2018 MIDTERM ELECTION

Time: D H M S

Here We Go: The Official ASPE Report Is Out...

(I'm "live-updating" this entry, so keep checking back for more notable data nuggets...)

OK, here we go. The top number isn't a particular surprise, of course, since a) I already had QHP selections marked at over 11.7 million as of 2/28 (today's ASPE report only runs through 2/22 for most states, 2/21 for the rest).

The key points (which have already been well-documented here and elsewhere, but it's nice to see it officially stated):

  • National plan selection data show that as of the end of the second Open Enrollment period, nearly 11.7 million Americans selected or were automatically reenrolled12 into a 2015 health insurance plan through the Health Insurance Marketplaces, specifically:
  • More than 8.84 million people selected or were automatically reenrolled in 2015 plans through the Marketplaces in the 37 states that are using the HealthCare.gov platform. This includes:
    • More than 4.6 million new consumers, 2.2 million active reenrollees, and nearly 2.0 million automatic reenrollees; and
    • 3.2 million (36 percent) people with plan selections who are under the age of 35.
  • Nearly 2.85 million people selected or were automatically reenrolled into 2015 plans through the Marketplaces in the 14 states (including DC) that are using their own Marketplace platforms in 2015.
  • Additionally, updated premium and tax credit information show that in the 37 States using the HealthCare.gov platform:
  • More than 8 in 10 individuals (nearly 7.7 million, or 87 percent) with a 2015 plan selection through the Marketplaces in the HealthCare.gov states qualify for an advance premium tax credit13 with an average value of $263 per person per month.
  • The average advance premium tax credit covers about 72 percent of the gross premium for individuals who qualify for an advance premium tax credit.
  • The average net premium is $101 per month among individuals with 2015 plan selections through the Marketplaces who qualify for an advance premium tax credit.
  • Overall, more than half (55 percent) of the 8.8 million individuals with 2015 plan selections through the Marketplaces in the HealthCare.gov states have 2015 plan selections through the Marketplaces with a monthly premium of $100 or less after applying the advance premium tax credit; about 8 in 10 had the option of selecting such a plan.

There's lots of other important stuff here as well:

  • The official 2/22/15 QHP selection total, according to HHS, is 11,688,074.
  • Part of the reason for the discrepancy between their number and mine is due to the 6-day difference; the rest is likely due to the 90,000 people who were kicked off of their policies due to legal residency verification issues:

For example, coverage has been terminated for approximately 90,000 consumers who had 2014 coverage were not able to continue their Marketplace coverage in 2015 because they did not provide the necessary documentation of their citizenship or immigration status, and these individuals are no longer included in the cumulative total. 

Those 90K have been "pre-purged" from the HC.gov total. I think they should have listed those folks separately (as part of the "attrition" column), since it's more confusing this way, but whatever.

Lessee...what else...

  • "Young Invincibles" (18-34 year olds) are the same as last year (28%), though kids under 18 are up from 7% to 8% of the total (HC.gov only)
  • As Andrew Sprung noted, check out the discrepancy between the income levels of those who enrolled in private policies via HC.gov in Medicaid expansion states vs. NON-expansion states:

If I'm reading this correctly, it looks like a whole lot of poor people in non-expansion states were effectively forced into padding their official income in order to qualify for federal tax credits due to their GOP overlords being jackasses. I'm not sure whether that's a problem legally (as opposed to deliberately cutting your official income), but it seems to me that this will only work for so long before it catches up with them recordkeeping-wise?

The HC.gov total (37 states) was already well-known a week or two ago. Big Picture-wise, this report mainly fills in the gap for the other 14 states:

Nearly 2.85 million individuals have selected 2015 plans through the Marketplace s in the 14 states (including DC) that are using their own Marketplace platforms for the 2015 coverage year as of 2-15-15 (including SEP activity through 2-21-15). 26 Several states (Maryland, Massachusetts, and Idaho) are unable to separate out data for new consumers and consumers reenrolling in coverage through the Marketplaces due to system vendor changes or other information technology system issues. This includes:

  • 357,764 plan selections through the Marketplaces in 3 states reporting all enrollees as new consumers because of systems issues. (Idaho, Maryland and Massachusetts); and
  • 2,492,019 plan selections through the Marketplaces in 11 states reporting data on new consumers, consumers actively reenrolling in Marketplace coverage, and automatic reenrollees (California, Colorado, Connecticut, District of Columbia, Hawaii, Kentucky, Minnesota, New York, Rhode Island, Vermont, and Washington).

