On Christmas Day I posted "New ACA Attack: "But how many have actually PAID???" in which I pointed out that unless there prove to be significant technical issues preventing large numbers of premium payments from going through, this is pretty weak tea in terms of being an anti-ACA talking point...or at least it won't have any teeth to speak of until after January 10th, the date which most insurance companies have agreed to extend their January payment deadlines out to.

However, in the interest of completeness, I did point out that in at least one case (Washington State), the enrollment numbers are indeed broken out between paid and unpaid; specifically, 65,000 out of 134,000 total enrollments had been paid, or 48.5%. The next day, Nevada's numbers came out and once again, 49% (6,219 out of 12,740) were paid. So the short answer I gave at the time was "almost half of enrollees have paid."

In 2012, more than 50 million Americans lacked any form of health insurance. The Affordable Care Act was enacted into law in order to reduce that number. This website aims to give an accurate picture of how much.

In April this year, after the six-month open enrollment period has ended, it will be interesting to examine the statistics. Foremost among those numbers, in the minds of political pundits, will be how many Americans enrolled in private health plans? We will then know whether we reached, surpassed or fell short of the 7,066,000 enrollments projected by the Congressional Budget Office – long since elevated to a “target” rather than the projection it was.

How many more people are insured?
As we start this new year, at least 2.1 million people will be covered by new private plans, roughly 30 % of CBO’s first-year projection. However, this is by no means the only key figure. More than 4 million people are embraced by the Medicaid expansion. In addition, an estimated 3.1 young adults are now insured though their parents’ health plans. That adds up to 9.2 million people, which is a respectable start and should significantly reduce the number of uninsured. However, it must be underscored that many complex factors make it impossible to quantify that reduction, at least for the time being.

On top of that are an unknown number of people who have purchased ACA-compliant insurance plan off-exchange, i.e. directly from the insurance company. There are strong indications that total is significant – and we’ll return to that issue.

Mississippi: Private up to 2,000 from 802 (h/t Steve Mullinax, aka rsmpdx)

Transcript from Jeffrey Hess of Mississippi Public Radio, NPR Audio:

Only two insurance companies are offering plans in Mississippi, and they only overlap in four of the state’s 82 counties. However, those two companies appear to be betting that the web site problems and skepticism about the exchange in general are passing. One of the two companies, Humana, launched a late-December ad campaign to drive more people to the site, says spokesman Mitch Lubitz. “There’s been a ramp-up as the HealthCare.gov web site has gotten easier to use and there have been other options for people to go on and get information and enroll.” Mississipi’s Insurance Commissioner Mike Chaney says the improvements to the enrollment process are good, but he’s still skeptical they’ll be able to get enough people signed up this year. “From zero to ten, I’d give it a confidence level of about a three.” Hess: “That’s still not very good.” Chaney: “That’s not, but it’s better than where I was, a one, a week before last. “Chaney says the unofficial count is around two thousand people enrolled, but he says if the confidence trend continues upward, his confidence will rise to a five.”

My only update today was to finally post the F.A.Q.

I have a dozen or so submitted updates to check into, so hopefully I'll have a lot to add tomorrow, but otherwise I'm spending a quiet New Year's Day curled up in front of James & the Giant Peach and Hugo with my family.

Happy 2014, everyone!

Two quick last-minute updates before the ball drops on 2013:

Rhode Island: private enrollments up to 9,800 (h/t to Betsy Cazden aka rugbymom)

Individuals and families had until the end of the day Tuesday to enroll throughHealthSource RI for coverage beginning Wednesday. About 9,800 people had signed up from Oct. 1 through Dec. 28 for commercial plans offered in the marketplace. It was not immediately clear how many of them were previously uninsured.

As Ms. Cazden notes: "We were at a bit over 5,000 at the end of November, so this means it's almost doubled. Our CBO target number is 12,000, which we're on track to hit by mid-January at this pace....there will be more numbers coming out since people can sign up until midnight tonight (12/31)."

In a conference call earlier today, the HHS announced a few things, most of which I already knew, but a few new items. First, they confirmed the 2.1M private enrollment figure which ACASignups has been projecting for a week now (my original prediction was 2.0M by 12/24 and up to 2.3M by midnight tonight, but that was before several states extended their enrollment deadliens; I changed this to 2.1M who will have their coverage start on January 1st).

They also confirmed the 3.9M Medicaid/CHIP enrollments through 11/30 (not surprising since I had already gotten that number from them anyway) and the 3.1M "Under-26'ers" on their parents plans thanks to the ACA.

