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Regional and State Trends in the Exchange

Another day, another set of awesome enrollment data from Covered California. This time we have a breakdown of enrollment by region, tier, and carrier in 2013. Here’s our analysis.

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The state is on pace to exceed base projections. Some areas, like much of Northern California, as well as Orange County and San Diego, have already exceeded projections three months early. These numbers only include enrollment through December; a more recent update shows that we have already met the performance target for 2013-14.

Some regions still need work. The Inland Empire, Fresno, Kern, and a few others haven’t enrolled as many people as we’d like. Other regions haven’t yet met projections, but are on pace to. These areas have a good number of folks eligible for subsidies but still not enrolling. Covered California and others will need to conduct more outreach in these regions.

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Price = market share. Carriers that could offer lower prices are the big winners when it comes to enrollment. Take the Northern Region for example. Anthem Blue Cross came in with the lowest bids, and beat out Blue Shield and Kaiser Permanente with 91% of enrollment. In San Francisco, small local plan Chinese Community captured 27% of the subsidy eligible with its very inexpensive premiums. Generally, areas with large, diverse populations, like Los Angeles, were far more competitive , with enrollment more equally distributed amongst carriers, albeit primarily amongst Kaiser, Blue Shield, Health Net, and Blue Cross. Regions with smaller populations were often dominated by one carrier.

Consumers seem to understand the tradeoffs. Luckily, those who qualify for subsidies seem to understand the system and are shopping smart. A vast majority (85% or more in most regions) of subsidized consumers are choosing bronze or silver coverage to minimize premiums. Very few people who qualify for premium assistance selected minimum coverage (catastrophic) plans, which subsidies cannot be applied to. It seems that consumers have a basic understanding of their options and are making informed choices.

The takeaway: the enrollment figures are promising. But remember, projections are not the same thing as targets. The base projection from CalSIM assumes we do an okay job of enrolling those eligible. Let’s set a higher goal, and then knock that out of the park.

Regional enrollment statistics by carrier and tier can be found here and here.

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