Charles Gaba's blog

Washington State is doing a fantastic job of tracking pretty much every data point about health insurance in the state (I already had the 146K number):

OLYMPIA, Wash. – The individual health insurance market has grown to more than 324,900 people in Washington state, according to updated enrollment information reported by health insurers to the Office of the Insurance Commissioner this week.

This number includes 178,981 enrolled outside the Exchange and 146,000 enrolled inside the Exchange, Washington Healthplanfinder, as of March 31. The total is expected to increase as late enrollments through the Exchange are processed and reconciled.

...Before open enrollment began on Oct. 1, 2013, approximately 278,000 people were enrolled in health plans in Washington state’s individual market. Some 238,000 people received discontinuation notices from their insurers and had to find new coverage by Jan. 1, 2014. Estimates were made earlier this year that 113,000 of those who received notices would qualify for subsidies and 30,000 would qualify for the state’s newly expanded Medicaid program, Apple Health.

Avera reported about 8,950 South Dakotans had both enrolled in its plans and paid their first premiums since the enrollment period began in October. Sanford reported 1,443 and DakotaCare 59. The total is 10,450, but the government relaxed the March 31 deadline and some enrollments are still coming in. The insurers also have some applicants who enrolled but didn't complete the purchase by paying their first premiums.

Avera, in earlier phone surveys, found that 54 percent of enrollments effective in January and February were people without coverage. Avera is studying the issue further and is working with Augustana College to explore what consumers care about most in a decision to buy.

Read that carefully--54% of the January and February-start policies were previously uninsured. That means people who enrolled between 10/1/13 - 1/15/14. All indications (and logic) are that those who enrolled later than mid-January are more likely to be newly-insured than the earlier enrollees.

I can't really use this number in the spreadsheet since it's less than the total for the state, but this is extremely telling news (besides, how often am I gonna get to post a Texas-specific entry?):

HOUSTON (AP) — More than 177,000 Houston residents have signed up for health insurance through the federal marketplace, far exceeding expectations for the city.

According to an email obtained by The Associated Press, as of April 5 177,825 Houston residents enrolled for insurance under President Barack Obama's signature law. The email was written by Marjorie McColl Petty, the regional director for the U.S. Department of Health and Human Services in Dallas.

The expectation had been that 138,000 Houston residents would sign up. Petty told Houston officials the numbers reflect a successful 13-county regional effort.

The quotes around "final" are there because DC also announced that they're bumping out the extension period one more time, to April 30th:

The exchange had 699 people enroll for coverage in the two weeks after open enrollment was originally supposed to close, with 22 percent of those signups coming on Tuesday, the final possible day. That brings the total number of private health coverage enrollments to 10,630, Medicaid signups to 19,217, and small business enrollments to 13,118.

A bunch of people have sent me this link to the latest Gallop poll, which is certainly welcome news but isn't exactly unexpected:

WASHINGTON, D.C. -- The uninsured rate among adults aged 18 and older in the states that have chosen to expand Medicaid and set up their own exchanges in the health insurance marketplace has declined significantly more this year than in the remaining states that have not done so. The uninsured rate, on average, declined 2.5 percentage points in the 21 states (plus the District of Columbia) that have implemented both of these measures, compared with a 0.8-point drop across the 29 states that have taken only one or neither of these actions.

So, this is awesome news. Aside from the obvious, though, let's look at the other key stats:

Key "final" numbers as of 4/15 (MN is actually allowing another week, through 4/22, for final stragglers):

QHP: 48,157

Medicaid: 140,678

SHOP (from Dashboard) 726 x 1.8 = 1,306

This is actually pretty impressive; NY had been averaging around 4,200/day up until yesterday, when they hit 949,428, so this means they racked up another 11,334 in the final day (around 5,600 QHPs and 5,700 Medicaid):

.@charles_gaba @charlesornstein final NY Enrollment total: 960,762 Medicaid: 525,283 Private: 435,479

— Dan Goldberg (@DanGoldbergCNY) April 16, 2014

OK, this doesn't really change the numbers beyond a couple hundred, but it's encouragingto see that my "15% in Non-Expansion States" rule of thumb for estimating the number of people who fall into the "woodworker" category seems to be pretty accurate, at least in Indiana:

Even without expanding eligibility for Indiana Medicaid, the program had enrolled 40,577 more Hoosiers as of March than it had in the same month last year.

More than 15,000 of that year-over-year increase occurred in March alone this year, as a flood of people here and nationally sought coverage before Obamacare would hit them with a tax for going uninsured.

