HealthCare.gov got off to a slow start, but volume has improved steadily both for new business and for renewal business. Although new signup activity was down 14% in the fourth week, year-over-over, that's an improvement from a 17% drop in the third week, and an 18% drop for all four weeks. The 4.9% year-over-year increase in renewal activity in the fourth week compares with a drop of 2.1% in renewal activity in the third week, and an 11% drop for all four weeks.
The Centers for Medicare and Medicaid Services (CMS), the federal agency that runs HealthCare.gov, counts a transaction as a sale only when a consumer has "effectuated" the coverage by making at least one premium payment. The consumers who are renewing their coverage are already making premium payments. Their renewals represent effectuated sales. The consumers who have signed up for the new coverage will not have to make their first payments for several weeks. Because, officially, many of the new customers have not yet bought their coverage, mid-season HealthCare.gov signup activity reports refer to "plan selection" activity, rather than to sales. The "open enrollment period," or time when people can buy individual major medical coverage without showing they have what the government classifies as a good excuse to be shopping for coverage, began Nov. 1 in most of the country and is set to run until Dec. 15 in most of the country.
HealthCare.gov runs what amounts to a family of web-based supermarkets for health insurance. The program helps consumers buy individual major medical coverage from commercial insurers, and use Affordable Care Act premium tax credit subsidies, in states that are unwilling or unable to handle all ACA exchange program operations. HealthCare.gov provides exchange enrollment and account administration services in 39 states. The District of Columbia and 11 states operate locally run exchanges. ACASignups.net is estimating that about 570,000 people had signed up for exchange plan coverage through state-based exchange programs by Nov. 24.
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