END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

Charles Gaba's blog

Minnesota was already doing pretty well, having surpassed their own internal goal of 135K QHP/Medicaid combined as of yesterday, of which over 36K were QHPs...but they released quite a jaw-dropper just a day later, with the QHP figure leaping up another 5,097 thanks to pushing through a mountain of paper applications.

Numbers released Wednesday at the MNsure board's regular meeting actually look better than those the agency highlighted in a Tuesday press release. On Wednesday, MNsure was able to add people who enrolled using paper applications  – and now the exchange can announce it has enrolled 148,068 people, including 41,273 people who used the exchange to purchase private health plans.

This brings MN's totals to 41,273 exchange QHPs and 106,795 new Medicaid enrollees.

The impact on the projection table?

In February, Minnesota averaged 122 QHPs/day. Prior to today's update, they were averaging 180/day in March, a 48% increase over February.

With these paper additions, this has skyrocketed to 385/day...over 3.1x February's rate. 

OK, things just went into overdrive. The media spotlight has been growing, and now Paul Krugman just said some very nice things about me in the NY Times. Believe me, I'm incredibly flattered, honored, etc etc...but I'm also getting overwhelmed, and have to make a few changes, at least until the dust settles on the enrollment insanity:

Oregon has been talking about this for weeks, but now it's official:

Oregonians now have an additional month to apply for private health insurance. New deadline to apply is April 30. The Oregon Insurance Division and Cover Oregon urge people to apply now to get coverage as soon as possible and avoid potential end-of-month rush. 

Colorado said something about this the other day, but now it's official:

DENVER - Colorado will give health insurance applicants extra time to finish the enrollment process, if they start before the March 31 deadline.

Connect for Health Colorado will make an official announcement about the extension Wednesday afternoon.

Add New York to the list as well:

I mentioned this briefly last night, but it's certainly worthy of its own entry.

I previously posted a whole bunch of entries about how various state-run exchanges are planning on extending their QHP enrollment deadlines for certain groups of people. The circumstances, revised deadlines and extension request process varies from state to state, but as of my last update, the list included Massachusetts, Oregon, Maryland, Nevada and possibly Vermont, Kentucky, Washington State and Colorado.

A couple of days ago, Minnesota jumped into the pool as well:

ST.PAUL, Minn. – Today, MNsure announced new procedures that will help people get coverage and avoid a federal tax penalty even if their enrollment isn’t complete when the deadline expires on March 31.

“It’s just like waiting in line to vote after the polls close; if a consumer can show that they have attempted to obtain coverage before the deadline, we will make sure they can complete their enrollment,” said interim CEO Scott Leitz.

I received the following yesterday, and was given the OK to post it publicly. Given my prior screeds about both a) off-exchange enrollments and b) insurance company billing systems being overwhelmed/backlogged, this is a perfect example of why both of these issues are so important to include when discussing the QHP numbers.

Obviously anecdotal stories can't be used as hard data, but I've read dozens of similar stories. Some refer to going off-exchange; some refer to billing problems with the companies; some, like this one, refer to both. Presented without further comment (emphasis mine):

I'm an independent contractor/consultant in Arizona. I have several friends in the same boat. We all had Arizona state-sponsored (but not supported) small business insurance that had no underwriting.

We were all basically locked out of the ACA website from early on and never got back on. BUT WE ALL BOUGHT insurance with BCBS directly, with ACA policies (none of us could have gotten through underwriting) because we all make too much for a subsidy. NONE of us, and the people like us, are being counted. But I'm sure BCBS is keeping track of these direct purchases, which have to be counted toward the total.

Eureka! Finally, some serious progress on the Massachusetts Mess front. Apparently the backlog of manual payment enrollments is seeing serious progress as people mail in their checks. As a result, MA's 15,140 exchange QHPs as of 3/19 have shot up to 25K. And yes, these all appear to be QHPs, not Medicaid (under any of the dozen Medicaid categores that Massachusetts seems to have), as all of those numbers are far, far higher than 25K.

I should further note that MA only reports enrollments to HHS if the first premium is paid.

In one shot, Massachusetts has gone from running 30% behind their February QHP rate to of three times higher, and my overall 3/31 projection has moved up from 6.26 million to 6.30 million.

Lefferts said some 25,000 people have enrolled in Affordable Care Act plans, with the bulk of those being former Commonwealth Choice enrollees, along with a small number of subsidized individuals from Commonwealth Care and about 2,000 people for new dental coverage.