To be honest, there wasn't a whole lot of new information given out.  The most interesting news is that they've gotten both CVS and Walgreens to agree to some sort of special "transitional phase policy" regarding prescriptions and other pharmacy transcations; the gist of it is that for a short period of time (A week? Two weeks? They didn't specify), you'll be able to get prescriptions filled and so forth from CVS or Walgreens as long as you provide some sort of proof of your insurance coverage, even if it's not in their regular system yet. I didn't catch what sort of proof would be required, but this makes sense and is a smart move under the circumstances.

Last night I teased that I'd be providing some context and insight into the Iowa and Nebraska updates posted on the spreadsheet, and I still plan on doing so later today. However, there's been an interesting development over at Minnesota which I need to address first.

Yesterday, Jackie Crosby of the Minnesota StarTribune posted "MNsure grids for late crush of enrollees", which among other things gave an update on the MNsure enrollment numbers, stating:

More than 53,000 Minnesotans have bought coverage as of last Friday, with the biggest gains coming from those buying private health plans on the individual market. By Friday, 19,420 had signed up for individual or family plans; 12,051 had been enrolled in Medical Assistance; and 12,708 were getting coverage through MinnesotaCare.

So far, fair enough. However, in the original version of the article posted yesterday, there were two more paragraphs immediately following this. The first paragraph specified that these enrollments actually represented about 125,000 actual people (i.e., additional family members, etc). It also specified that about 20,000 of those were being held up due to paperwork issues and so forth. The next paragraph stated that around 3,900 people had completed enrollment but hadn't actually paid their first premiums yet.

Yesterday morning's big news, of course, was that the Federal ACA exchange (covering 36 states) is now up to over 1.1 million private healthcare plan enrollees. Today brings 4 new state-level updates...and a teaser for two others you probably weren't expecting to see.

New York:
Today's big news is in New York, which announced that they're up to a total of 241,522 enrollees in either private plans or Medicaid/SCHIP expansion. They haven't broken out the number yet, but based on the split in the previous update (156K private, 58K Medicaid/SCHIP) I'm going with a 73% private / 27% Medicaid split until more specific info is released. This increases NY's private enrollments to 176K, up 20K from last week. h/t to Buenaventura for being the first to notify me.

Connecticut:
Connecticut issued a formal press release which includes their final 12/23 deadline enrollment tally for 1/1/14 plan coverage. The total is only slightly higher than what I had (34,295 instead of 34,000 even); the noteworthy part of the announcement is that they've confirmed ACASignups.net's declaration of CT as the first state to surpass their original CBO enrollment projection. CBO had them achieving 33,000 private enrollments by 3/31/14; instead they've managed to break through that number in less than half the 6-month enrollment period. Given the poor October performance of the ACA exchanges as a whole, this is an amazing development.

OK, exhausted from the frenzy of activity today, but I did want to get one issue cleared up as best as I could. There's a lot of confusion about the "3.1 million young adults on their parents plan" figure which is mentioned on the graph but not referred to in the spreadsheet itself.

The 3.1 Million figure comes from a CNN Money article from June 2012. According to that article, the comparable number a year earlier (June 2011) was 2.5 million, so it's safe to assume that this number has only gone up further in the past 18 months.

However, according to the Kaiser Family Foundation (h/t to "Nadeem" for the heads up), the actual number may be even higher; see this story from October of this year, which cites, in turn, a 2013 tracking survey by the Commonwealth Fund which lists the number as far higher: 7.8 Million:

There is concern that many young adults (ages 19–29) will remain without health insurance in 2014 despite the Affordable Care Act’s reforms, including subsidized private coverage offered in new state marketplaces and expanded Medicaid eligibility. How things turn out will likely depend on outreach efforts and states’ decisions on expanding Medicaid. Commonwealth Fund Health Insurance Tracking Survey data from 2011 and 2013 show increasing awareness among young adults of the 2010 requirement that health plans cover chil- dren under age 26. Of the estimated 15 million young adults enrolled in a parent’s plan in the prior 12 months, 7.8 million would not likely have been eligible to enroll prior to the law. Still, only 27 percent of 19-to-29-year-olds are aware of the marketplaces. Meanwhile, most uninsured young adults living below poverty will not have access to subsidized public or private insurance in states opting out of the Medicaid expansion. 

Given the craziness of the past few days, I haven't had a chance to check into this further, but assuming it checks out, it certainly looks like 7.8 million is the more appropriate number to use. Of course, if I do change it from 3.1 to 7.8 I'll no doubt be accused of making up phantom numbers, so I'll have to double-check before proceeding.

OK, I wasn't really planning on setting this site up as anything more than an embedded Google Spreadsheet, but along with the spike in ACA enrollments over the past 2 weeks has also come a similar spike in website traffic and exposure. Over the past few days, I've been linked to and/or cited by major media outlets including Forbes, New York Magazine and, most notably, the Washington Post, so I figured it was time to organize and tidy up things a bit.

