Duke Health Sector Advisory Council

Speaker Spotlight – Matthew Eyles

Exchange enrollment 55% projections, state progress varies dramatically

I’m looking forward to being at the Health Sector Advisory Council meeting April 28-29, 2014.  We’ll be looking in more depth at the enrollments and the structural changes that are occurring in the US health care system since the passage of the ACA.
My colleague Caroline Pearson worked with me and the Avalere team on this quick analysis regarding the enrollments to date.  In total, enrollment grew by 1.1 million in January, a 50 percent increase over 2013 year-end totals. In 15 states, enrollment exceeds 60 percent of those expected to enroll in 2014.

“The latest data shows that exchange enrollment continues to rebound following early technological problems, although progress is uneven across states,” said Caroline Pearson, Vice President at Avalere. “The question remains if the final enrollment surge at the end of March will make up the ground lost in October and November.”
Several states with state-based exchanges continue to lead the way in meeting enrollment expectations, including California and Washington. Meanwhile, state-based exchanges in Massachusetts, DC, and Hawaii continue to lag behind. Interestingly, enrollment in Oregon is average (52 percent), despite delayed launch of their online webportal.

States using healthcare.gov infrastructure outpaced state-operated exchanges in January. Idaho and North Carolina lead the way among federally-operated states, while Arkansas and Iowa have enrolled less than 20 percent and 30 percent respectively.

Methodology and Notes

Avalere’s analysis incorporates the HHS enrollment figures released on February 12, 2014 as well as updated state-specific tracking from publically available resources. Enrollment projections are based on Avalere’s enrollment projections for year-end 2014, assuming smooth implementation across states (i.e., stable participation rates), applied to the CBO’s February enrollment projection of 6 million.

* Note: Projected exchange distribution from the Avalere model includes Medicaid enrollees through state premium assistance programs in Arkansas, Iowa, and Pennsylvania.

Matthew Eyles guides Avalere’s focus on health care reform, health plans, providers, and data analytics. He joined Avalere from Coventry Health Care, where he oversaw policy, government relations, and corporate communications, and was central to crafting the firm’s strategy on exchanges, Medicaid, and Medicare. Before his work for Coventry, he directed worldwide policy at Wyeth, and began his career as a health care analyst at the Congressional Budget Office.