Forbes' Avik Roy and I butted heads last week on Twitter regarding the "How many enrollees were previously uninsured???" issue, and with it, the McKinsey study which claimed that only 11% (in January) or 27% (in February) of the QHP total were previously uninsured.

In a nutshell, I never said that McKinsey's 27% claim was wrong, I just said that the methodology they used to come up with 27% didn't tell us anything about the previously uninsured percent of exchange QHPs because McKinsey mixed together both exchange and off-exchange enrollments...without noting how many of their respondents came from each pool. Since we have no idea how many off-exchange enrollments there are, and we don't know how many of the respondents came from either pool anyway, there's no way of knowing how much of that 27% comes from either. It could be 0% and 54%. It could be 54% and 0%. It could, in theory, be 100% of one and 0% of the other.

One final update for today, just under the wire: Kentucky reports that QHPs are up to 66K, Medicaid up to 266.4K. That's an increase of 1,509 QHPs and 8,911 Medicaid enrollments in 4 days. A slight slowdown from last week, but March is still well above 2x February's rate.

In KY, 49% of those enrolled in #kynect are under the age of 35: 266,388 have qualified 4 Medicaid; and 65,964 purchased private insurance.

— kynectky (@kynectky) March 25, 2014

 

A huge turnaround from last week, when it looked like WA was starting to slow down. Exchange QHPs are up from 112,225 as of 3/13 to 125,207 as of 3/23...an increase of 12,982 in 10 days (not quite the "past week" described in the press release, unless it took the first 3 days for 901 of them to go through).

The impact on the projection chart is equally dramatic: Washington State has now gone from running 37% below February's daily average to 25% higher than February did.

On the Medicaid side, new enrollments now stand at 250K "strict expansion" and 130K "woodworkers", up from 235K & 122K respectively, for a total increase of 23,000 new enrollees.

Lots of numbers here, but only one of any relevance here: 5,744 QHPs as of 3/22.

At just 350 higher than the 5,394 from 3/17, this is a bit of a slowdown from the first 2 weeks of March. Fortunately the HI numbers are too small to negatively impact the projection to any visible degree.

Total for the period of Mar. 16, 2014 through Mar. 22, 2014

  • 7 Certified Kōkua or In-Person Assisters
  • 2 Certified Kōkua or Certified Application Counselors (CACs)
  • 11,216 Unique Visitors to HawaiiHealthConnector.com
  • 2,997 Calls received by our Customer Support Center

Total since October 1, 2013

I just got back from taping my first TV interview appearance. Details to follow. Meanwhile, while I was gone, apparently the following happened:

--an update from Hawaii

--even HIGHER numbers from Connecticut (I started to post about this just before I had to leave, haven't finished writeup

--Washington State apparently released some VERY big numbers, a complete reversal from last week, which saw enrollments slowing

--Harry Reid stated that the final number of exchange-based QHPs will be between 6.5M - 7.0M

However, now I have to have dinner with my family. Will try and update all this stuff tonight...

Earlier today I posted CT's QHP total as "at least 65K", but didn't have an exact figure.

This new article lists the combined total (QHPs/Medicaid) as 170K.

Kevin Counihan says that Access Health CT now has a goal of signing up 185,000 individuals for health insurance by March 31. The exchange originally hoped to sign up 100,000 people but has already enrolled 170,021 individuals in private insurance and Medicaid plans.

UPDATE: HOLD THE PHONE...This just in from Access Health CT's Twitter feed:

RT @AccessHealthCT Our Grand Total is already over 174,000 Blowing way past our orginal goal. #EnrollCT -kc

— Tonya Wiley (@changetospare) March 25, 2014

Thank you to new contributor JTP for this CNBC article, which finally brings some clarity to the "how many already had insurance?" question.

Until now, the only hard numbers available were from New York and Kentucky, which were reporting 70% and 75% of all enrollees as not already having insurance respectively. However, these numbers included both exchange QHPs and Medicaid enrollees, which made it difficult to parse what percent of QHP enrollees only didn't have insurance prior to their enrollment.

This article is more specific: The number for NY QHPs is 59% of QHP enrollees (vs. 90% of Medicaid), and in KY is, surprisingly higher, at 75% for each!

Contributor deaconblues brings a very nice find. Massachusetts continues to be one hell of a mess, but this latest official briefing helps bring some clarity to the situation, while raising some more questions. Rather than restate it all myself, here's deaconblues summary, and the chart in question:

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