START OF 2018 OPEN ENROLLMENT PERIOD

Time: D H M S

New York: 218K QHPs, 636K BHP, 286K CH+ through 12/24

At long last, the New York State of Health ACA exchange has released hard enrollment numbers for the 2017 Open Enrollment Period:

22 Percent Increase Over Last Year  •  New Yorkers Show Demand for Quality, Affordable Healthcare

ALBANY, N.Y. (January 6, 2017) – NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.4 million people have enrolled in health insurance through December 24, 2016.

With almost a month to go until the end of the 2017 Open Enrollment period, participation in the NY State of Health Marketplace has already increased more than 22 percent since the last Open Enrollment period ended, January 31, 2016. Enrollment has increased in all 62 counties of the state. The overall share of New Yorkers now enrolled through the NY State of Health has reached nearly 18 percent of the state’s population.

“NY State of Health continues to make it easy to get a good, low-cost health plan, driving down the state’s uninsured rate from 10 percent in 2013 to 5 percent, in 2015, the lowest rate in decades,” said NY State of Health Executive Director Donna Frescatore. “We encourage New Yorkers who have not yet signed up to enroll now, before the January 31st deadline.”

In 2016, the Essential Plan, a new program New York launched for lower income individuals has proved to be a tremendous success. As of December 24, 2016, more than 635,000 individuals have enrolled in the Essential Plan, up from nearly 380,000 at the end of the 2016 Open Enrollment Period.

The breakdown of enrollment as of December 24, 2016, is as follows:

  • Total cumulative enrollment: 3,472,214
  • Total Medicaid enrollment: 2,332,683
  • Total Non-Medicaid enrollment: 1,139,531
    • Essential Plan: 635,909
    • Qualified Health Plan: 217,995
    • Child Health Plus: 285,627

My official QHP projection for NY is 295,000 by the end of January. Until now, the only hard number I had was 55,000...except that was only over a 3-day period during the December deadline rush, making it pretty useless for figuring how well they're doing. 218K QHPs is around 74% of that target. Based on this, I'm lowering my target for NY to 270,000 (flat over last year).

While the QHP number is disappointing, there's a pretty obvious reason: Much of the QHP enrollment has been cannibalized by the Essential Plan (aka Basic Health Plan, or BHP), which has seen an impressive 67% enrollment increase year over year (and again, there's still 5 weeks to go, since this only counted through Christmas Eve). NYSoH could potentially break 700,000 BHP enrollees by the end of January (BHPs are available year-round, but enrollment still tends to center around the official period due to the outreach/advertising campaign).

There's also NY's unique Child Health Plus program. There's a lot of confusion over the name (and function) similarity with the federal State Children's Health Insurance Program (SCHIP, or CHIP)...which is no coincidence, since CHIP was based on CHP:

The Child Health Plus (CHP) program was created by the New York State legislature in 1990 and by August 1991 children had begun receiving coverage under the program. New York’s CHP program served as a blueprint for the federal State Children’s Health Insurance Program (SCHIP) statute, which was enacted in 1997. CHP in NYS originally provided services to children under age 13, but after enactment of SCHIP, NYS expanded the program to include children through age 18.

In 2001, in an effort to provide a seamless health care system for children, the NYS Department of Health renamed Child Health Plus to Child Health Plus B (CHP B). Medicaid’s expanded income eligibility for children became Child Health Plus A (CHP A). A significant change occurred in 2008 when NYS expanded the program’s income eligibility guidelines up to 400% of the federal poverty, simplified the enrollment process and expanded outreach and education efforts.

In 2009 New York State reversed the name of CHP B back to Child Health Plus, and now refers to CHP A as Children’s Medicaid. The distinction is important because Children’s Medicaid is an entitlement program that includes due process rights to notices and fair hearings, whereas Child Health Plus is not an entitlement and has more limited protections, i.e. the grievance process and external review available from all the managed care plans.

The short version is that Child Health Plus (which I'm gonna call CH+) covers a different group of children than CHIP itself.

Finally, there's the actual Medicaid enrollment number...which, just yesterday, was "only" 1.96 million New Yorkers. By 12/24/16 it had increased by another 366,000 people. If I'm understanding the situation correctly, all 366K of these additions would also be kicked off their policies if the ACA is repealed. However, after the confusion over the past few days, I'm asking around to be certain.