Yesterday I posted an entry on Nevada's enrollment numbers which was a problem because the Nevada Health Link claimed to have lower enrollment figures as of 1/11 than the official HHS report had them at as of 12/28.
I asked them to clarify why HHS had them at 22,566 Private QHP enrollments on 12/28 when they were claiming only 18,864 as of 1/11 (of which only 11,409 were paid).
Today, they responded in a pretty to-the-point fashion:
@charles_gaba Nevada Health Link provides HHS and the public the same stats on a weekly basis. We do not know why the HHS # is incorrect.
These 3 updates push the Private QHP enrollment tally up to about 2.4 million; add about 4.5 million Medicaid/CHIP enrollments and 3.1 million "sub-26'ers" added to their parents plan thanks to the ACA, and you hit just over 10 million total.
A few days ago the New York exchange released an oddly-worded press release which mixed some numbers through December 24 with other numbers through January 12. My reading of it at the time was that the state had added roughly 53,000 (private QHP + Medicaid/CHIP combined) since 12/30.
However, today, the Deputy Director of the NY exchange stated that they've been enrolling "about 7,000 per day" total in January...which adds up to 98,000 if you assume that runs through yesterday, the 14th. Even subtracting the extra 2 days, this means her number is 31,000 higher than yesterday's press release, but I'm not about to argue with the Deputy Director of the exchange, so another 98K it is. Assuming this breaks down roughly 72% Private QHP to 28% Medicaid/CHIP (as prior numbers have in NY), that comes to about 70.6K private and 27.4K public.
In addition, this pushes New York over the top in terms of their original CMS projection of 218,000 private QHP enrollments by March 31st. They should easily double that number by the end of the enrollment period, and could potentially hit 2.5x at this rate.
I really, really like the way that the Washington Health Exchange does their press releases. No screwing around, they make the key numbers clear and obvious, and they make sure to separate out unpaid private QHPs as well as Medicaid "redeterminations" (ie, those who already had Medicaid under the pre-ACA rules and are simply renewing it).
As a result, here's where Washington State stands as of January 9: Private enrollments went from 71,205 paid / 72,178 unpaid (143,383 total) to 73,098 / 76,058 (149,156 total), while new Medicaid enrollments increased from 177,065 up to 197,770.
Thus, since Jan. 2nd, WA has increased private QHPs by 4% and Medicaid enrollments by almost 12%.
As an added bonus, WA also separates out the other Big, Important Number: How many Medicaid enrollees are renewals vs. how many are new. I do not include renewals in the spreadsheet in cases where I can separate them out.
Qualified Health Plans: 73,098
Medicaid Newly Eligible Adults: 134,700
Medicaid Previously Eligible but not Enrolled: 63,070
Qualified Health Plan Applicants – Need to Pay 76,058
Some slightly updated numbers out of Oregon today, revealed during a conference call with the director of the beleaguered Cover Oregon exchange. Private enrollments are up from 20K to 23K, and exchange-based Medicaid enrollments up from 39,711 to about 42,000.
In addition, some info on the method of the 115,000 "direct transfers" to Medicaid off of the exchange: Apparently they used food stamp income information to do so, which is pretty clever if you think about it.
More than 65k enrolled so far through exchange, he says, 23k in private plans
I've already noted that the State-Level CMS Projection Numbers are, for 40 out of the 50 states (plus DC), not particularly well-arrived at. However, for good or for bad, those are the numbers that the states are "supposed" to be striving for, so let's take a look at how they're doing.
With the official 12/28 HHS numbers in hand plus more recent updates for 13 states, here's where things stand purely on a "% of CMS projection attained" basis.
This is important to understand in cases like Kentucky, which has actually been operating quite successfully but which shows up as performing "poorly" due purely to the absurdly high "projection number" that it was assigned in the first place.
The official HHS ACA Exchange Medicaid enrollment figure for Illinois released earlier today was 82,286. However, contributor sulthernao noted that the actual number of people enrolled in Medicaid under the ACA in Illinois is at least 53,714 higher. As he/she put it:
Illinois is a partnership state for Medicaid enrollment, has used SNAP autoenrollment, and early expansion experiment in Cook County. For this reason, the numbers reported by the Federal Government (ASPE) are a severe underestimate of the enrollment. People who apply directly through the state's website may not be counted.
I realize that this probably has no connection to the "mystery" 1.24 million Medicaid/CHIP enrollments that I just wrote about an hour or so ago, but it's been a very long day and I'm extremely tired, so until I hear a better explanation for those 1.24M, I'm lopping the 53K difference out of that "unspecified" total at the bottom of the spreadsheet.
OK, the Medicaid situation is, to put it mildly...confusing. For most of the states I simply swapped out whatever numbers were there from the November report for the Dec. 28 total. However, there are easily a dozen states which either have one-time bulk automatic transfers from an existing state-run program (such as the 630,000 transferred from California's LIHP program, which was itself created in preparation for the ACA's Medicaid Expansion program); earlier mass enrollments in Medicaid which were quietly put through via other ACA elements long before the actual Exchanges launched (see DC and Minnesota); "special" cases such as Arkansas' unique "private Medicaid option" program; or simply updated numbers which have been released since 12/28.
Even with all of this, there's still roughly 1.24 million "unspecified" Medicaid/CHIP enrollments which are necessary to make up the other "3.9 million" figure which the HHS Dept. has been touting since around December 20th. I am simply unable to determine exactly what these "unspecified" enrollments are, since the "normal" Exchange-based Medicaid/CHIP numbers only add up to about 1.58 million.
In short, as best as I can figure, it breaks down as:
