2018 MIDTERM ELECTION

Time: D H M S

No sooner had the January CMS report come out then wham, a new update from Kentucky...unfortunately it's actually a drop in QHP enrollments, since the prior 59K estimate was based on a very general statement by KY Gov. Beshear. As a result, QHPs drop about 5K (from 59K to 54,369) while Medicaid/CHIP enrollments go way up (from 185K to 210,545).

Under @kynectky so far, 210,545 have qualified for Medicaid coverage and 54,369 have purchased private insurance. #ACA

— Joe Sonka (@joesonka) February 28, 2014

OK, to repeat: The January CMS Medicaid/CHIP Report has finally been released:

According to a new CMS report released today, between October and January, more than 8.9 million individuals were determined eligible for Medicaid or CHIP through state agencies and through state-based Marketplaces. More than 2 million people were informed in January that they are eligible for Medicaid and the Children’s Health Insurance Program (CHIP); more of those individuals are in states that have chosen to expand Medicaid coverage to more of their residents.

Details to follow, keep watching this space... (or "developing" as some would put it...)

According to a new CMS report released today, between October and January, more than 8.9 million individuals were determined eligible for Medicaid or CHIP through state agencies and through state-based Marketplaces. More than 2 million people were informed in January that they are eligible for Medicaid and the Children’s Health Insurance Program (CHIP); more of those individuals are in states that have chosen to expand Medicaid coverage to more of their residents.

Vermont continues to have impressive enrollment numbers (relative to their population size) despite their ongoing technical problems, partly due to an aggressive SHOP/Small Business enrollment program. Private QHPs have somehow more than doubled from 13,514 paid / 3,392 unpaid as of 2/10 up to 28,486 paid / 4,805 unpaid as of February 25th.

Meanwhile, the SHOP enrollment numbers are also impressive, jumping from 29,200 at the beginning of the year up to 40,000 as of 2/25.

In addition, the article claims that the 28.4K figure only represents policies, not people, which suggests that the actual number of individuals could be as many as 51,200, but I'm already finding it difficult to believe that they've managed to go from 13.5K to 28.4K in just 2 weeks in the first place, so I'm holding off on that factor for now.

The latest figures from the Department of Vermont Health Access, presented to lawmakers Wednesday, show 33,291 individuals have selected a plan and 28,486 are fully enrolled...

After being cited by both the Washington Post as well as PolitiFact as one of only two sources for a reasonably accurate tally of ACA-enabled Medicaid/CHIP expansion (Avalere Health is the other one, although their analysis only included data through the end of December), I decided to go back and review my methodology. I've pored over both the HHS and CMS reports again, as well as reviewing the "Targeted Enrollment Strategy" and other special "bulk transfer" cases.

Looks like the previous update claiming over 5K in Hawaii was mistaken. Not that it makes much difference, but I have to lower HI's tally by 533:

Total for the period of Feb. 16, 2014 through Feb. 22, 2014:

4,467 Enrollments in the Individual Marketplace

Nevada's latest update as of 2/22: Paid QHPs have shot up 2,095 from 17,047 to 19,142; unpaid QHPs are down 702 to 7,893 from 8,595, which means that Nevada, like Washington yesterday, is starting to convert unpaid enrollments to paid more quickly. Total enrollments are therefore up just 1,393.

Update as of 2/22: 27,035 consumers have confirmed QHP selections through Nevada Health Link, 19,142 have paid.

— Nevada Health Link (@NVHealthLink) February 26, 2014

These new enrollees are not all from February; they actually have been scattered throughout the entire enrollment period to date, some going as far back as October or November...but they're not actually being added until this week. This brings the total number of new Medicaid enrollments for Ohio to 129,000:

COLUMBUS, Ohio (AP) -- Ohio officials are preparing to receive more than 106,000 applications for Medicaid-eligible residents who sought health coverage through the federal insurance marketplace.

The first batch of cases, which had been in limbo for months, could be transferred as soon as Wednesday, said Greg Moody, director of the Governor's Office of Health Transformation.

Minnesota's official enrollment figures as of 2/24 are up slightly from a few days ago...Private QHPs are up just 434 people to 31,522 while Medicaid is up 3,015 people to 73,271.

