Over the past month or so, several researchers, reporters and other data nerds have inquired about whether I'd be willing to open up the QHP and Medicaid spreadsheet permissions to let people export them to Excel. It was always my intent to do this once the 3/31 deadline was past. However, a few things complicate this.
An article up in today's National Journal states that according to the Blue Cross Blue Shield Association, their Paid Enrollee figure is around 80 - 85%...for policies from October, November, December and the first half of January.
On the one hand, this is significant for two reasons: First, because the BCBSA is huge; I don't know their collective marketshare, but it's big (they include Anthem/WellPoint, the various Blue Cross companies such as Highmark, Regence and so forth). I dunno...maybe 30% or more of the market in total?
Secondly, according to the article, this specifically refers to policy premiums which are well past-due. That is, policies which started either January or February 1st. This does not apparently include more recent enrollments (those from late January, February or March):
A few weeks back (upon my request) I was sent updated enrollment data (both on- and off-exchange) from CoOportunity Health, which operates in Iowa and Nebraska.
Earlier today (upon my semi-request...that is, I had asked about it a couple of weeks ago but kind of forgot about it), I was sent a press release for Blue Cross Blue Shield of Michigan, which included their ACA Open Enrollment data breakdown (well, most of it...I had to have them clarify the rest).
A few minutes ago, without any doing on my part, eHealth Insurance (which I've written about a couple of times for off-exchange data, and which is actually a broker, not an insurance company themselves) tweeted out a link to one of my stories about them.
A lot of good info here, mostly about off-exchange enrollments, but also about the "Paid/Unpaid" question:
That total breaks down as 27,968 individuals who used HealthSource RI to sign up for plans from Blue Cross or Neighborhood Health Plan of Rhode Island, along with 11,271 who bypassed HealthSource and boughtObamacare-compliant policies directly from Blue Cross, the two organizations told WPRI.com.
Those 11,271 direct-purchasers are important to Blue Cross because they will be combined with those who bought through HealthSource RI to make up the insurer’s 2014 risk pool for individual insurance. The size and shape of the risk pool is crucial to determining how much premiums will cost.
...Roughly four in five of those who bought insurance through HealthSource by March 8 had paid their first premiums at that point.
OK, this hasn't become an issue yet, and perhaps I'm deluded about my importance by thinking that it might, but I figured it would be a good idea to post it "on the record" just in case it ever does.
I am a not a professional journalist. I don't work for the AP, Reuters or any other media organization. I wasn't even a "freelance journalist" prior to this project, unless you count my rants over at dKos as journalism (in a few cases they might have approached it). I'm a web developer and a blogger. Yes, I've received some donations (thank you again to everyone who has helped out!), but that's a voluntary, unofficial sort of thing. This is where the whole "blogger/journalist" fuzziness comes into play.
I am also not a lawyer, so I have no idea what, if any, legal obligations I'm under when it comes to "disclosing sources" or "keeping confidences". I haven't signed any nondisclosure agreements with anyone, nor do I plan to. I found this primer on the issue from Slate, way back in 1999, and it doesn't help me much.
So, I just received a press release from Blue Cross Blue Shield of Michigan (BCBSM), which includes a bunch of data covering the full open enrollment period.
The key part for me is this:
DETROIT, April 2, 2014 – At the close of the six-month ACA Marketplace open enrollment period, Blue Cross Blue Shield of Michigan and its HMO subsidiary, Blue Care Network, were selected by more than 300,000 Michigan consumers.
...BCBSM will report final, confirmed numbers later this month once all enrollments are processed and tabulated by the federal government. The results announced today are initial figures based on reporting by the federal government and BCBSM’s records:
180,000 members enrolled with BCBSM and BCN “on-Marketplace,” meaning through Healthcare.gov.
53,000 members enrolled “off-Marketplace,” meaning directly through the companies.
However, this is a bit confusing, because there aren't any other enrollment numbers listed. 180K + 53K = 233K. If the total is over 300K, where are the other 67K?
OK, I don't mean to sound full of myself, and it's a fine article, but it's a bit amusing to see the reporter refer to "politicians and policy makers" as being the only ones who have "largely overlooked" off-exchange enrollments.
Millions of newly insured people are hiding in plain sight.
They are the people who have bought new health insurance since the start of this year but have chosen for one reason or another to bypass the state and federal exchanges that opened last year under the Affordable Care Act. While the exact number is unknown, some health care experts estimate that it may be in the millions.
Politicians and policy makers have focused on the number of people who signed up through the exchanges — at nearly seven million and counting a day after the March 31 deadline — but they have largely overlooked the group that did not use the exchanges, even though it could have a major impact on the program’s financial success in the years ahead.
