Charles Gaba's blog

(sigh) OK, I saw a reference to this piece of fiction from The Daily Signal (a front for the right-wing Heritage Foundation...you know, the same guys who pretty much created the Affordable Care Act in the first place, but later changed their tune when their own plan was implemented by a Black Democrat) earlier today, but wasn't planning on responding to it since a) I already have addressed pretty much every one of their BS claims as recently as yesterday and b) if I spent the time it took to rebut every piece of feces that comes across my line of sight, I'd likely have a shingles relapse as a result.

A second nice DC find today by contributor deaconblues; as he put it, "so much for the triple-digit increases predicted by the Republicans"...

The D.C. Department of Insurance, Securities and Banking received proposed health insurance plan rates to sell on the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2015.

Four major insurance companies – Aetna, CareFirst BlueCross BlueShield, Kaiser Permanente and UnitedHealthcare – have proposed rates for individuals, families and small businesses.

 UnitedHealthcare proposed rate decreases of eight percent for all of their 2015 plans; Aetna and Kaiser Permanente proposed a mix of rate increases and decreases resulting in a slight overall net decrease for Aetna and a slight overall net increase for Kaiser; and CareFirst proposed rate increases for all plans. Most of the individual plans and all small business or “SHOP” plans reflect increases greater than 10 percent.

While that last item about CareFirst raising rates over 10% puts a damper on the good news, it may not be final:

When we last checked in with the DC exchange, I had to do an estimated breakdown between QHPs, SHOP and Medicaid enrollments of around 11,100, 14,200 and 22,700 respectively.

Today they released the actual totals, which are shoved around a bit from my estimates:

From October 1, 2013 to June 11, 2014, 48,188 people have enrolled through DC Health Link in private health plans or Medicaid:

  •  11,582 people enrolled in private health plans through the DC Health Link individual and family marketplace;
  •  23,008 people were determined eligible for Medicaid coverage through DC Health Link; and
  •  13,598 people enrolled through the DC Health Link small business marketplace.

So, QHPs are about 600 higher than I thought, SHOP about 600 lower and Medicaid about 300 higher. Not bad!

Seriously, don't ACA opponents ever get tired of being wrong about...everything?

Hot off the presses...

PRINCETON, NJ -- Five percent of Americans report being newly insured in 2014. More than half of that group, or 2.8% of the total U.S. population, say they got their new insurance through the health exchanges that were open through mid-April.

These data are based on Gallup Daily tracking interviews with more than 31,000 adults conducted between April 15 and June 17. Those who say they have health insurance were asked if their policy was new for 2014, and if so, whether they obtained their policy through a state or federal health exchange or in some other way. The exchanges officially closed on March 31, although people who indicated they had begun the process prior to that date were allowed to continue to enroll through April 15.

So, let's see here. The Gallup poll only includes adults over 18, so...

My 8-year old son and his best friend, just walking down the sidewalk together.

Some moments are just too perfect.

Slowly but surely, Michigan looks like it may end up achieving 100% expansion enrollment by the end of the first year, an amazing accomplishment (especially considering that the GOP state legislature delayed the program by 3 months for absolutely no reason whatsoever, financial or otherwise):

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 307,143
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of June 23, 2014 
*Updated every Monday at 3 p.m.

Last night, Jonathan Chait of New York Magazine posted a great story entitled "Republicans Finally Admit Why they Really Hate Obamacare".

For the most part, it lays out the major anti-ACA talking points (No One is Signing Up; the Policies are Too Expensive; But How Many Were Previously Uninsured?, There Won't Be Enough Competition, etc.), followed by the reality which has sliced through each of them, one by one like Toad's "List of Things to Do Today". To be perfectly honest, I was a bit surprised that he didn't bother including the chestnuts which have been disproven in the most spectacular fashion: The "But How Many Have PAID???" and "OMG!! 5MM Policies Cancelled!!" memes. Anyway, it's a good piece, and he concludes it as follows:

Good for him. Not only is this the right thing to do, assuming it goes through (it sounds like the logistics will be a bit awkward to implement under the circumstances), it also makes the Virginia Republican Party look like even bigger jackasses than they already did (and don't even get me started on the former Democratic state Senator who agreed to their bribery scheme).

Virginia Gov. Terry McAuliffe (D) said on Friday that he planned to act administratively to expand health coverage in his state, defying the Republican-controlled legislature that maneuvered to block him from expanding Medicaid under Obamacare.

The specifics of McAuliffe's plan aren't clear. But he vetoed an item in the Virginia budget Friday that would have required the legislature to approve any expansion and asserted that he planned to "move administratively" to expand coverage to as many as 400,000 low-income Virginians.

