Charles Gaba's blog

2018 MIDTERM ELECTION

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I think this is the first Nevada update I've posted which didn't come from the Nevada Health Link's Twitter feed. Technically only 28,208 have actually paid their first premium so far, but another 4,332 have scheduled their payment which is certainly a huge step ahead of having "enrolled but not even arranged for a payment" (and my model has 7% of this total being lopped out for potential non-payment anyway). So, 32,540 it is until further notice.

And the number of people who enrolled in and paid for a qualified health plan through the exchange hit 28,208 on April 5, up from 25,899 people on March 31. Another 4,332 consumers have scheduled payments.

Yesterday, at around the same time that (outgoing) HHS Secretary Kathleen Sebelius confirmed my estimate that ACA exchange QHP enrollments had hit 7.5 million people, Edward Morrissey wrote an article over at Yahoo News claiming that (wait for it) the HHS Dept. was "cooking the books":

Last week, that [the ACA being here to stay] sounded like wishful thinking. Two new studies released this week prove it. 

The studies that he uses are the Rand Corp. survey and a study released by Express Scripts regarding prescription drug coverage. I'm not even going to get into the Express Scripts study, because Mr. Morrissey makes so many errors in the Rand section I don't even think it's necessary to continue beyond that:

While the White House can claim credit for a net increase of 9.3 million insured and a lowered uninsured rate from 20.5 percent to 15.8 percent, the data provides a significantly different picture than that painted by President Obama and the ACA’s advocates. 

This is great news, but I have to reduce Ohio's Medicaid total by about 54,000 due to a bit of sloppy double-counting on my part. However, there's another (potential) 120K in the batter's box:

More than 106,000 Ohioans have signed up for Medicaid under an expansion of the taxpayer funded health program, while thousands of others are waiting to hear whether they are deemed eligible.

...Ohio's monthly report on Medicaid caseloads shows that 106,238 residents had enrolled under the extension as of March 31. That's about 29 percent of the roughly 366,000 newly eligible people estimated to sign up by the end of June 2015.

More than 345,000 people have sought Medicaid coverage through the state's benefit site since Oct. 1. About 65 percent of the applications have been resolved, while roughly 120,000 are still pending. Many of those cases await eligibility determinations by the state's largest counties.

Yesterday, contributor Stevef101 noted that Blue Cross of Idaho was bragging about enrolling 45K people via HC.gov...more than the total exchange QHPs for the state through the end of February. Today he further notes that the company has enrolled 70,000 people in new QHPs total during the enrollment period...meaning that 25K of them were done off-exchange.

Six-thousand people responded to the program, and at last count, 70,000 Idahoans signed up for insurance during the first open enrollment period.

"All of this publicity, people really starting to talk about what insurance can do for them, really made a big difference in getting people covered," said Zelda Geyer-Sylvia, President and CEO of Blue Cross of Idaho.

Note that this doesn't change the high-end potential total of 7.8 million from the Rand Corp. study, it just fills in the documented number within that a bit further.

OK, I've made one more major update/change to The Graph (I've been meaning to get around to this for awhile): I've split the 2 Medicaid/CHIP categories into a total of 3. The new section is specifically for bulk transfers and other special Medicaid enrollments, including things like:

  • The 650,000 LIHP transferrees in California
  • The 107,000 people auto-transferred from Commonwealth Care in Massachusetts (permanently...this is separate from the 200K+ stuck in temp "limbo" care)
  • The 33,000 transferees from VHAP/Catamount in Vermont
  • The 96,000 transferees from Maryland's PAC program
  • Most recently, the 53,000 people transferred over from Michigan's Medicaid Adult Benefits Waiver program

It's very important to note that the total number of new ACA-enabled Medicaid enrollees has NOT changed, only the way these are categorized. I've done this purely in the interest of clarity and transparency. In addition to the "bulk transfers", this also includes people who were not previously insured but dont' quite fit into the normal Medicaid enrollment category--for instance:

No exact numbers here, but the wording of the article gives the rough breakdown:

About 3,500 Connecticut residents have enrolled in health insurance through the state’s health care exchange, Access Health CT, since the official open enrollment deadline passed on March 31. That’s in addition to the nearly 200,000 who enrolled by the health care deadline.

Access Health CT CEO Kevin Counihan said there were roughly 10,000 people in the state who wanted to enroll but couldn’t complete the process by deadline for some reason. Those people were told to leave their contact information, and that the state would follow up with them to make sure their enrollment was completed.

...Customers to the state marketplace could either buy insurance through one of three private carriers on the exchange, or get covered through Medicaid. The majority of those covered through the exchange — more than 120,000 — were covered under Medicaid.

Not an official update, but Idaho was already at 43,861 as of March 1st from all 4 companies operating on the exchange, so over 1,000 more than that total from just 1 of the four companies bodes well for the official total, which will probably come out next week:

About 45,000 people applied for health-insurance plans from Blue Cross of Idaho through the state's insurance exchange, Your Health Idaho, over the past six months.

