2018 MIDTERM ELECTION

Time: D H M S

When I last checked in on the state of Arkansas' unusual "private Medicaid option" a month ago (which uses Medicaid money to pay for private exchange QHPs...basically a QHP with a 100% subsidy, but still counted as Medicaid instead), the tally stood at around 155,000.

Today, that number has risen another 15,000 people and now stands at over 170K, or over 75% of the 225,000 estimated Arkansas residents eligible for the program:

According to testimony today from the Arkansas Department of Human Services, 170,033 people through the end of April have been deemed eligible and gained coverage under the private option, the state's unique plan using Medicaid funds to purchase private health insurance for low-income Arkansans. This likely means that the policy has already made a significant reduction in the rate of uninsurance in the state. The private option has also made the Arkansas Health Insurance Marketplace as a whole dramatically younger, which could help lead to lower premiums in the future. Details below the jump. 

Huh. The Minnesota exchange just released updated data as of 5/22; this brings another 4 days of numbers into view:

.@MNsure enrollment as of 5/26/14: 127,712 in MA, 46,836 in MinnesotaCare and 50,793 in QHP. Total: 225,341. pic.twitter.com/uDzt8AHqcO

— MNsure (@MNsure) May 27, 2014

OK, so that's another 166 QHPs and 958 more people added to Medicaid in the past 4 days.

MN's off-season QHP rate is now 697 in 34 days, or 20.5 per day. If that holds steady, that's around 615 per month, or around 4,300 more QHPs by the time the 2nd open enrollment period opens on November 15.

Way back on March 21st (wow, that seems like forever ago, doesn't it?), I posted the following towards the end of "The Paid/Unpaid Brouhaha":

So, I'll say this here and now:

Whatever percentage of total exchange-based QHP enrollments still haven't been paid by the policyholder as of May 31st should indeed be subtracted from the official HHS total number, assuming that those non-payments are due to either a) the policyholder bailing/refusing to pay or b) the government-run exchange (not the insurance company's billing system) screwing up.

If the total number ends up being 6.2 million but the non-payments fitting these criteria are 7% as of May 31st, I'll gladly subtract 434,000 from the total. If the total number is 6.5M and the non-payments are 10% as of 5/15, I'll subtract 650,000, and so on.

Well, it's not quite May 31st, but I wanted to make sure to get this blog entry off my chest before June 1st, so I'm giving the Republican Party a 4-day lead time.

OK, according to the March/April HHS report, Colorado's official QHP tally as of 4/19 was 125,402. However, according to the state exchange itself, the tally as of 4/15 (the actual end of open enrollment) was 127,233. I'm not sure whether the difference is due to purging unpaid enrollments, clerical errors on one side or the other or what, but they appear to have added either another 2,919 QHPs between 4/20 - 5/03, or another 1,088 between 4/16 - 5/03, depending on which starting number/date you use:

Reporting Period: 10/1/13 - 5/3/14

  • Covered Lives:
    • Individual: 128,321
    • SHOP: 1,983

 

Sometimes you just have to ask directly:

MNsure Hi Charles - working on that stat now. At last analysis, about 95% of QHP enrollees had paid their first month's premium.

Mr. Brann--

On May 25, 2014 you emailed me with the following request:

I am an insurance agent and in the communities I serve...south texas...San Antonio, Austin, we saw limited demand...so these numbers amaze me...can I advertise on your site...and reference you on my site?

I took a look at your website, and I'm a little confused. According to your site, the healthcare policies you offer are "not Obamacare compliant". There's technically no such thing as "Obamacare"...the actual name of the law is "The Patient Protection and Affordable Care Act", generally shortened as "the Affordable Care Act." While "Obamacare is a popular nickname for the law, it's a bit troubling to see a supposedly professional insurance agency using slang terminology throughout the website.

Now that we're completely out of the Open Enrollment period (for QHPs, anyway), it'll be interesting to see how the QHP numbers climb based purely on Qualifying Life Events and Native American enrollees.

latest enrollment numbers

May 22, 2014 

Medical Assistance 126,928
MinnesotaCare 46,662

Qualified Health Plan (QHP) 50,759
TOTAL 224,349

Minnesota's final official number as of 4/22 (they bumped their extension period out an extra week from the normal 4/15) was 50,096, so they've added another 663 people in the first month since then, or around 1.3%.

Assuming that rate ends up being typical of both MN specifically and is representative nationally (and of course there's absolutely no evidence that either of these will be the case), this would mean:

Over the past 7 months, plenty of healthcare reporters, insurance executives and political pundits have started following this site and/or my Twitter feed. For the most part the ones I know of tend to be either of unknown ideology or left-leaning, but there's also a substantial number of Republican, Conservative, Libertarian or other wise right-leaning types, and that's fine.

I've butted heads publicly with a few of these folks. In some cases they've presented honest, intelligent disagreement; in others they've spewed tired, BS talking points. Here's a great opportunity to prove whether you're dealing an intellectually honest hand or not. I present you with the following:

MCCONNELL: KY. EXCHANGE UNCONNECTED TO HEALTH LAW

LOUISVILLE, Ky. (AP) -- Kentucky Sen. Mitch McConnell says he would try to repeal the Affordable Care Act if he's elected Senate majority leader.

