The Graph, UPDATED with 1 major addition & 2 major changes!
OK, I know I recently posted my "final" update to The Graph for the first Open Enrollment period...but I included an asterisk next to "final" for two reasons: First, because there will obviously still be more enrollments added throughout the summer and fall (Medicaid, SHOP, etc); second, because I've been debating one other major addition for awhile.
As regular readers know, when the famous RAND Corp. survey came out a month or so ago, there was a lot of hubbub about their claims of up to 7.8 million OFF-exchange QHPs between October and mid-March. I made a note of this figure, but eventually downshifted in favor of the 5 million off-exchange QHP figure estimated by the CBO.
However, RAND also estimated a net reduction in the uninsured rate overall of about 9.3 million as of mid-March...which would appear to be borne out by the recent Gallup poll showing a net reduction of about 11 million through the end of April.
So...which one is correct: 5 million or 7.8 million (more like 8 million for the RAND number, really, since the study only ran through mid-March)?
Well, there's a simple solution to that...the same one I'm using for other "depends on how you look at it" figures such as including Medicaid "woodworkers" or the dispute over whether the "sub26er" number is 1.6M or 3.1M: A range.
Therefore, I've added in one more section to The Graph. The OFF-Exchange QHP section is now broken into three areas: Documented (ie, specific hard numbers from scattered companies), Low-End Estimate (which adds up to the CBO's 5M figure) and High-End Estimate (which addes another 3M for the RAND figure).
In addition, I've gone back and retro-fitted a few of the earlier numbers to correct for the fact that the Medicaid/CHIP data tends to come in a full month or more after the actual time period when those people enrolled (ie, I recently added a good half-million people to Medicaid for March...but the report didn't come out until May, so they showed up as a weird spike at the end when in fact they belonged a good 5 weeks earlier). This has no impact on the final tallies, it just makes the earlier graph data more accurate visually.
Finally, there's one more significant change: While the GOP House Energy & Commerce Committee's infamous "67% paid" report was utterly full of crap, the testimony given by major insurers Wellpoint, Aetna and Health Care Service Corp (which operates Blue Cross/Blue Shield in 5 states) has actually led me to tentatively lower my own 93% figure slightly, to a flat 90%.
Don't get me wrong--I still think 93% is a possible final payment tally by the end of May, but the existing evidence does seem to indicate that around 90% is where things currently stand.
Now that we're out of the enrollment period, it should be easier to drill down and get more solid figures for every state (and in fact I now have data collected in May for at least 10 states). I'll adjust the 90% figure as new data warrants, and still expect it to nudge up a few percentage points...but it seems appropriate to start working more with the hard data at this point than with projections.
There's nothing to fret about, however: Even at 90%, the "How many have PAID???" figure still comes in at around 7.3 million QHPs...which is still 300,000 people more than the CBO's original 7 million projection from last year.
That's something to be impressed by no matter how you slice it.