Colorado: 13x as many people GAINED insurance this year due to the ACA than are "losing" it

2018 MIDTERM ELECTION

Time: D H M S

Some fun with numbers.

As I predicted in early September, Part Two of the "OMG!! GAZILLIONS OF POLICIES CANCELLED!!" freakout has commenced with 3 weeks to go before the election. Case in point: Colorado, where the state Insurance Commissioner sent a letter to "state Senate Republicans" yesterday (I'm going to assume that this was in response to their request, as opposed to the Commissioner voluntarily choosing to only inform the Republicans specifically) stating that a total of 22,000 policies are scheduled for cancellation due to non-compliance with ACA provisions:

Over 22,000 Coloradoans have had their health insurance canceled by Obamacare in the past month — and 200,000 are slated to be shut down in 2015, the state insurance department announced Friday.

The Colorado Division of Insurance wrote to state Senate Republicans Friday, notifying them that five more insurance carriers have ended plans for 18,783 more Coloradoans in just the last month. By far, the most canceled plans will come from Humana Insurance Company and Humana Health Plan.

OK, so: That's 22,000 people. Now, I could repeat the perfectly valid point that the insurance companies had 3 full years to bring their policies into compliance with the ACA before the first open enrollment period began last year, and that Humana/etc. could have followed the lead of some other companies in the state and extended these 22,000 out by another year or two thanks to the Obama administration's "grandfathering" provision.

However, they didn't do either of those things, and President Obama, to be fair, did kind of bring some of this on himself with his "If you like your plan you can keep it" declaration, so it is what it is: 22,000 Colorodans will have to replace their noncompliant policies with a compliant one by December 15th to avoid a coverage gap starting on January 1st. So be it.

That being the case, let's deal with the numbers as they are. First, regarding the other 200,000 "slated" to be discontinued next year, that's highly misleading. First, the actual number appears to be 192,942, about 7,000 fewer. More significantly, however, due to the heavy churn rate of the individual market, the odds are very high that around 58% of those 200K will be switching to some other form of insurance policy over the next year anyway, for reasons which have nothing to do with ACA noncompliance. That number is likely to be knocked down to perhaps 81,000 or so.

OK, back to the 22K at hand right now. Yes, that's kind of a bummer for them. They supposedly "liked" their policies (though an insurance policy seems like an odd thing to "like" as opposed to "being OK with" or "not minding"), and now they are, indeed, being told that they "can't keep it." Instead, they'll be required to (GASP) move to a compliant policy, which may or may not have higher premiums/co-pays/deductibles...but will almost certainly have better coverage, and in many cases may very well have lower premiums/etc. thanks to the tax credits available to about 85% of ACA exchange enrollees.

In other words, there's a world of difference between "not being able to receive healthcare insurance" (like, for instance, someone with a pre-existing condition or someone who makes too little to afford it but doesn't qualify for Medicaid, which was the situation before the ACA) and "having to move from one policy to another" which is a bit irritating but hardly devastating (I should know; I was one of those who was in this exact situation a year ago).

However, there's another factor to consider here: While 22,000 people in the state are facing the annoying-but-not-horrific prospect of switching policies, another 300,000 of their fellow Coloradoans have gained insurance who didn't have it before...thanks to the Affordable Care Act.

How do we know this? Well, the August Gallup survey states that the uninsured rate in Colorado has plummeted from 17% to 11% since last year. Colorado has around 5.26 million residents, which means if the Gallup survey is accurate, the number without insurance has dropped by around 315,000 people. Knocking off 15K from this in the interest of caution and that's still more than 13 times as many people who have gained insurance state-wide than who have "lost" it...and again, "lost" is pretty misleading since a half-hour of shopping around and a few forms will move them over to a new policy with better coverage, for the most part.

So, who are those 315K? Well, 148,600 people have enrolled in either private QHPs or SHOP plans, and CO's Medicaid/CHIP enrollment total had gone up by over 315,000 as of the end of August (from 833,480 in December 2013 to 1,148,834 as of August 2014). Assuming about 57% of the QHP enrollees were newly insured (that was the national rate according to the KFF), that means around 84,000 of that group, plus another 231,000 of the Medicaid/CHIP additions (the other 84,000 added to Medicaid/CHIP presumably had fallen on hard times and moved there from other coverage).

UPDATE: It just occurred to me that Gallup surveys generally don't include children under 18 (presumably for legal reasons), which includes about 23% of Colorado's population, leaving around 4.03 million adults. 6% of that is around 242,000, so I suppose it's unfair to say that the number of uninsured in the state has gone down by 315K; a more accurate statement would be "242,000 + an unspecified number of children under 18"...which is presumably somewhere between 0 and 73,000. If you split the difference, that's a total of around 280,000 Colordadoans, or "only" 12.7x as many as the 22K "losing" their policies this year.