Yes, I know I just posted a Michigan Medicaid expansion update a few days ago, and the numbers since then are "only" up 4,000 since then, but this story has another important data point. Regular visitors should have noticed that the Medicaid spreadsheet and section of The Graph always seems to be somewhat higher than the CMS's occasional reports on actual Medicaid enrollment. The main reason is that there's a difference between Medicaid determinations and Medicaid enrollments; the HHS and CMS reports, along with the occasional state-level reports, generally only list how many people have been determined to be eligible for Medicaid. There's still a process that they have to go through in order to fully enroll.

Amy Lynn Smith has a great piece over at Eclectablog about the Get Covered America campaign, which is devoted to educating people about the law and helping them enroll:

The task of getting more people insured is never done. That’s why the Get Covered America campaign is kicking off a weekend of action on Friday. While celebrating its one-year anniversary of educating consumers about their new health insurance options, the campaign will be sending volunteers into communities across the country.

In addition, there's a related organization called Young Invincibles (hah!), specifically devoted to educating and assisting young adults (the sought-after 18-34 crowd) in enrolling, particularly during the off-season:

Well slap my ass and call me Susan. Remember that pissing match between Avik Roy and I back in late March over the now-infamous "McKinsey Study" which claimed that only 27% of individual market enrollees since the start of Open Enrollment were "previously uninsured"?

McKinsey itself stated no less than seven times throughout that it included both ON- and OFF-exchange enrollees, and therefore was pretty much useless for trying to figure out how many of the exchange-based QHP enrollees were "previously uninsured", since there was no separation between the two in the data. For all anyone knew at the time, there could have been twice as many off-exchange QHPs as exchange-based ones, and even if it was a 50/50 split, for all anyone knew, it could have been 0% prev. uninsured OFF exchange and 54% prev. uninsured ON the exchange. Basically, it was meaningless for that purpose.

This didn't stop Roy from insisting that...

Yesterday I posted an entry which noted a story published by Avik Roy over at Forbes about an extensive study by the Manhattan Institute which compared the average insurance policy premiums last year vs. the average premiums this year, after the first ACA open enrollment period. Roy's piece breathlessly claims "Obamacare Increased 2014 Individual-Market Premiums By Average Of 49%"

I wrote a response piece which also included the HHS report about ACA subsidies covering an average of 76% of the premium cost for the Federal marketplace, but I didn't really have time to do a full analysis of the Forbes piece. However, I did note 4 major points which lept out at me right off the bat:

As of the end of the open enrollment period (4/19), New Jersey's exchange QHP total stood at 161,775; this hasn't been updated officially since. Their Medicaid enrollee tally was updated to 201,095 as of 5/30. That means that the combined total is up around 37,000.

The QHP/Medicaid ratio is tricky to estimate, not just because it isn't provided but because of the differing dates. However, I'll assume for now that NJ's off-season QHP rate has been running at around 20% of the total enrollment period rate of about 800 per day; that would make it 160/day, or 9,400 QHPs plus another 27,600 Medicaid enrollees:

The federal government reported in May that 161,775 Jerseyans bought insurance policies on the Marketplace since HealthCare.gov launched Oct. 1. The health insurers, however, are reporting enrollment numbers that exceed the government’s numbers. And experts predict those numbers will rise, since individuals whose health insurance policies don’t comply with ACA rules will be able to buy new policies on HealthCare.gov through 2014 as their old policies expire.

Total since October 1, 2013

  • 32,654 Applications completed in the Individual Marketplace
  • 9,528 Individuals and families enrolled in the Individual Marketplace
  • 637 Employers applied to SHOP Marketplace
  • 861 Employees and dependents enrolled via SHOP Marketplace

The DC exchange has always been a bit of an anomaly: It's one of only 2 exchanges where SHOP enrollments exceed QHPs (the other is Vermont), mainly because the ACA requires Congressional staffers to enroll via the DC SHOP exchange instead of their home states or even the DC QHP side. As a result, as of April 30th (the most recent update), the breakdown was 11,106 QHP's (25%), 13,230 SHOP (30%) and 20,497 Medicaid enrollees (45%). Add them up and you get 44,833 total.

As contributor deaconblues notes, the QHP number seems to be almost identical, so the bulk of the 3,200 additional enrollments are broken out between Medicaid and SHOP enrollees. I'll assume a 70/30 split until better data is made available.

A spokeswoman for DC Health Link said this week that reports of problems, “if true, were isolated incidents.” She noted that the exchange has enrolled more than 48,000 individuals and families; about 11,000 are enrolled in private plans.

Pages