The 22 States That Exceeded PPACA Exchange Enrollment Expectations

Last week, HHS released a data brief showing the state-based and federally facilitated exchanges had enrolled just over 8 million people.

Based on that data, healthcare advisory firm Avalere Health conducted an analysis and found 44 percent of the states will have met or exceeded their enrollment expectations for the first open sign-up period under the Patient Protection and Affordable Care Act, even if not everyone who enrolled in a plan will complete the enrollment process by making the first premium payment.

Avalere's analysts assumed only 85 percent of the people who signed up for a health plan will complete the enrollment process by making the first premium payment, in line with public comments made by health insurers participating in the exchanges and America's Health Insurance Plans. That means the overall enrollment total would be around 6.8 million people, still higher than the Congressional Budget Office's estimate of 6 million. In some states, the enrollment total will be much higher than the CBO predicted.

Elizabeth Carpenter, a director in Avalere's health reform practice, says it's hard to pinpoint why the top-performing states did so well. While the performances in some states that experienced significant problems with their exchange sites (such as Hawaii, which ranked 50th and enrolled only 46 percent of the expected amount after accounting for unpaid first premiums) predictably fell short of the benchmark, the top-performing states are a mixed bag in terms of whether the exchange was run by the state or by the federal government, as well as political inclination.

Ms. Carpenter says the analysis suggests other factors such as community assistance and outreach efforts played a part in exchange success. "Unfortunately, there isn't a common thread," she says of the top states. "The message it does deliver is there was more than a website and more than politics in play when it came to exchange enrollment."

From the analysis, here are the 22 states that exceeded expectations, after factoring in the assumed 85 percent attrition rate for the exchanges.

1. Florida (199 percent of projected enrollment)
2. California (186 percent)
3. Idaho (185 percent)
4. Washington (165 percent)
5. North Carolina (154 percent)
6. Michigan (153 percent)
7. Pennsylvania (150 percent)
8. Georgia (149 percent)
9. New Hampshire (141 percent)
10. Virginia (136 percent)
11. Montana (135 percent)
12. Colorado (126 percent)
13. Vermont (122 percent)
14. Utah (118 percent)
15. Tennessee (112 percent)
16. Alabama (109 percent)
17. Texas (108 percent)
18. Missouri (108 percent)
19. Kentucky (107 percent)
20. South Carolina (105 percent)
21. Nebraska (102 percent)
22. Mississippi (100 percent)

More Articles on PPACA Enrollment:
Health Insurers: Most Exchange Enrollees Have Paid First Premiums
6 Key Statistics on PPACA Enrollment for 2014
More Than 400k Enroll in PPACA CO-OPs


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