I also wasn't planning on launching the new version of ACASignups.net until January 1st, but given this morning's announcement that the Federal healthcare exchange (Healthcare.Gov) has topped 1.1 million enrollments (h/t to David S. for the heads up!)--which in turn brings the overall total of private plan enrollments to over 2 million--I decided to go ahead and launch it a bit earlier than expected.

So, as you can see, I'm still scrambling to get the new digs ready. I'm separating out the visual enrollment graph from the spreadsheet itself, and will be back-porting my older blog entries from Daily Kos and Eclectablog over here (don't worry, I'll still be cross-posting there as well). I also still have to add the FAQ and other resource links.

Perhaps the most important functional addition, however, is the new Submit an Update form. I have a dozen or so people who have been sending me updates for one state or another until now, but their method of getting it to me has been inconsistent. I hope this new form will give everyone a single place to send the latest state or federal exchange enrollment numbers. Of course, there's always the chance that someone will try and flood me with junk links or vitriol; if that happens I'll have to rethink this feature.

In the meantime, thanks for your interest and support, and keep an eye on the site for more info in the coming days.

Noteworthy mainly because this is the only case other than Washington State where a breakdown between paid and unpaid enrollments is being given.

Update: As of the 12/23/13 deadline to enroll, 12740 consumers confirmed QHP selections, 6219 have paid. Payment deadline is 12/30/13.

  • First it was "No one can get on the website!"
  • Then it was "OK, the site is loading but no one can create an account!"
  • Then "OK, you can create an account but no one can view the plans!"
  • Then "OK, you can view the plans but no one can fill out their application!"
  • Then "OK, you can apply but no one can actually enroll!"
  • Then "OK, it works now, but no one bothering to do so anymore!"
  • Then "OK, (a lot of) people are enrolling, but none of the data is being transferred to the insurance companies!"
  • And now that we've hit over 1.8 million private enrollments, the new attack is:

"FINE, a lot of people have ENROLLED, but how many have actually *PAID*???"

Here's a simple 2 part response:

1. Actually, Washington State DOES break enrollments out between "enrolled but not paid" and "enrolled and paid". In their case, about 48% of their 134,000 private plan enrollees have fully paid. Assuming this is a typical spread across the other states, it should be roughly 875,000 enrollees who have paid already.

Washington State (h/t ArcticStones):

Enrollments in private health plans on Healthplanfinder, the state’s online insurance marketplace, surged past 65,000 as applicants hustled to beat the Monday night deadline for coverage beginning Jan. 1, Washington Health Benefit Exchange officials reported Tuesday. Nearly 69,000 others have completed the enrollment process, but haven’t arranged payment, and another group of undetermined size has begun applications that are in varying stages of completion. ... As of Monday at midnight, about 100,800 people newly eligible for health insurance through the state’s expanded Medicaid program had signed up. Almost half of those were transferring from the now-discontinued Basic Health program or were presumed qualified for a federal assistance program for the disabled. An additional 47,500 enrollments were from those who previously qualified for Medicaid under the old rules — primarily children — but had not been signed up. And more than 88,000 people already covered by Medicaid renewed their eligibility.

For private enrollments, Washington is the only state that distinguishes between "enrolled but not paid yet" and "enrolled and first month's premium paid"; every other state, and the HHS, counts you as being enrolled even if you haven't actually paid yet, so that's the criteria I use, although I did separate out the other 69K on the spreadsheet. For Medicaid, I'm not counting the 88K since they were just renewals, but the 47.5K do count since they appear to fall into the category of people who were already qualified but didn't know about it until the ACA and the state exchange. In addition, as in several other states, another 47,000 people are being automatically transferred over to Medicaid proper from an existing state program; this is one of the "orange cells" on the spreadsheet. Also, h/t to sulthernao, who found the actual WA exchange source that gives the precise numbers.

The article is a bit confusing, but it looks like 15,800 belong in the "Private Exchange" category with another 29,200 under the "Small Business (Direct)" category which doesn't even exist on the spreadsheet yet. I'll have to review this further to get a straight answer, but for now I'm entering both numbers under the "Private Exchange" heading.

The delayed deluge of applications — 5,000 were filled out in the past four days — brings the total number of Vermonters who should be settled with their coverage at the start of 2014 to 45,000, the administration says.

That’s roughly two-thirds of the 65,000 Vermonters whose insurance expires at the start of the year. Another 9,300 people have three months worth of breathing room — their plans have been extended through March 31, either because their employers chose that route or because the payment piece of the website isn’t working for them.

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