But the veteran senator won't say what would happen to the 413,000 Kentuckians who have health insurance through the state's health care exchange.

McConnell told reporters Friday that the fate of the state exchange is unconnected to the federal health care law. Yet the exchange would not exist, if not for the law that created it.

I spent a lot of time the past couple of days hammering on the HHS Dept. for announcing that they're discontinuing their official monthly enrollment reports. However, it also occurs to me that I haven't heard a peep out of most of the state-run exchanges in almost a month either:

That's not me saying it; that's the actual headline and the conclusion of a report by the Robert Wood Johnson Foundation:

RENTON — The first look at the Affordable Care Act’s impact on New Jersey reveals the percentage of uninsured people is on track to reach its lowest level in nearly a quarter of a century, according to a new report released Thursday by the Robert Wood Johnson Foundation.

The proportion of uninsured adults decreased 38 percent from September to early March, according to the foundation. That decline is likely to accelerate, knowing that many people waited until the last minute to beat the March 30 enrollment deadline.

"These findings suggest that uninsurance in New Jersey is at its lowest level since 1990," according to the report produced by the foundation and the Rutgers Center for State Health Policy.

After my back-to-back Cranky Screeds, this is a breath of fresh air.

Given the "How many have PAID???" fuss & bother, I've been debating how to handle an interesting number-crunching dilemma ever since the (final???) HHS report for March/part of April was released a few weeks back.

The question is this: When people ask "how many have paid?" their first month's premium, are they really interested in the percentage or in the actual number of people who are paid up?

This may seem like a curious distinction, but consider the following: Officially, the maximum total number which could potentially be "fully enrolled" (ie, premium paid) is 8,019,763. That's the number that the HHS Dept. listed in their last report, which runs through April 19th.

So, 90% of that number would be around 7.22 million, give or take.

Dear (outgoing Director) Kathleen Sebelius, (presumptive incoming Director) Sylvia Burwell, and whomever is in charge in between:

Your office is not supposed to be a political one. I, however, have the luxury of not being restricted by that fact. I'm a proud, unapologetically progressive Democrat. While I certainly have my issues with President Obama and the ACA, in general I think that it's an excellent start towards an eventual goal of a single payer healthcare system. While I'm still disapointed as to why they didn't simply drop the "65" age requirement from Medicare (perhaps phasing it in 5 years at a time...60, 55, 50 and so on, with an accompanying funding mechanism), or at the very least add a Public Option to compete with the private corporations, I do understand that the political realities at the time presumably didn't allow for either one.

I received some disturbing news this morning which, if true, will piss me off to no end.

Supposedly, now that the open enrollment (and extension) period is over, the HHS Dept. has decided NOT to issue any further monthly ACA exchange enrollment reports going forward.

I don't know if this only means that they're mothballing the reports from now through November (when the 2nd open enrollment period starts up again), which would be bad enough, or if they mean permanently (which would be far worse).

I should stress that I have not confirmed this yet; if this information is incorrect, disregard everything below.

Assuming this news is accurate, however, HHS has lost their mind and will deserve every bit of criticism that they receive over it.

I've said many times before that the only reason that I started this website in the first place is because neither the HHS Dept. nor the major news media outlets seemed to be willing (or able?) to post accurate exchange enrollment data on a timely basis (and by "timely", I mean daily or weekly, not monthly, which is just too damned long in the modern political/media world).

First Oregon told Oracle to go pound sand after paying the company hundreds of millions of dollars for a useless website; now Nevada has officially done the same thing to Xerox:

The Silver State Health Insurance Exchange board voted unanimously Tuesday to end its relationship with Xerox, the vendor contracted in 2012 to build the exchange’s Nevada Health Link website.

In place of Xerox, the exchange will adopt the federal Healthcare.gov exchange’s eligibility and enrollment functions for the sign-up period that begins Nov. 15, though it will keep its status and funding as a state-controlled system. The exchange will also issue a request for proposals to evaluate replacement systems in coming years. A new platform could come from a state with a functional marketplace, or from a vendor with a similar, proven program.

Unlike Massachusetts, which is taking a dual-path approach (they're scrambling to replace their own crappy site with a new one while simultaneously preparing to move over to HC.gov just in case the first plan doesn't pan out in time), Nevada is sort of doing the opposite: They're moving over to HC.gov this year, but reserving the right to try a do-over on their own exchange for 2016 and beyond.

Interestingly, even though we're well past even the extended QHP enrollment period, Hawaii continues to have new enrollments trickle in. I'm not sure if these are clerical corrections from before 4/30 or if these are "Qualifying Life Events", but either way they just added another 111 people to the tally (plus a whopping 5 more people in their SHOP enrollments).

Total since October 1, 2013

32,086 Applications completed in the Individual Marketplace
9,397 Individuals and families enrolled in the Individual Marketplace
604 Employers applied to SHOP Marketplace
636 Employees and dependents enrolled via SHOP Marketplace

In addition, Hawaii's exchange just became a slightly better value, dropping from $23,899 per person enrolled down to $23,617 per person. So, there's that, I guess...

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