GRAHAM-CASSIDY REPEAL BILL DEADLINE:

Time: D H M S

Considering that one of their Senators is a major Presidential candidate, Vermont is awfully quiet this year...

As I noted last week, Your Health Idaho has released their final official OE3 number. I had previously noted that there were only 8 states in which the exchanges appeared to have performed worse on private policy enrollment in 2016 than they did in 2015, and that most of those had special circumstances:

  • Idaho and Connecticut are both above 99% of their 2015 numbers and are still missing some data (5 and 12 days worth respectively), so they'll both almost certainly make it over the 100% line in the final tally.
  • Vermont is only at 89% of their 2015 total, but is still missing a whopping 36 days worth of data; if they tacked on another 3,400 people since Christmas they'll break 100%.
  • Pennsylvania and Indiana both expanded Medicaid last year; around 100K and 50K people likely were shifted over to Medicaid who otherwise would've enrolled in private policies this year.
  • New York is only at 64% of their 2015 mark, but they also enrolled 400K in their new Basic Health Plan, 300K of whom were moved from QHPs.
  • That leaves only Kentucky and Arizona below the 100% threshold...and even Arizona (at 98.74% of their 2015 total) was likely slightly above 100% if you assume that a proportionate percentage (2.1%) of the 300K "pre-purged" HC.gov enrollees were located in AZ. That would add around 6,300 more to their total, putting them at around 209,300...or around 3,600 ahead of last year.

Since then, both Connecticut and Idaho came out with final numbers, and as I expected, both nudged them over the top.

New York's Basic Health Plan number was actually later clarified; the total number is still accurate, but it looks like only around 160,000 of them actually transferred over from exchange QHPs. Still, when you add those to the 260,000 QHP enrollees for this year, it still adds up to over 420,000...which, again, is slightly ahead of last year's 408,841 New Yorkers.

As noted, a similar case holds true in both Pennsylvania and Indiana, where thousands of people were shifted from exchange QHPs over to Medicaid thanks to ACA expansion kicking into gear in both states.

Kentucky I've already discussed ad nauseum.

Arizona is officially exactly 2,600 behind last year, but again, if you include their share of the 300K who were "pre-purged" from the HC.gov number, they're almost certain to have squeaked over the 100% mark.

This all leaves...Vermont.

As I noted earlier, as of December 26th they had signed up exactly 28,258 people, 3,361 fewer than they did in 2015 (which itself was 6,429 fewer than 2014). If this number holds, Vermont could conceivably hold the distinction of being the only state to drop ACA exchange enrollment two years in a row.

Of course, as I also noted, there's still 36 days of data missing from VT's total. They should have easily made up that 3,361 gap in that time. Nationally, as of 12/26, there roughly 11.2 million people had selected QHPs out of the 13.0 million who would eventually go on to do so (remember, at least 300,000 selections were "pre-purged" but have to be counted here for an apples-to-apples comparison). That's around 86.1% of the final total. Assuming Vermont followed this pattern, 28,258 would equal aorund 86.1% of their total, which would be around 32,800, or roughly 1,200 more than last year. Even if their 12/26 tally represented 89% of the total, they'd still inch just over the 100% mark.

Of course, I could avoid a lot of this tea leaf reading if the Vermont exchange would actually release their enrollment data...which they've failed to do at all so far.

I'm serious--not a single number has been released from VT Health Connect. Last year they released numbers on a fairly regular basis, and happily replied to my email requests...this year, zilch. Radio silence. They've only posted a single press release since 2016 Open Enrollment started back in November, and even that was just to let residents know that they'd finally added some sort of window shopping tool.

In fact, the only reason I even have the 28,258 figure from 12/26 is because of the mid-period ASPE report. They're reporting the numbers to HHS, so obviously they could be publicizing their enrollment data on a more frequent basis, but they're choosing not to this year.

(Note that the NY State of Health exchange hasn't exactly been a bastion of enrollment data frequency either, but at least they've chimed in a couple of times along the way.UPDATE: Strike that; New York just released their final numbers as well.

For whatever reason, the Vermont ACA exchange has made a conscious decision to go backwards on transparency this year, and I suspect I have a good idea of what that reason is.