In a classic case of missing the forest for the trees, I posted two very wonky, detailed entries over the past couple of days about Minnesota and Connecticut's latest enrollment numbers...but completely missed one crucially important data point.
Back in January I noted that Moda Health Plans, which had plenty of self-inflicted wounds in addition to being kneecapped by the Risk Corridor Massacre, was dropping out of the Oregon exchange and likely the Alaska exchange as well, so today's news isn't a big surprise.
The individual market in Alaska has just two carriers in 2016: Moda and Premera. Both have struggled with significant losses under the ACA, and Moda nearly exited the Alaska market altogether in late January (more details below).
Finally, on the Medicaid spreadsheet, I've gotten as close as possible to an accurate count of the number of new Medicaid/CHIP enrollees which are PURELY due to ACA Expansion. To achieve this number, I took the total number of new enrollees and first removed the 25 states which haven't expanded Medicaid at all. This leaves 26 states (including DC). Then, I used Washington State as a guideline for the split between "ACA Expansion Only" and "Out of the Woodwork" enrollees (ie, people who were previously eligible pre-ACA but didn't enroll until after October 1st for various reasons). Washington has had a pretty consistent ratio of 2/3 Expansion Only to 1/3 "Woodworkers". I have no idea if that's representative of the other 25 states, but it's the best I can do for now. Note that this still also includes those who are newly eligible...but under the old Medicaid rules (ie, someone who simply fell on hard times after October 1st).
Gov. Rick Snyder said Tuesday he will seek permission from the Obama administration to allow all young people in Flint the chance to receive publicly funded health care services for lead exposure amid the city's contaminated drinking water crisis.
...The White House and federal Department of Health and Human Services did not have an immediate response Tuesday to Snyder's initiative targeting Flint residents up to age 21 through the expansion of Medicaid.
Even then, he wasn't exactly in a big hurry to do so; he waited another 3 weeks to get around to actually submitting his request:
I was fascinated when I saw this phenomenon happen here in Michigan last year, but it's repeated itself in several other states since then. State and federal officials crunched their demographic data and came up with estimates of the maximum number of residents who they expected to be eligible for the ACA's Medicaid expansion provision a couple of years back, along with the number of those expected to enroll in the program in the first year. They're then caught offguard when not only does the actual number eligible turn out to be far higher than they expected, but far more of those eligible go ahead and sign up in the first year than expected.
In Michigan, estimates ranged from 477K - 500K being eligible; instead, the number broke 600,000 the first year, where it's hovered around ever since (as of last week it stood at 615,536).
A couple of days ago I noted that after two years of nothing but doom & gloom (and coming just a week after UnitedHealthcare pulled the plug on the individual market in over two dozen states) there seems to finally be some positive developments, with companies like Centene and Anthem reporting better-than-expected results. They may not be making a profit yet, but at least they aren't losing money hand over fist the way they did the first couple of years.
I also made a brief mention of the Maryland Co-Op, Evergreen Health, which reported their first quarterly profit since launching 2 1/2 years ago.
Consumer operated and oriented health plans in Maryland, New Mexico and Massachusetts will report profits in the first quarter, in a sign that some of the remaining Affordable Care Act-created nonprofits could be finding their footing on the state exchanges.
Ryan wants to end Obamacare cost protections for sick consumers
U.S. House of Representatives Speaker Paul Ryan called on Wednesday for an end to Obamacare's financial protections for people with serious medical conditions, saying these consumers should be placed in state high-risk pools.
In election-year remarks that could shed light on an expected Republican healthcare alternative, Ryan said existing federal policy that prevents insurers from charging sick people higher rates for health coverage has raised costs for healthy consumers while undermining choice and competition.
The rule, a cornerstone of President Barack Obama's Affordable Care Act, has been praised by patient advocates for providing access to medical care for people who previously could not afford private health insurance. The Affordable Care Act also bars insurers from excluding coverage for pre-existing conditions.
A few months ago I noted that while UnitedHealthcare and some other carriers may be losing money hand over fist on the ACA exchanges, at least some of them are making a profit, breaking even or at least cutting their losses down to a reasonable level.
As a simple reminder, competitive markets should see some companies make money and some companies that offer more expensive and less attractive products lose money. I would be extremely worried if everyone was making money after three years, just like I would be extremely worried that everyone was losing money after three years of increasingly better data.
Over the past week or two I've been compiling the currently effectuated exchange enrollments for as many states as possible (the official Q1 ASPE effectuation report likely won't be available until early June). So far I have the data from either February, March or April for 7 states: CO, CT, MA, MN, NH, OK and WA.
Today I can add Idaho to the list, and unlike some of the other states, Your Health Idaho's number appears to not only be cut & dry, but very good news indeed:
Hello Mr. Gaba,
Your Health Idaho’s effectuated enrollments for March stand at 95,522. Numbers for April are preliminary at this point.