If you take a look at the Medicaid Spreadsheet, you'll see that I currently have the "woodworker" tally for Indiana at 40,951...only 374 more than the number reported above.

That 40,951 is 15% of the combined total number of new Medicaid enrollments for Indiana from both the HC.gov website as well as through traditional state Medicaid agency offices (273,005).

OK, the various ACA exchanges are just messing with my head now.

First, Nevada announced that they've extended their enrollment out to May 30 for those who started by March 31st.

Then Oregon announced that they've extended full open enrollment out to April 30.

Then I found out that anyone who submitted a paper application by April 7th in any of the 36 states run by HC.gov still have until April 30 to finish.

Colorado, I've discovered, is allowing people who applied for Medicaid but were denied up until May 31st to finish their enrollment process.

And, of course, Massachusetts has over 200K "Limbo Status" people who may (theoretically) get squared away as late as June 30.

Late last night I learned that Hawaii has bumped their extension deadline out to April 30.

I said I'd keep the poll for the "woodworker" terminology open until tonight, but until I decide what to do about it I'll be continuing to use that term for consistency.

This article from Kaiser Health News brings solid numbers for Colorado, but also gives other good info about the Medicaid situation. For instance, they give a simple explanation of where the term comes from...

Hundreds of thousands of those people were already eligible and could have signed up even before the Affordable Care Act made it much more generous.

They came “out of the woodwork” to get enrolled, analysts say, thanks to the Affordable Care Act’s individual mandate and publicity around its new marketplaces.

...then they give the exact number in Colorado...though only through the end of February...

Oh for the love of...(sigh) Look, I'm all for letting as many people as possible enroll in healthcare coverage, but even I admit that I'm getting awfully tired of having to change the final, FINAL deadline dates.

The Hawaii Health Connector has extended the  initial grace period— which would have ended on Tuesday — given to individuals in need of extra time completing the enrollment application process for health insurance by a couple of weeks to April 30.

Let's just hope they resolve their Heartbleed issue.

Every person counts...up to 8,182 through 4/12:

Total for the period of Apr. 6, 2014 through Apr. 12, 2014

Total since October 1, 2013

29,314 Applications completed in the Individual Marketplace
8,182 Enrollments in the Individual Marketplace

Leigh McGivern of coOportunity Health has helpfully provided their final (well, near-final...through 4/14) tallies for both on- and off-exchange enrollments. The exchange-based numbers aren't really relevant to me since those are reported by HHS, but the off-exchange QHPs and ESI's are vital:

IOWA

  • Individual/Family members: 18,358 (10,809 on exchange/7,549 off exchange)
  • Small group members: 7,848
  • Large group members: 274

NEBRASKA

  • Individual/Family members: 30,668 (20,308 on exchange/10,360 off exchange)
  • Small group members: 11,292
  • Large group members: 2,774

TOTAL ON EXCHANGE IOWA AND NEBRASKA (individuals/families): 31,117

TOTAL OFF EXCHANGE IOWA AND NEBRASKA (individuals/families): 17,909

TOTAL BUSINESS (employees and dependents) IOWA AND NEBRASKA: 22,188

TOTAL BOTH STATES ON AND OFF EXCHANGE (individuals/families/businesses): 71,214

This represents increases as follows:

This doesn't change the actual total number of Rhode Island's Medicaid expansion numbers, but it does specify the ratio between "strict expansion" and the "woodworker" enrollees...66% to 34%. Interestingly, this is virtually identical to the Washington State ratio (again, 67% to 33%).

This isn't enough to apply to the other expansion states yet, but if it does prove to be the case, that should be helpful in figuring out how accurate my current estimates are. I currently have "strict expansion" at roughly 3.7 million, while "woodworkers" are at 2.05 million. A strict 67/33 ratio would have the "woodworker" number at around 1.82 million...except that the non-expansion states also have some woodworkers as well, which should account for the additional 230K or so.

Figures obtained from the Chafee administration by WPRI.com show that out of the 64,590 Rhode Islanders who signed up for Medicaid from October through March using the state’s new HealthSource RI marketplace, 34% were eligible before the new law expanded the rules for who could sign up.

A few days ago, Michigan's newly-expanded Medicaid tally sat at around 32,000, plus another 54,000 people transferred into the program from an existing state-run one, for a total of about 86,000 people.

Today that number has grown to over 109K:

Healthy Michigan Plan Enrollment Statistics

• Updated every Tuesday at 3 p.m.

Total Healthy Michigan Plan Beneficiaries (including ABW transition prior to April 1): 109,228

Total Enrollment in Healthy Michigan Plan after April 1: 72,921

*Statistics as of April 15, 2014

Pages