The insurer announced its enrollment numbers Thursday.

Your Health Idaho is expected to release total enrollment for exchange plans soon. Open enrollment ended March 31.

Four companies — Blue Cross, SelectHealth, PacificSource and the Regence BlueShield of Idaho sister company BridgeSpan — sold plans on the exchange.

Additional note: 45K just happens to be my own "fair share of 7M" target for Idaho, so a single insurance company has hit the target. The other three are basically gravy.

One of the few updates out of New Jersey, it looks like Chris Christie made one decent decision last year, anyway...

New Jersey FamilyCare has added over 100,000 people to its rolls, contributing to savings that Gov. Chris Christie has already anticipated in his proposed budget.

In just the first three months of this year, 102,268 state residents were added to the rolls of FamilyCare, which includes recipients of two federally supported programs – Medicaid and the Children’s Health Insurance Program (CHIP).

Through April 6, 41,402 Arkansans have purchased plans on the Arkansas Health Insurance Marketplace, the new marketplace created by Obamacare, according to information released yesterday by the Arkansas Insurance Department (see county  by county map above). As in the rest of the country, Arkansas saw a surge in enrollment recently, with more than 7,800 people signing up in the last two weeks. But while national enrollment in the marketplaces across the country hit initial projections, Arkansas will fall well short. 

...This does not include enrollment in the private option, the state's policy for Medicaid expansion which purchases plans on the Marketplace for folks that make less than 138 percent of the federal poverty level 

Oregon continues to slog it's way through enrollments in spite of their technical problems...

April 10, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 217,413
Total private medical insurance enrollments through Cover Oregon 1: 63,325 

Oregon Health Plan enrollments through Cover Oregon: 154,088

Net private medical:  59,923

This just in...Kentucky's tally is now up to nearly 80K exchange QHPs and 323K Medicaid enrollees:

BREAKING: 402,407 Kentuckians are enrolled in @kynectky. 322,827 in Medicaid, 79,580 have purchased private insurance. #ACA #kyga14

— Joe Sonka (@joesonka) April 10, 2014

Still ~75% of @kynect enrollees previously did not have insurance. That's over 300,000 Kentuckians who now have health coverage due to #ACA

— Joe Sonka (@joesonka) April 10, 2014

The numbers are small, but the percentages are impressive: Delaware's 3/31 tally is in:

DOVER – Delaware ended its first enrollment period for the nation's new Obamacare health plans with 11,335 people enrolled – about 3,000 more than federal goals for the state.

Another 3,411 people gained coverage through the state's expanded Medicaid coverage, which extended eligibility to 138 percent of the federal poverty level.

According to L.A. Times reporter Chad Terhune, CoveredCA has confirmed enrolling another 70,000 people in private QHPs in the first 9 days of the extension period. They had 1,221,727 as of 3/31, so that brings their total to 1.29 million as of last night:

#CoveredCA added 70,000 (on top of 1.2M) who picked a plan in the 9 days of the "grace period" since March 31 to April 15. @charles_gaba

— Health Access CA (@healthaccess) April 10, 2014

#CoveredCA exchange: 70K more enrolled since 3-31 deadline after extending sign-ups to 4-15, adding to 1.2M already in #ACA

— Chad Terhune (@chadterhune) April 10, 2014

Yeah, I know, I keep bouncing around on this; first I thought 8M was feasible, then I backtracked. However, let's do some simple math.

  • Obviously it wasn't exactly 7.1M on the nose at midnight on 3/31. Let's assume an overage of, say, 20K at a minimum.
  • It's also safe to assume that it was slightly over 7.5M as of midnight last night; let's say 20K there as well.
  • That means that in the first 9 days, QHP enrollments averaged 500K / 9 = 55.5K per day
  • I'd say a final weekend mini-surge is also likely for those who wait until the absolute last possible moment, which should cancel out what I'm assuming is a natural dropoff throughout the week. So...figure something like 30K/day today and tomorrow, then back up to 60K/day for the last 4 days. That's 300K added to the existing 7.52K, or 7.82M.

So, as my final projection for 4/15, I'm going with: Somewhere between 7.7M - 7.9M, with an outside chance of squeaking by the 8M mark after all (wishful thinking?)

Me, last night: Hey, Guess What? I think we just hit 7.5M QHPs.

HHS Secretary Kathleen Sebelius, moments ago: 

Health and Human Services Secretary Kathleen Sebelius says 7.5 million Americans have now signed up for health coverage under President Barack Obama's health care law.

That's a 400,000 increase from the 7.1 million that Obama announced last week at the end of the law's open enrollment period. The figure exceeded expectations, a surprise election-year success for the law after a disastrous roll-out.

Sebelius disclosed the new figure during a hearing Thursday before the Senate Finance Committee.

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