare.gov has not yet been effectuated, CMS reports activity data in terms of the number of people who have selected plans, rather than the number of people who have purchased plans.

Tighter Deadline

The enrollment period for 2017 started Nov. 1, 2016, and ended Jan. 31, 2017.

The enrollment period for 2018 started Nov. 1 and is set to end Dec. 15.

The earlier end date means that HealthCare.gov must generate higher average weekly activity levels this year to bring in as many enrollees as it brought in last year.

In past years, making HealthCare.gov Jan. 1 enrollment projections based on weekly activity reports has been difficult, however, because floods of last-minute applicants have caused spikes in deadline-week activity levels. 

—Read HealthCare.gov Managers Talk About Agent Comp on ThinkAdvisor.

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