START OF 2018 OPEN ENROLLMENT PERIOD

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In which the CDC confirms what I was saying last fall: 6.8M exchange QHPs over course of Summer/Autumn 2014

Hey, remember this, from November 6, 2014?

In any event, there you have it. IF the other 2/3 of the states follow similar retention patterns to the 1/3 I have data for, the current number enrolled in exchange QHPs as of this writing should be somewhere between 6.8 - 7.0 million people.

Remember how I made 6.8 million the low end of that range in the interest of caution because HHS had previously insisted that the August effectuated enrollment number was 7.3 million?

And remember how 4 days after I posted the above, the HHS Dept. claimed that the actual number as of mid-October was still 7.1 million, and therefore I was supposedly "wrong"?

And remember how, 10 days after that (on November 20th), Alex Wayne broke the story that HHS had actually overcounted healthcare policy effectuations on the ACA exchanges by several hundred thousand people by including dental policies, meaning that the actual number in August was 6.9 million and the actual number in October was 6.7 million, meaning that I was actually right all along (even if I didn't know why at the time)?

Well, today the Center for Disease Control has issued their own Big Health Insurance Coverage report, and in the middle of the other data points, one leapt out at me:

  • Some 6.8 million people were covered through the health care law's new insurance markets during July-Sept. of 2014.

Yeah, I know, big deal; I was already vindicated when the dental plan story (which I labelled #ObamaDentata, too cute by half, at the time) broke, right?

OK, yes...but this is the first time that I've seen concrete evidence (beyond a vague "We said it was around 7.3 million at the time, but we overcounted by several hundred thousand" admission) of the actual effectuated number of enrollees during last summer and fall.

Why is this significant to me personally? This is why (click for higher-res image):

Last summer I spent a lot of time (and got into quite a few discussions/arguments with folks like Chris Conover) trying to figure out the number of a) off season enrollments on the exchanges and b) the drop-out (attrition) rates. I came up with a bunch of different scenarios using different percentages and daily/monthly rates, but in the end, the table above is the one that I settled on as likely being the most accurate depiction of how 2014 played out.

Take a look at the "Total" row: I had it reaching 6.7 million in May, climbing to just shy of 6.9 million in September and then dropping off to 6.6 million in December (thanks in large part to the 112K kicked off by HHS due to legal residency verification issues).

As for the rest of the CDC study, the Big Headline is actually quite misleading. Here's the headline:

Number Of Uninsured Fell By More Than 11 Million Since Passage Of Obamacare, CDC Reports

OK, that's good, but it's also far less than the 16.4 million that HHS is claiming, and even less than the 14.1 million that I agreed is a more realistic measurement. What's going on here?

Well, two things, which can both be found in this bullet point:

  • The number of uninsured dropped from 48.6 million in 2010 to 37.2 million for the period from Jan.-Sept. last year. That amounted to 11.4 million fewer uninsured since the signing of the health care law.

See that? First of all, "more than 11 million" is actually 11.4 million, 400,000 people higher; that's pretty significant.

The larger point, however, is that the CDC study only runs from 2010 through September 2014. That means it doesn't include anyone who gained coverage during the 2015 Open Enrollment period (of the 4.2 million new enrollees who are actually paying up). It doesn't include any of the net increase of 2.1 million additional people who have enrolled in Medicaid/CHIP since September (remember, Pennsylvania has added 200K since December alone, and Michigan has added another 190,000 since then).

Of course I don't know how many of those Medicaid or new exchange enrollees are newly insured, but if you assume, say, 35% and 60% respectively, you get:

  • 11.4 million + 1.5 million exchanges + 1.2 million Medicaid = 14.1 million to date.

Those numbers may be higher or lower respectively, since other people may have gained coverage off-exchange, or via SHOP, while still others may have gained or lost coverage via ESI etc, but the point remains: The CDC study stops as of last fall, not spring of 2015, and a lot has happened since then.