END OF 2018 OPEN ENROLLMENT PERIOD (41 states)

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Charles Gaba's blog

No official update, but an article in yesterday's Coloradoan.com gives the Private QHP number as 93,000 as of Thursday, up 5,234 from 87,766 as of March 8th:

WASHINGTON — At least 100,000 Coloradans are expected to sign up for private health insurance on Connect for Health Colorado by March 31, according to the head of the state’s online health exchange.

With 93,000 people enrolled as of Thursday, “we are really exceeding our expectations,” Patty Fontneau, CEO of Connect for Health Colorado, told reporters in a conference call arranged by Families USA, a health care consumer advocate.

OK, I already had Kentucky down with 60K QHPs / 240K Medicaid; just just straightens the numbers out precisely:

300,290 Kentuckians are enrolled in new health coverage through @kynectky. 239,453 in Medicaid, 60,837 purchased private insurance. #ACA

— Joe Sonka (@joesonka) March 14, 2014

Hmm...Last week Maryland finally reported their Paid/Unpaid numbers (54% paid); this week they didn't for whatever reason. Anyway, their total QHPs are up from 38,070 to 40,693, an increase of 2,623 since March 1st.

On the Medicaid side, they've decided to bundle together the 96K PAC transferees with the "normal" new Medicaid enrollees for whatever reason. Subtracting out the PAC number gives 97,781 through March 11th, a very impressive 37% (26,332) gain since Feb. 25th.

From October 1, 2013, through March 8, 2014, there have been more than a million unique visitors to the Maryland Health Connection website. 186,268 Marylanders have created identity- verified accounts. Through March 8, 40,693 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

As of March 11, 193,670 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage.

UPDATE: CNBC Reports that 2 additional states (well, one state, Minnesota, as well as DC, anyway) have released their paid/unpaid data; the chart has been updated below, which changes...nothing really; Minnesota is at 90% while DC is at 75%, and Vermont's paid rate has apparently fallen from 85 to 59%...between the three they seem to have cancelled each other out.

I've written about the "But How Many Have PAID???" issue many times before, but going into the final stretch, I wanted to explain my reasoning as clearly as possible.

The following chart only includes states which have broken out Paid vs. Unpaid Enrollments. If you only use these 9 states as a guideline, it looks like the paid rate is around 80%:

Connecticut continues to Do It Right®. Not only have they broken their own combined goal by 60%, they're also now 37% past their fair share of the CBO's original 7 million QHP figure. The exchange's CEO is quoted in the article as saying that CT doesn't expect to see much of a "March surge", but that isn't too concerning to me--they're already doing fantastic, so any enrollment rate increase wouldn't be as dramatic by comparison anyway.

Oh, yeah--and 92% of all of their enrollees to date are paid up, even more impressive considering that this should include people whose policies don't even start until April.

In Connecticut, 160,580 people have enrolled in coverage through Access Health CT, surpassing the exchange's self-imposed goal of 100,000 people. Counihan said roughly 62,000 of those who enrolled signed up for one of three private health plans represented on the exchange. Most of the remainder signed up for some form of Medicaid.

Considering that their exchange website is still a complete mess, Oregon is actually doing a pretty good job of processing enrollments (not sure how many of these are newly added or reducing the backlog of older ones, not that it matters). Private QHPs are up almost 2,800 over last week, and Medicaid enrollees are up over 8,700.

In fact, so far, Oregon's March QHP enrollment rate (526/day) is actually nearly triple what it was in February (179/day). If every state were to pull this off, the total would actually surpass 7 million after all, though that doesn't seem likely at the moment.

Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Total: 145,941 
Private insurance: 45,119
Oregon Health Plan: 100,822

Earlier today, contributor Esther Ferington brought an old New York Times article from last October to my attention. The article is actually about off-exchange enrollments as an option to using the exchanges, but the opening line of the story includes an interesting snippet:

WITH so much attention being paid to the troubled debut of the Obama administration’s health insurance exchanges, another alternative has largely gone unnoticed: unless you live in Washington, D.C., or Vermont, you can also buy insurance outside the exchanges — by going directly to insurance brokers, agents or company Web sites.

Things are quickly getting crazy as we go into the home stretch, so I wanted to take a moment to note a few milestones now just in case I get too frazzled to do so properly 3 weeks from now:

Exchange Milestones Reached as of Today:

(Sigh) Don't get me wrong, I'm glad Minnesota is staying on the ball with their updates but really, this is like 8 in the past 9 days or something...anyway, this one includes specific numbers for both categories, no messing with private/public ratios: 33,722 QHPs, 86,932 Medicaid.

Today, MNsure announced more than 120,000 Minnesotans have enrolled in comprehensive, affordable health insurance coverage through the state’s health insurance marketplace. With an original goal of enrolling 135,000 Minnesotans, MNsure is on pace to meet or exceed that goal when open enrollment ends on March 31.

“We are averaging about 1,000 new enrollees every day,” said interim CEO Scott Leitz. “We anticipate we will continue, or improve this pace, keeping us on track to meet our original goal of enrolling 135,000 Minnesotans during this open enrollment period.”

The goal of enrolling 135,000 Minnesotans during the 2014 open enrollment period was discussed at the MNsure Board of Directors meeting on October 16, 2013.

No breakout between Private QHPs & Medicaid yet, but KY Governor Steve Beshear just announced that Kentucky has broken the 300K mark, adding an impressive 20,000 new enrollees in the last 6 days:

Congratulations, Kentucky! 300,000 people now enrolled in affordable health care through #kynect. Sign up by March 31 .@kynectky

— Steve Beshear (@GovSteveBeshear) March 13, 2014

Their last update had them at 57,090 QHPs and 223,378 Medicaid/CHIP, 280,468 total, so this is an increase of at least 19,532.

KY has recently shifted towards roughly a 17.5% QHPs / 82.5% Medicaid split. I'll assume a 15/85 with the newest batch for now, which brings the totals to 2,932 QHP / 16,600 Medicaid, for totals of over 60,000 and 240,000 respectively.

Looks like California is fully recovered from their ugly February outage, but they're still not quite up to where I thought they were this week:

#CoveredCA enrollment reaches 923,832 through March 9. 1 million just around the corner!

— Covered California (@CoveredCA) March 13, 2014

In addition, California's NEW Medicaid enrollee numbers continue to skyrocket, up from 877K (exchange) / 652K (bulk transfers/other) at the end of January to a whopping 1.136 Million + 968,500 = 2,104,500 total (!)

The wording of the 1.136M Medicaid number specifies that this is a combination of NEW enrollees as well as "ongoing caseload activity", which sounds to me like people who enrolled a few months earlier but are still having paperwork issues. Either way, it sounds clear to me that these are not "renewals (aka rederminations)".

A beautiful find by new contributor Uncle Toby: Highmark Inc., a major insurer which serves Pennsylvania, West Virginia and Delaware, just did exactly what I've been wanting every insurer to do: They officially announced not just their off-exchange enrollments, but specified the exact date that these run through and the fact that they're all 100% ACA compliant.

As a bonus, they've included specific state-by-state breakdowns as well as a comparison against their on-exchange enrollments. 32% of PA's, 27% of WV's and 29% of Delaware's QHP enrollees to date have been off-exchange. This proves exactly what I've been saying: There are absolutely several million (at a minimum) direct QHPs out there which simply haven't been documented publicly yet.

A couple of days ago, Avalere Health, with whom I've alternately butted heads with and agreed with on all things Medicaid-related, has issued their QHP projection: They're calling for around 5.4 million total. In order to hit that number, the March average would be around 38,600/day.

Avalere is basing their projection primarily on the Medicare Part D enrollment pattern back in 2006. They could very well be correct, but there's also some key differences between that situation and this one (the most obvious one: Medicare enrollments were presumably mainly limited to those over 65, whereas it's the "Young Invincibles" that are the primary target at the moment). However, I'm not going to pooh-pooh their projection either, as there are many similarities between the two as well: Both were/are large, national government healthcare enrollment programs, with a 6-month limited enrollment period, a financial penalty for not enrolling by the deadline and so on.

After a couple of weeks where the paid QHPs seemed to only be drawing from the existing unpaid enrollments (a sign of new additions drying up), WA seems to be back in gear with 2,740 more paid QHPs, 4,019 more unpaid QHPs and 16,247 new Medicaid/CHIP additions, all since February 27th.

Enrollments Completed:

  • Qualified Health Plans: 109,021
  • Medicaid Newly Eligible Adults: 222,607
  • Medicaid Previously Eligible but not Enrolled: 115,159

In-Process Applications

Qualified Health Plan Applicants – Need to Pay: 82,060

*Note: These numbers reflect enrollments and applications through March 6.

Looks like the 30/70 QHP/Medicaid split that I've been assuming for Minnesota has shifted somewhat; as a result, I actually have to lower the QHP number by a bit compared with the 3-4 mini updates from last week. MN QHPs now stand at 33,362; new Medicaid/CHIP enrollees are at 85,267 as of March 11.

In addition, SHOP (Sm. Biz) enrollees are up a bit from 1,042 to (660 employees x1.8 per household) = 1,188 total individuals covered.

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