Charles Gaba's blog

I'm typing this at 9:40am on Tuesday, January 31st, 2017.

The 2017 Open Enrollment Period ends at Midnight tonight (I'm assuming that's Eastern time).

That means you still have just over 14 hours to enroll for a Qualified Health Plan for the rest of 2017. If you enroll today (and pay your first month's premium), your policy will go into effect starting March 1st, and as long as you keep paying your premiums, should remain in effect until December 31st.

Many people are understandably concerned or outright scared about what will happen to their coverage given the insanity swirling around the Trump Administration, the Republicans in the House and Senate actively taking steps to repeal the ACA and so forth.

Now, I've already said many times that 2018 coverage options are likely to be a complete disaster thanks to the massive uncertainty and sabotage being deliberately created by both Donald Trump and the GOP. For the current year, 2017, it's a different story.

So, here's what you need to know:

From a last-minute press release:

The Washington Health Benefit Exchange is alerting customers that tomorrow, Jan. 31 is the deadline to sign up for 2017 health and dental coverage through Washington Healthplanfinder.

Individuals and families have until 11:59 p.m. tomorrow to select a plan that is good for the remainder of the year. Residents who fail to secure coverage by the deadline could be required to wait until the following year to sign up for health and dental coverage.

 

Last week, Congressional Republicans held a closed-door meeting to try and figure out how the hell they're going to replace the ACA (also known as "Obamacare" donchaknow?).

Amusingly, someone secretly recorded the meeting and anonymously sent it to the Washington Post.

The recordings confvirmed what anyone who's been paying even the slightest bit of attention over the past seven years suspected all along:

They got bupkis:

This may seem a little silly, but given the upcoming Open Enrollment deadline, the did-they-or-didn't-they confusion regarding the Trump administration's attempt to pull the final TV commercial/social media/phone/email notifications and the general insanity going on right now, I figured it might be helpful to provide direct links to the various ACA (Obamacare) websites for people to actually sign up for 2017 coverage.

Remember, regardless of how much the GOP-held Congress screws things up for 2018, signing up for a Qualified Health Policy (QHP) via one of these exchange websites by Tuesday, January 31st at Midnight should lock in both your policy and premium rate through the end of 2017.*

With that in mind:

Last week I posted an exclusive story over at healthinsurance.org regarding attempts by the Minnesota Republican-held legislature to sneak in a nasty amendment which, had it passed and been signed into law, would have given insurance carriers the right to offer policies which cover, basically nothing whatsoever.

The story ended on a happy note a few days later, as the massive negative backlash caused the state GOP to yank the amendment from the bill in question just before it went to the final vote. Awesome!!

However, I never really explained exactly what bill the pulled amendment was attached to in the first place. I should have written up a full entry on this, but have been swamped all week due to the political insanity and rapidly-changing situation on everything, so here's the basics:

New Mexico is one of five states (also including Nevada, Oregon, Hawaii and Kentucky) which technically operate their own state-based ACA exchange, but utilize HealthCare.Gov as their website enrollment platform. As such, their enrollment numbers are usually only released along with the other three dozen states on the federal exchange.

However, once in awhile they post the enrollment numbers themselves; today is such a day:

@charles_gaba NMHIX: 52,006 total signups - almost as much as last year. Still anticipating a surge as NMHIX continues ads and outreach.

— Colin (@colinb1123) January 27, 2017

The breakout here is 36,579 renewals + 15,427 new enrollees, or a 70/30 split.

Last year, New Mexico's total came in at 54,865 QHP selections, so they've hit 95% of that so far.

My original target for New Mexico for this year was 60,000, though I've knocked this down to 57,000 more recently. They're at around 91% of that so far, with less than a week to go. They'll have to add another 5,000 people in the final surge, which seems unlikely, but who knows?

For weeks now I've been pointing out that just when the most recent round of unusually high (unsubsidized) rate hikes seemed to have reassured insurance carriers on the ACA exchanges that they were over the hump...just when things seemed to be settling down for next year's enrollment period...Donald Trump won the the election, triggering the Republican-held Congress to start tearing things apart left and right, throwing everything into chaos again.

On Tuesday I noted that all of this confusion and uncertainty caused by Trump/the GOP Congress has started giving heartburn to insurance executives. Again: In October, just before the election, Molina Healthcare was happy as a clam with their exchange business and projected "another solid year" ahead. And now???

UPDATE 3:00pm 1/27/17: 

HHS official tells @CitizenCohn that Ocare automatic phone calls and outreach tools will remain. but not tv ads https://t.co/jjYfReoylD

— Sam Stein (@samsteinhp) January 27, 2017

Huh. OK...that's directly opposed to what Demko's Politico story said last night (all media outreach including email reminders), but whatever.

UPDATE 11/28/17: OK, here's the latest:

The Trump administration apparently was unable to scrap all outreach efforts to enroll individuals in Obamacare, following widespread concern that its move Thursday to pull ads promoting enrollment could destabilize the insurance marketplace.

It may seem a little silly to keep posting these tiny individual-state updates with everything going on at the moment, but every enrollee counts. Access Health CT held their monthly board meeting yesterday and posted some noteworthy data/policy points.

The irony is that this is exactly how the ACA should be being handled by Congress and the President: By using actual hard data and logic, problem-solving, fixing what's broken and improving upon what isn't.

...none of which seems to mean a damned thing to Trump or the Trumpublican Party.

107,736 have enrolled in a QHP for 2017. That includes 12k new customers. #AHCTBoDMeeting

— Access Health CT (@AccessHealthCT) January 26, 2017

Last year, 50% of #AHCT customers used broker to enroll. This year, only 25%. #AHCTBoDMeeting

With the GOP Congress still obsessed with repealing the ACA and Donald Trump doing everything in his power to sabotage the law whether it gets repealed or not, the final 5 days of the 2017 Open Enrollment Period, which would normally see a spike in enrollments regardless, is going into a bit of a panic mode. Trump and his Republican cohorts are doing whatever he can to discourage people from enrolling before the deadline, while the insurance carriers, healthcare advocates and everyone else is doing whatever they can to encourage it.

New York State of Health, the NY ACA exchange, just announced that with the 1/31 final deadline rapidly approaching next Tuesday, they're extending their customer service hours on Saturday and Sunday.

NOTE: I started writing this up as an update to an earlier post, but it was already pretty lengthy so I've broken it off onto a separate entry.

Last year, around 12.7 million people selected QHPs via the ACA exchanges nationally, including roughly 9.6 million via the federal exchange (HealthCare.Gov) and another 3.1 million via the 13 state-based exchanges.

This year, prior to the November election, both the HHS Dept. and I were projecting somewhere in the 13.5 - 14.0 million range.

UPDATE 7:00pm 1/26/17: Welp. This puts the nail in the coffin:

The Trump administration has pulled the plug on all Obamacare outreach and advertising in the crucial final days of the 2017 enrollment season, according to sources at Health and Human Services and on Capitol Hill.

Even ads that had already been placed and paid for have been pulled, the sources told POLITICO.

...Individuals may still sign up for Obamacare plans until the Jan. 31 deadline — but the Trump administration isn't advertising that fact any longer.

It is also halting all media outreach designed to spur signups in the days leading up to the deadline. Emails are no longer being sent out to individuals who visited HealthCare.gov, the enrollment website, to encourage them to finish signing up. Those emails had proven highly successful in getting stragglers to complete enrollment before the deadline.

A few weeks ago, frustrated with the disturbingly large number of Trump supporters (and, let's face it, plenty of non-voters and even a few Hillary supporters) who still seemed to be unaware that "Obamacare" and "The Affordable Care Act" are the exact same thing, I whipped up a snarky and admittedly sarcastic infographic trying to clue them in.

A few days later, after calming down a bit, I reworked the infographic into a nonjudgmental, more informative version:

Shout-out to Amy Lynn Smith for capturing this exchange between Republican Senator Pat Toomey (PA) and HHS Secretary Nominee Rep. Tom Price (GA):

SEN. TOOMEY: “Now, one way to force it is to force insurance companies to provide health insurance coverage for someone as soon as they show up, regardless of what condition they have, which is kind of like asking the property casualty company to rebuild the house after it’s already burnt down.”

Now, aside from the obvious callousness of this statement, there's a couple of important problems with his comparison:

 

Friday, January 20th:

Politically, the big unknown is whether or not Paul Ryan and Mitch McConnell will get away with trying to pin the blame for this on the Democrats/the law itself. That's why they've been pushing the "Obamacare is already in a death spiral!" claim hard for the past few weeks, even though it quite simply isn't.

...So, if this does end up in a worst-case scenario, Trump's "stop enforcing the mandate altogether!" order here could end up causing that death spiral even if the GOP doesn't technically end up repealing anything legislatively. The carriers would start announcing that they're bailing next year as soon as this spring (remember, the first paperwork for 2018 exchange participation has to be filed in April or May), and McConnell/Ryan would simply say, "See?? We told you it was collapsing all by itself! We didn't touch nuthin'!!"

Tuesday, January 24th:

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