END OF 2018 OPEN ENROLLMENT PERIOD (41 states)

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Well THAT just figures! In the words of Emily Litella..."Never mind..."

Hot off the presses: California has released their first-half of February enrollment data: 100,228 people have enrolled in Private QHPs in "the first 2 weeks" of February (actually February 2 - 15, I assume, since the 728K number includes Feb. 1st). This breaks down to 7,159/day:

Nearly half of those covered [through 2/01] — 728,410 Californians — selected a Covered California health insurance plan. This strong enrollment trend is extending into February, where in the first two weeks more than 100,000 individuals enrolled in Covered California, increasing the cumulative total enrollment in Covered California to 828,638.

California's January enrollment rate was (728,410 - 498,794) = 229,616 / 35 days = 6,560/day, which means that their February enrollment rate is actually increased from that of January, by over 9%!

So, how does this impact the "February Drop-Off" factor? MASSIVELY! Take a look:

Hawaii's private QHP enrollments continue to crawl along, increasing from 3,879 as of 2/08 to 4,297 as of 2/15.

Total since October 1, 2013

18,752 Applications completed in the Individual Marketplace
 4,297 Enrollments in the Individual Marketplace
 444 Employers applied to SHOP Marketplace

They also list the number of employers enrolled in their SHOP system, but there's no update on the actual number of people covered by those plans, so it stays at 307. No Medicaid/CHIP update either.

The good news is that Hawaii becomes the first state of the 11 for which I have partial February data to actually increase it's enrollment rate over January. The bad news is, Hawaii's numbers are so tiny that this is a drop in the bucket, only reducing the overall drop percentage by 0.2%.

I know I've become a bit obsessive about this "February Drop-off" thing, but I couldn't help myself. Since the Jan. HHS report was simply wrong on New York's private QHP figure, I found the closest correct figure to Feb. 1st that I could--an official NY State of Health press release from 2 days later, Feb. 3, which gives the correct private QHP enrollment number as 241,242 as of Feb. 3.

Updating the "Feb Drop-off Chart" with this info as well as yesterday's Nevada update, we now have some more solid Feb-vs-Jan data to work with. I've modified the graph to show how many days are being counted for each state, as well as the starting & ending dates for each month:

This morning I noted that New York has seen a dramatic increase in the percent of their ACA enrollees who were previously uninsured, rising from 66% of the total on 1/10 up to 69% as of yesterday. While a 3% increase doesn't sound like much, this is especially notable because, as I demonstrated, it means that between 92 - 100% of the newest enrollees were previously uninsured (probably around 95%), since that's what it would take to raise the overall enrollment up with such a comparatively small number of additional enrollments.

However, I forgot another, earlier NY update which fills in this picture even further. Back on January 13, there was another press release which noted that as of December 24, 2013, about 50% of the 230,624 New York enrollees were previously uninsured:

Another update from Nevada: Private QHPs up from 16,030 paid / 7,656 unpaid to 17,047 paid / 8,595 unpaid from 2/08 - 2/15.

This also gives some additional data to work with regarding the February Drop-off issue...and there's some good news here, whether you look at total QHPs or paid only:

Update as of 2/15: 25,642 Nevadans confirmed QHP Selections. 17,047 have paid.

— Nevada Health Link (@NVHealthLink) February 18, 2014

Over the weekend, I threw some cold water on the ACA enrollment momentum theme with a one-two punch: First, I pointed out that the February report will only include 4 weeks of data (2/02 - 3/01) vs. January's 5 weeks (12/29 - 2/01); then I looked into the actual data to see if this story from Yahoo Finance was correct in suggesting that enrollments have dropped off even on a daily-average basis since January.

Ah, just in time to help clear up my confusion about the New York situation from over the weekend: The latest tally has NY with a total of 266,177 private QHP enrollments, up 14,871 from 251,306 a week earlier. Medicaid enrollment via the exchange is up to 189,865 from 160,915, an increase of 28,950.