After having my enrollment projection model confirmed by the administration twice in the past week, I thought this would be a good point to see how close I've gotten various milestones since I started this thing:

Private QHPs: Total thru the end of December
ACA Signups, 12/25 2,100,000 98.24% accurate
Actual (HHS), 1/13 2,137,630
Medicaid/CHIP: Total thru the end of December
ACA Signups, 1/21 6,320,000 99.68% accurate
Actual (CMS), 1/22 6,300,001
Private QHPs: Total thru the end of January
ACA Signups, 2/07 3,300,000 99.98% accurate
Actual (HHS), 2/12 3,299,492
Private QHPs: Percent Paid
ACA Signups, 2/13 (10 AM) 75-80%

basically the same

New York Times, 2/13 (5 PM) 75-80%
Private QHPs: Total thru Feb. 19
ACA Signups, 2/19 3,860,000 at least 95% accurate
Pres. Obama, 2/20 "close to 4M"
Private QHPs: Total thru Feb. 24
ACA Signups, 2/25 (3:48pm) 4,013,762 99.66% accurate
Actual (HHS), 2/25 (5:59pm) 4,000,000

 

On a completely separate note, I should also point out that while the actual enrollment period for Private QHPs ends on 3/31/14, we won't know how many actual enrollments there are until mid-April, and we won't know how many paid enrollments there are until sometime in early to mid-May.

ACA Signups February Enrollment Projection, 3:48pm today:

#ACASignups With #NY update, new Feb. projection is 870K QHPs for 4.17M total by 3/1 http://t.co/MYSDQWQTVC @LOLGOP @Eclectablog

— Charles Gaba (@charles_gaba) February 25, 2014

  • February 2 - February 24 = 23 days
  • 23 days / 28 days) = 82.1%
  • 82.1% x 870,000 = 714,270 enrollments from 2/02 - 2/24

714,270 + 3,299,492 = 4,013,762

The Huffington Post, 5:59pm:

WASHINGTON -- Approximately 4 million individuals how now signed up for health care plans under the newly created Obamacare insurance exchanges, a senior administration official told The Huffington Post on Tuesday.

The official press release hasn't been posted to the state exchange website yet, but here's the latest out of the Evergreen State:

Feb 25, 2014 - More than 100,000 Washingtonians have now enrolled in private health plans offered on the Washington state health insurance exchange www.wahealthplanfinder.org, exchange officials said Tuesday.

Overall, a total of 717,933 have enrolled in health insurance on the website. 

Here’s the breakdown: 

101,857 have enrolled in private plans
202,168 newly eligible residents have enrolled in Medicaid.

102,238 who had previously been eligible fro Medicaid but had not enrolled.
311,670 who had been previously eligible for Medicaid who have reenrolled.

And additional 82,249 have enrolled in private plans but have not yet paid their premiums.

These numbers bring WA's Private QHPs up from 90,723 Paid / 85,372 Unpaid as of 2/06 for a total increase of 8,011. More notable is that the state's Paid percentage is slowly increasing, from about 50% a month or so ago up to 55% this week.

OK, I'll have to pull the numbers apart a bit because this story with New York's latest enrollment tally has some overlapping dates and numbers:

More than 800,000 New Yorkers have completed applications to enroll in New York's health-care exchange since Oct. 31, and 501,205 have officially enrolled, a 22 percent increase since Feb. 10, the state Health Department said today....

The state said that 70 percent of those who have enrolled were uninsured at the time of application. But the state didn't immediately say how many of those lost insurance because of the federal Affordable Care Act.

Of the total 501,205 people enrolled, the state said 276,681 chose private insurance plans, while 224,524 qualified for coverage under Medicaid, the government-sponsored health insurance program for low-income Americans.

"Woodworkers", in ACA Medicaid parlance, refers to people who were already eligible for Medicaid coverage prior to the ACA expansion (in states which have done so),  but who didn't actually enroll in Medicaid until after October 1st for a variety of reasons, ranging from not being aware that they qualified, to finding the enrollment process too difficult, to not even knowing what Medicaid was before the ACA exchanges launched.

In other words, these are people who already qualified, but were "brought out of the woodwork" to sign up since the exchanges launched in October.

I've been struggling with the question of whether to include "woodworkers" in the Medicaid/CHIP tally or not since I first learned of the distinction between them and the far stricter definition of who should "count" (ie, limiting it to "people who only legally qualify for Medicaid/CHIP due to expansion provisions within the ACA".

There's really two questions here--a philosophical one (should they be included) and a data-driven one (if you do include them, how many people fall into this category?).

Yesterday I posted an analysis of the current enrollment trends and gave a range of possible final QHP tallies through the end of March, ranging from 5 to 7 million depending on a variety of factors. However, I didn't really go into what those factors actually are, so here's a simple list of the forces supporting and opposing higher or lower enrollment going into the final 6-week stretch:

POSITIVE FACTORS:

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