Well this one came out of nowhere...it doesn't seem to be an April Fool's joke. It makes little sense, however...why would FL's be extend to 4/30 when the other 35 Federal-Exchange-run states are all cut off at 4/15? And what's with the April 7th "paper" application bit? Weirdness.
The open enrollment period for health insurance coverage for Floridians under the Affordable Care Act is extended through April 30 for people whose paper applications are received by April 7.
The QHP number (80K) looks about right, but that 67K Medicaid number bears no connection whatsoever to the existing number (91,115). On the other hand, AZ has some sort of unusual situation going on with their Medicaid program anyway, so I'll leave that one alone for now.
As of March 1, the enrollments were behind projections, with just about 58,000 enrolled. But Plese said she’s seen unofficial figure that show the number rose to about 80,000 by mid-March.
Another 67,000 who used the federal site had been determined to be eligible for Medicaid.
That's right, Medicaid Expansion finally came to Michigan starting today, April 1st, 2014:
Enrollment began Tuesday for Healthy Michigan, which extends Medicaid eligibility to adults making up to 133 percent of the federal poverty level, or about $16,000 for an individual and $33,000 for a family of four.
By 4 p.m. Tuesday, 11,848 applications had been received, and 4,152 had been automatically approved, according to the Department of Community Health. The state expects 320,000 residents to sign up in the first 12 months. The number could grow as high as 470,000 over time.
I actually have Michigan down as having up to 500,000 people qualifying for expansion, but whatever. I'm not entering this into the spreadsheet or anything yet; I really want to lock down the March numbers before I start up with the April ones. However, it was at least worth mentioning, especially since this is my home state and all... :)
OK, in addition to the appx. 7.041 million enrollments on the Federal exchange (HC.gov), I've brought CO, CT, DC, HI, KY, MD, MN, NY, RI and WA completely up to date, with all QHP data through midnight on 3/31 (some of the Medicaid/CHIP data is still missing, but that's a lesser concern at the moment).
However, I'm still missing the following exchange QHP data:
California: 22 hours (that's right...the current tally runs thru 2am on 3/31)
Massachusetts: 3 days (current is thru 3/28)
Nevada: 2 days (current is thru 3/29)
Oregon: 3 days (current is thru 3/28)
Vermont: 1 day (current is thru 3/30)
I can't tell you how frustrating it is to be this close to full data while still missing it.
So, how much is actually missing? Well, if these states were running at their prior average March daily rate, it would be
MA: 512 x 3 = 1,536
NV: 427 x 2 = 854
OR: 502 x 3 = 1,506
However, this obviously doesn't apply since the final weekend and especially yesterday were insane.
Without the final day's numbers, this update is both helpful and frustrating, because it's so close yet so far away. The QHP number is actually somewhat lower than I had thought a few days ago (not that I'm complaining; HC.gov more than took up the slack, and CA was going nuts on the final day anyway...which is why I'm so anxious to get the data from the 31st):
Consumer interest in Covered California has been strong, with 1,209,791 Californians signing up as of 2 a.m. March 31. From March 24 through 2 a.m. March 31, 155,988 individuals signed up for coverage. During the same week, 389,840 accounts were started — including 123,787 on Saturday and Sunday, as consumers hurried to meet the deadline.
“We’ve set records on accounts created five of the past six days,” Lee said.
Maryland's exchange may be a mess, but this article gives solid, no-nonsense totals: 60K QHPs and 232K Medicaid through 3/31.
Sharfstein provided updated enrollment numbers on Tuesday. He said the state enrolled 60,003 people into private health plans. The state initially hoped to have 150,000 enrolled in private plans. O’Malley has tried to offset the disappointing private plan enrollments by highlighting a higher numbers of Medicaid enrollments through the federal Affordable Care Act. Sharfstein said Tuesday that 232,025 have been enrolled in Medicaid. The state’s goal of total enrollments was 260,000.
Excellent find by contributor deaconblues; HighMark is one of the few major insurance companies which has been very open about their off-exchange QHP enrollments. This press release contains some great updates for 3 different states, including a total exchange QHP update for West Virginia (since HighMark is the only insurance company operating on the exchange there anyway):
Highmark's total enrollment* for individuals who have purchased Affordable Care Act-compliant plans both on the federal marketplace exchange and through Highmark directly:
Pennsylvania: 148,003 total with 104,324 on-exchange and 43,679 off-exchange
West Virginia: 20,131 total with 14,839 on-exchange and 5,292 off-exchange
Delaware: 13,010 total with 9,187 on-exchange and 3,823 off-exchange
Through both on- and off-exchange purchases, Highmark had a noteworthy percentage of new members, which are likely those who were previously uninsured or had insurance with a competitor.
Pennsylvania: 53 percent new members
West Virginia: 63 percent new members
Delaware: 67 percent new members