St@teside

Since open enrollment began on October 1, 2013, the media and others have been intensely interested in the progress of exchanges in registering and enrolling consumers. The challenges and “glitches” in the exchange websites have intensified this interest and put pressure on states to report how people are moving through the process. While exchange officials continue to stress that consumers have time to complete eligibility applications and select plans, they have also begun to report some initial metrics. The following table (from the New York Times with some additions by SCI) reports some of the initial numbers coming from states and the federal government.

Following are some other state strategies for exchange officials to consider as they develop their own reporting approach.

• Given that it may take time for consumers to complete the full application and enrollment, states can share intermediate metrics. For example, Connect for Health Colorado released a “Week 1 Snapshot” that highlighted total unique website visitors (162,941), total customer accounts created (18,174), total calls and chats serviced (9,658), average call and chat wait time (5 minutes, 44 seconds), percent of calls answered within 20 seconds (33%), enrollments (226), and covered lives (305).
• States have varied as to whether they include Medicaid data in their exchange metrics; those who have included Medicaid have been able to show higher enrollment rates.
• States have been able to further increase Medicaid enrollment through express lane enrollment (ELE), relying on eligibility information from other state agencies to streamline enrollement. Express Lane agencies include Supplemental Nutrition Assistance Program (SNAP), School Lunch, Temporary Assistance for Needy Families (TANF), Head Start, and Women, Infant, and Children's program (WIC), among others. For example, Oregon used financial data on food stamp recipients and participants in the Healthy Kids program to identify adults who likely will qualify for the Oregon Health Plan under Medicaid expansion.
• Minnesota has reported progress in relation to their goals. Last week, MNsure announced it had reached 10 percent of its enrollment goal for the first open enrollment period, with 11,684 people signed-up and another 3,769 applications in the works. 
• State exchanges have countered some of the negative reports by recounting personal stories of consumers who have successfully enrolled. Stories can be identified through social media sites, among other places. While individuals have acknowledged the access challenges, they have also expressed their excitement over ultimately becoming enrolled.
• Maryland has taken the approach of giving more detail on the types of people seeking coverage, including the announcement that the two most common age groups to register for coverage were between the ages of 25-29 and 30-34.
• While they have released some interim metrics, Peter Lee, the executive director of Covered California, held firm that they will not release enrollment figures until mid-November. He has maintained that the expectation of daily and weekly updates is unreasonable, pointing out that public companies normally present quarterly reports. He has stated that Covered California will release a detailed report in November that includes regional variation, demographics, and the type of plan selected, among other things.