Charles Gaba's blog

When I made my original projection of 12.0 million QHP selections by 2/15/15, I assumed that roughly 6.1 million of the 6.7 million current 2014 enrollees would re-up via one of three methods:

  • Actively logging into their existing account and renewing their current policy/switching to a different one
  • Actively creating a new account (in states like MA, MD, OR & NV) and enrolling the same/a different policy for 2015
  • Taking no action whatsoever and being automatically re-enrolled in their current account (or one nearly identical if the current one is no longer available).

In other words, I was operating on the assumption that roughly 6.1 million (91%) of current enrollees would stay on board one way or another, plus another 5.9 million new folks signing up for the first time.

When we last checked in on New York State, they had added a total of 195,000 new people since November 15th in addition to those already enrolled for 2014. This broke out to around 126.6K added to Medicaid and 68.4K set up for 2015 private policies.

NY's enrollment deadline for January QHP coverage ended on Saturday, and they've just come out with an updated total. Again, this does not include renewals of current enrollees:

NY up to 225,244, enrollment, not counting renewals @charles_gaba hopefully medicaid /qhp breakdown soon

— Dan Goldberg (@DanGoldbergCNY) December 22, 2014

Again, no breakout yet; that usually shows up within an hour or so of the initial total, based on Dan Goldberg's past scoops. Assuming it's roughly a 65/35 split like the prior total was, that should mean roughly 79,000 private policies and 146,000 Medicaid/CHIP.

I'll update this with more details as they come out...

On Friday I discovered that my estimate of roughly 60% of Massachusetts "determined eligible for QHPs" actually selecting a plan was way too high; the actual ratio was closer to 48% overall, meaning that my prior estimate of about 62K QHP selections was too high; the actual number was 53,490 as of Thursday the 18th, which is still excellent, just not as great as I thought it was.

Today I received confirmation directly from the exchange that total enrollments (ie, selected plans) are up to 61,470 as of this morning, which means that the ratio is indeed starting to move up, just later and not as quickly as I had thought (61,470 / 124,403 QHP determinations is just shy of 50%).

I haven't written much about the recent announcement by Vermont's governor that after years of pushing a single payer plan for the state, he's basically pulled the plug on it (at least for the time being). I noted the announcement but didn't have much to add myself.

Part of this is because I'm swamped with the actual ACA open enrollment itself, of course. Part of it is because it's too depressing a development for me to really think about right now. Part of it is because others far more knowledgeable than I am have much more to say about it.

One such person is Vox's Sarah Kliff, and she's written a fairly definitive explanation of what went wrong. The short version: Vermont's tax base is too small to support the initial costs, even if it would save gobs of money in the longer term.

In Vermont, this is massive: the state only raises $2.7 billion in taxes a year for every program it funds. Early estimates said that Vermont's single-payer plan might need $1.6 billion in additional funds — a huge lift. But $2.5 billion was impossible.

Way back in July, when the Halbig v. Burwell case was on the media radar, I wrote about the potential backlash against Republican governors/legislators who failed to take any action towards establishing a state-based exchange to salvage the tax credits for tens or hundreds of thousands of their own residents. At the time, I speculated that doing so could be as simple as slapping up a simple splashpage & redirect to HC.gov, which I termed the "Grand Slam Solution" (ie, "for less than the cost of a Denny's Grand Slam breakfast...")

...the "domain solution" I describe above would still have one more hurdle, of course: You'd still have to get the individual states to agree to pony up $9.95 per year and set up a simple domain redirect. Illinois has already done so; presumably other blue-leaning states would follow. That would leave about 30 states, give or take, including Texas, Florida and so forth.

All of these stories deserve full write-ups, but I just don't have time right now...

Employer coverage stays steady in 2014

One persistent Obamacare fear, for years now, has been that the new law would decimate the employer-sponsored insurance system. Why would companies waste money on buying coverage for their workers, the argument goes, when they could hand these people off to Obamacare's new exchanges?

And some high profile companies like Walmart went through and did this, leading to much speculation about whether Obamacare would kill employer-sponsored coverage.

New research from the Urban Institute suggests that, at least in year one, companies like Walmart were the exception rather than the norm: employer-sponsored coverage held steady through the Affordable Care Act's launch.

Huh. OK, this one is unexpected, mainly because they waited until 4 days after the original 12/15 deadline to make the announcement:

The Hawaii Health Connector has extended the deadline for residents to enroll in health insurance that takes effect on Jan. 1.

The extension will be until noon on Dec. 31. The original deadline was this past Monday.

The state's health insurance exchange created by the Affordable Care Act, also known as Obamacare, signed up 3,500 residents in the first month of open enrollment , which started on Nov. 15. To enroll, call 1-877-628-5076 or go to www.hawaiihealthconnector.com.

So, that makes 3 states now which have bumped their deadline for January 1st coverage out until 12/31: Hawaii, Vermont and Minnesota.

A week ago, I reported an update regarding the "Florida Health Choices" website, spearheaded by Florida GOP Senator Marco Rubio, which is a taxpayer-funded healthcare exchange to sell private insurance policies to Florida residents:

TALLAHASSEE — Last year, legislators allocated $900,000 to help Floridians find affordable health care through a new state-backed website.

At the same time, they refused to expand Medicaid or work with the federal government to offer subsidized insurance plans.

You know...Obamacare, without the "Obama" part.

It also doesn't offer any tax credits to make healthcare policies, you know, affordable.

Then again, that's kind of a moot point, since it doesn't actually even offer healthcare policies anyway--just "discount cards" for dental visits, prescriptions and prescription eyeglasses.

So...you know, it's basically a coupon store.

Oh, yeah...and even some of those coupons are kind of a scam:

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