Add them up and that's 2,849,783 via the 14 state-based exchanges. 

(For the record, my estimate for the SBMs as of February 22nd was 11,685,000 - 8,928,291 + 90,000 = 2,846,709).

Again, a minor point but bear in mind that today's report runs through February 22nd for 38 states (HC.gov + California), but only through February 21st for the other 12 states +DC.

Anyway, there's a whole mess of other stuff in the 70+ page report, of course, but let's cut to the info most of interest to me here at ACASignups.net: The state-level breakdown.

Hmmm...OK, for the most part the numbers only shifted slightly. Remember, while 131,000 more people enrolled across the 37 HC.gov states during the "Waiting in Line" extension period, these were mostly cancelled out by the 90,000 renewals who were given the boot for legal residency issues.

As a result of this, along with what I assume are corections of various clerical errors in prior reports, there are some mildly interesting tweaks here:

  • FLORIDA: The Sunshine State managed to actually lose about 5,000 from the 1.601 million they listed as of 2/15. I'm guessing that the bulk of the 90K with legal residency issues were in FL, and more than cancelled out the additions during the overtime period.
  • Similarly, Iowa, Kansas, Missouri and Montana are showing slightly lower totals; again, presumably residency cancellations outweighed additions.
  • TEXAS actually shows the greatest increase over the 2/15 total: Up around 15,000 total. Again, they might have had a lot of legal residency cancellations, but in their case the additions outnumbered those substantially.

There are, however, two states which puzzle me:

  • HAWAII: I was assured 8 ways from Sunday that Hawaii's 23,000 enrollee figure was specifically for 2015 enrollment. This made no sense to me given their tiny enrollment last year, but I was assured of it. Well, apparently my original instincts were correct, because they're showing up with only 12,625 in the end.
  • IDAHO: This is the only state which hasn't given their own enrollment update in forever. According to the prior ASPE report, they were at around 90.5K as of January 17th...yet somehow they only managed to rack up another 6,500 enrollees over the entire final month of Open Enrollment?? I was expecting upwards of 30K or so. This makes zero sense to me...am I missing something here?

In addition, there are a few states where their most recent official enrollment reports had some confusing data, which the ASPE report pretty much trumps regardless of anything else (at least, this is the official number which will be tossed around no matter what anyway):

  • CALIFORNIA: The CoveredCA report made it sound as though the total number selected was 1.439 million as of 2/26, minus 31,000 who had past-due payments or whatever. However, today's report gives the total as 1.412M, or 27K fewer. Whatever; they still barely squeaked past 2014.
  • COLORADO: Yesterday's official report added an extra week to the tally, but again, there seems to be around a 10,000 enrollee discrepancy due to the confusing nature of the CO report. 140.3K is CO's final official number.

Between Hawaii, California and Colorado, that's about 47,000 enrollees "lost" due to confusing reporting/interpretation.

Finally, for all the grief that California has taken for coming up 17% short of their internal target, New York really came up short; they were targeting an insanely ambitious 720,000, which would have been a whopping 94% increase over 2014. Instead they only hit 409K, which was just a 10.5% increase.

I'll be plugging the numbers into the Spreadsheet soon. Bear in mind that the ACA Signups spreadsheet totals will be slightly higher than today's report because I have more recent data from a few of the state exchanges (Maryland, Massachusetts, etc).

UPDATE x5: OK, after plugging in all of the data from today's report, subtracting out the 47K from CA/CO/HI, and then adding the additional numbers since 2/21 for various states, the official grand total confirmed as of today comes in at...

11,697,212.

Again, if you were to include those 90K "legal residency" folks it would be 11.79 million, but I'll let that go at this point.

16 more days have passed since just about all of these numbers. Assuming 9K/day "off-season" enrollees, that should mean roughly 140K more have been added, bringing the current total up to over 11.8 million.