Open Enrollment Deadline

Time: D H M S

Charles Gaba's blog

Since the day I started this project (before it, really), I've been asking for the HHS Dept. to simply release the enrollment data in as much detail as possible on a frequent basis...and by frequent, I didn't mean "monthly"; that's far too long given the 24-hour, 24-second news and political cycle. For 7 months, the HHS Dept. ignored this plea, followed by another 6 months of not just ignoring it but actually going backwards on enrollment data (ie, cutting off even the monthly reports during the off-season). Fortunately, since November, they've done a total 180, issuing not only "weekly snapshot" reports giving the overall HC.gov enrollment numbers, but more recently breaking these down by all 37 states on a weekly basis. This is awesome!

This press release from the Washington exchange about tax credits for 2014 ACA enrollees isn't an official enrollment update, but they do include a rough update about 2/3 of the way down the text:

As of Jan. 25, more than 127,000 residents have enrolled in Qualified Health Plans for 2015 coverage, with approximately 40,000 of those customers signing up for the first time through Washington Healthplanfinder. 

127K is about 10K more than they had enrolled as of January 17, or around 1,250/day. At that rate, they'd be likely to add another 26K by 2/15, for 153K total, which would be far short of the 215K that they're targeting (and way short of the 250K I was anticipating for WA). A decent mid-February surge should bring them up to around 175K, and a full surge could max out at 200K even. It's conceivable that they'll even squeak by their own target, but I don't see any way of reaching my own target.

Last Friday I posted:

The last 4 weekly HC.gov reports saw 96K (Christmas), 103K (New Year's), 163K (nothing significant) and 400K(the February coverage deadline for most states) on the federal exchange.

With the 1/15 deadline out of the way, the past week (and the next two) should come in somewhere between the last two: Fairly quiet, but steady and not completely dead. I'm assuming roughly 30K/day on HC.gov (around 40K/day nationally), which should have brought the total on HealthCare.Gov up to around 7.36 million as of Friday, January 23rd (around 210K for the week).

HHS Dept., just now:

Whoops. Only 137K for the week; I overshot the mark significantly (off by 53% for the week, or about 0.9% cumulatively). The post-deadline drop-off was more significant than I figured. Crud.

As of January 17th, Rhode Island had enrolled about 28.8K people in private plans for 2015, or around 78% of their "official" target (based on the HHS Dept's "30% higher than last year" target).

Today they've released another update, bringing things up to date through January 24:

RENEWAL UPDATE*
As of January 24, 2015, 79% of Year One customers have renewed (selected a plan) for 2015 (75% of renewing customers paid the first month’s premium).
Total New Customers: 7,862 (6,539 paid)
Total Renewed Customers: 20,283 (19,189 paid)
Total HealthSource RI enrollments for 2015 coverage: 28,145 (25,728 paid)

Hey, cool! That's a 91% payment rate! Um...except for one thing...somehow they've lost 644 people? Oh, wait...

This morning I noted several new developments in the ongoing King v. Burwell saga (formerly Halbig v. Burwell...and yes, I know that's technically a separate case, but cut me some slack here). However, I forgot a couple more:

Here's a list of people who--to the best of my knowledge--have now been proven not to ever have the slightest inkling, hint, suggestion or thought that federal tax subsidies weren't supposed to go to states which didn't establish their own ACA exchanges at any point throughout the many-year process of the law being crafted, drafted, printed, read, debated, argued about, voted on or signed into law:

I've moved the CA & NY additions from the original post over to this one, plus some additional items of note:

The exact number via HC.gov (thru 1/16/15) was already given out last week: 7,156,691. The exact number via the other 14 states (thru 1/17/15 or 1/18/15 in the case of California) is included in today's report: 2,383,004Add them up and you get exactly 9,539,695.

Now, technically speaking, that exact number isn't precisely what it was as of January 16, because it includes 1 extra day for 13 of the state exchanges and 2 extra days for California. I have no clue why they did it that way, but whatever. Really, though, enrollment dropped off dramatically for a few days after the 15th, because that was the February-start deadline in 46 states +DC (including California), so I don't imagine more than 10-15,000 of this came in on the 17th or 18th.

Remember all last summer and into the fall when I kept pointing out to anyone who would listen that just because the official Open Enrollment period had ended back on March 30th (or April 15th, depending on your POV), there were still a good 9,000+ people per day enrolling via the ACA exchanges due to major life changes?

Of course, those people being added were also being cancelled out to some degree by people dropping their policies (or being dropped whether they liked it or not due to non-payment or immigration/residency issues). From what I could tell, the additions seemed to be outnumbering the subtractions for most of the summer, up until around August, at which point the trend reversed. However, it was difficult to know this for certain until the CMS head unexpectedly mentioned that 7.3 million people were still enrolled as of mid-August (going up!), followed by a drop to 7.1 million as of mid-October (going down!).

Here in Michigan, the official estimates of how many residents are eligible for ACA Medicaid expansion ranged from around 477K to 500K, and over the past month or so, the weekly reports from the official MI Dept. of Community Health "Healthy Michigan" website has pegged the current enrollment total at between 490K - 510K. This led me to assume, naturally, that the program has been essentially tapped out, with close to 100% of those eligible already having signed up within the first 10 months.

Yesterday, however, they posted the weekly update again, and guess what?

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 533,110
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of January 26, 2015 
*Updated every Monday at 3 p.m.

Wow. 533,000 people. So, what's going on here? Well, possibilities include:

This Just In...

Gov. Pence gets federal OK for Medicaid alternative

Indiana has been given the green light to expand its Healthy Indiana Plan, which would offer insurance to an additional 350,000 Indiana residents who currently lack insurance.

The state will begin taking applications immediately for its so-called HIP 2.0 plan, for which coverage begins Feb. 1, Gov. Mike Pence announced Tuesday morning at a packed speech at St. Vincent Health.

So, what makes this different from standard Medicaid expansion?

Indiana is the only state to apply private market measures, such as requiring participants to make monthly contributions to help cover the benefit.

Anyone who falls below 138 percent of the federal poverty level will now be eligible to enroll in what the state is terming the Healthy Indiana Plan Plus. The plan includes dental and vision benefits, as well comprehensive prescription drug benefits.

Participants in this plan will be expected to make contributions of between $3 and $25 per month, or about 2 percent of the annual income for the year.

In recent weeks, I've turned into quite the Debbie Downer regarding the outcome of the King v. Burwell federal ACA tax credit case, set to be argued this March with a decision expected to be announced sometime in June. This is a far cry from 6 months ago, when I first proposed my apparently naive "Denny's Grand Slam" workaround (has it really been that long?).

Anyway, today brings three important takes on the case from The New Republic's Brian Beutler, the Washington Post's Greg Sargent and Scholars Strategy Network's Prof. Theda Skocpol which have bolstered my spirits somewhat. First up, Beutler:

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