Confirmed Exchange QHPs: 12,024,658 as of 7/03/15
Estimated: 12.80M (9.71M via HCgov) as of 7/03/15

Estimated ACA-Enabled Policy Enrollment: 32.7M
(10.3M Paid/Effectuated Exchange QHPs, 8.2M OFF-Exchange QHPs, 180K SHOP, 14.0M Medicaid/CHIP)

OK, this is kind of amusing. Over at right-wing nutbag-conspiracy-theory-repository/occasional-real-news site Breitbart.com, there's an attack piece hyping up the expected 2016 individual insurance market rate increases, based on various recent articles such as Robert Pear's piece over at the New York Times last Friday, which I talked about this morning.

Needless to say, being Breitbart, they lay on the "OMG!! SKY IS FALLING!! MASSIVE RATE HIKES!!" stuff pretty thick, and as I've noted repeatedly, in some cases that may very well be true. I didn't bother reading most of it since I already know what it says.

However, there's one rather curious passage which did catch my eye:

Regulators for Covered California, the largest Obamacare exchange with 1.4 million members, have been mum on just how big their premium rate increase will be. But with the exchange already expected to lose $78 billion in the state fiscal year that began July 1, there is no state money for extra subsidies.

As I noted at the end of April, after climbing at a furious pace every week for months on end, Michigan's implementation of the Affordable Care Act's Medicaid expansion provision (aka "Healthy Michigan") plateaued at around 600,000 enrollees back in February, and then bobbled around the 600K level for several weeks straight. As I noted at the time, I'm still checking this figure weekly, but it has never deviated far from that number--sometimes a bit higher, sometimes lower.

As of June 30th, it stood at 606,779. 600K seems to be the level that ACA Medicaid expansion can be expected to stay at for the forseeable future.

Louise Norris has provided some valuable information about 2016 individual market rate change requests in her home state of Colorado:

For 2015, Colorado HealthOP cut premiums aggressively, and ended up with the lowest-cost plans in eight of the state’s nine rating areas.  Unsurprisingly, that resulted in the CO-OP garnering the highest market share in the exchange during the 2015 open enrollment period, with nearly 40% of exchange enrollees selecting Colorado HealthOP coverage (among our own clients, Colorado HealthOP was even more popular, including among those who selected off-exchange coverage).

...In 2015, Colorado HealthOP got almost 40% of the exchange’s market share, and Kaiser was a close second with 35%; the two non-profits accounted for three-quarters of all the private plan enrollees in Connect for Health Colorado this year.

The last official enrollment update for Rhode Island was 31,513 people as of 2/23/15, of which 30,001 had paid their first monthly premium at the time.

On the one hand, that makes it look like an amazing 95% payment rate; however, RI also "pre-purged" unpaid enrollments which missed the payment deadline prior to officially reporting them, so their payment rate actually ended up being more like 91% (ie, 30K out of around 33K total selections).

As of July 3rd, the QHP selection total for RI stood at "over 36,000":

HealthSource RI has enrolled over 36,000 Rhode Islanders in 2015 healthcare coverage to date. Some Rhode Islanders may be eligible for a special enrollment period (outside of open enrollment) during which they can get coverage because of qualifying life-change events (such as a change in family status, loss of insurance, and certain hardships).  More information about who qualifies for a special enrollment period is available at HealthSourceRI.com.

I've had no fewer than a dozen different people call my attention to a story in the New York Times last Friday by Robert Pear which lays out the dramatic 2016 rate increase requests from various insurance companies across multiple states:

Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more, saying their new customers under the Affordable Care Act turned out to be sicker than expected. Federal officials say they are determined to see that the requests are scaled back.

Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives.

(sigh) Just when you thought it was safe to go back in the risk pool...

Now that the dumbest lawsuit ever to make it to the United States Supreme Court has been kicked to the curb, you might think that it's smooth sailing for the Affordable Care Act, at least legislatively-speaking. You would, of course, be wrong:

The Obama administration and House Republicans are clashing over the healthcare law in court, with the Justice Department blasting a GOP lawsuit as "unprecedented."

House Republicans are suing President Obama over what they call executive overreach, saying Obama is unconstitutionally spending money on an ObamaCare program Congress declined to appropriate money for.

The Obama administration counters it does not need an appropriation because the funds were made permanent and mandatory by the Affordable Care Act. The funds in question are for “cost-sharing reductions” that help insurers lower out-of-pocket costs for low-income people.

As we head into the holiday weekend, and with King v. Burwell finally in the rearview mirror (thank God...and the Supreme Court), it's time once more to update The Graph.

As you can see, assuming appx. 7,500 QHP selections per day nationally during the off-season, the grand total for 2015 should be crossing the 12.8 million mark right about...NOW. (OK, give or take a week or so...it's possible that things slowed down considerably in the days leading up to the King v. Burwell decision due to all the uncertainty...on the other hand, there might have been a mini-surge this week as a bunch newly-married same-sex couples signed up. Who knows?

Back in April, the HHS Dept. provided a massive Excel file containing total 2015 QHP selections across the 37 states run through Healthcare.Gov, broken out by Zip Code.

By digging into the weeds and doing some serious data-crunching, you can get all sorts of interesting info. For instance, Families USA was able to figure out just how many people were at risk of losing their federal tax credits in each individual Congressional District in the 34 states which were at risk from King v. Burwell, and so forth.

As I noted last week, now that the King v. Burwell debacle is behind us, all options are on the table for the future of the 13 remaining "full" state-based exchanges (Hawaii is in the process of moving over to Healthcare.Gov for 2016, joining Oregon and Nevada). The two additional state exchanges most likely to make the move are Vermont (which is having both serious technical and funding issues) and Minnesota (where neither issue is quite as bad, but still troubling). The other 11 exchanges are in considerably better shape on the technical side, but the financing situation varies widely.

Fortunately, it looks like at least one state exchange has turned the corner, or at least is pretty confident that they're about to: The largest one in the country, Covered California. They just released a report at the Alliance for Health Reform forum; for the most part it's a general overview of CoveredCA's 2015 enrollment situation, rehashing data which was already known (1.3 million currently enrolled, etc.) However, there's a few noteworthy slides which fill out the picture more completely.

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