This is noteworthy for a couple of reasons. First of all, this gives some additional, solid data to plug into my weekend "NY Enrollment Number Mystery Project" that I've written a couple of posts about the past few days. Connected to this, however, is something which may be cause for a bit of concern--up until now, New York has been bucking the tide and averaging around a 60/40 split in favor of private QHP enrollments. Today's additions, however, reverse that with the numbers switching to 34/66 in favor of Medicaid enrollments:

Another 44,000 people enrolled in a health insurance plan through the state's exchange over the past week, pushing the total to 456,042, according to the state Department of Health.

Earlier today, I pointed out some potentially bad news for total ACA enrollmentthat February's enrollment tally is likely to be a good 20% lower than January's for the simple reason that the February HHS report is only going to include 4 weeks' worth of data, while January's included 5 weeks. Nothing neferious or evil going on here, just measuring 28 days instead of 35 (for the record, the final report for March will include 30 days' worth of data (March 2nd - 31st)).

While writing up the main part of the entry, however (which addressed a Yahoo Finance article which claims that February enrollments will be way down for a variety of unrelated reasons), I noticed something very curious about New York's enrollment numbers. I went into this in the earlier entry but decided that it's important enough to merit it's own full repost.

Here's the official enrollment numbers from the October, November, December and January HHS Reports...and the most-recent official press release from the NY State of Health Exchange:

Most ACA critics now grudgingly admit that people are getting insured after all, but they say there's a catch. "Where are we going to get all the doctors?" a social worker asked me recently. "We're overwhelmed as it is." A letter in the local paper said, "People aren't really covered unless someone accepts their 'insurance', and if nobody is accepting it, then why should people pay for it?"

I briefly answered the letter writer online, saying that the solution was in the provisions of the Affordable Care Act to increase the primary care workforce, not only with more primary care doctors but also more nurses, nurse-practitioners and physician assistants. I was then curious to find out more about what the ACA has been doing to upgrade primary care in the U.S. and found that it has already made major improvements.

NewA couple of weeks ago I predicted the total January Private QHP enrollment number with accuracy that surprised even myself (I called it at precisely 3.3 million; it came in at 3,299,492).

I also gave airy, back-of-the-napkin predictions for February and March, figuring that February would come in at around 1.14 million in Febuary and between 1.5 - 2.0 million in March, for a final total of roughly 6.0 - 6.5 million enrollments. Note that this does not take into account the "paid vs. unpaid" factor, since some people won't be paid in full until mid- to late-April or beyond.

This just in...Kentucky's latest update has KY Private QHP enrollment up to 49,662 from 48,611 on February 1st (a modest 2% increase) and Medicaid enrollment up to 181,705 from 155,172 (a 17% increase).

231,367 Kentuckians are enrolled in new health coverage through @kynectky. If #ACA is repealed, 231,367 Kentuckians are SOL. #kysen

— Joe Sonka (@joesonka) February 14, 2014

181,705 Kentuckians have enrolled in Medicaid, 49,662 in private insurance through @kynectky.

— Joe Sonka (@joesonka) February 14, 2014

Maryland's Private QHP enrollment is up to 31,112 (up from 29,059 on 2/01), and their Medicaid/CHIP enrollment has increased to 52,091 people plus another 95,889 transfees from the Primary Adult Care program; this is up from 44,592 Medicaid + 95,824 PAC transfers a week earlier.

Through February 8, 31,112 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

95,889 Marylanders signed up through the Primary Adult Care (PAC) program were automatically enrolled in Medicaid coverage on January 1, 2014, and now have full Medicaid coverage. As of February 11, 2014, an additional 52,091 individuals were newly enrolled in Medicaid effective January 1.  

OK, not exactly an eruption of new enrollees, but add 265 more people to the list...

Total since October 1, 2013

3,879 Enrollments in the Individual Marketplace

Happy Valentine's Day!

Now that the dust is settling on the January HHS Report and I've had a chance to fully tackle the "But how many have PAID???" issue, I decided this would be a good point to do some cleaning up of The Graph.

First of all, as I announced last night, I've added a "90% Either Paid or Unpaid for Legitimate Reasons" marker to address the "Paid/Unpaid" issue.

Secondly, now that I've switched both the Medicaid and Private QHP numbers over to a "range" format, I've decided to drop the Grand Total numbers from 2 decimal points to one (that is, the range is now 8.8 - 14.4 million instead of 8.78 - 14.46). All of the numbers involved are large enough now that it doesn't make sense to be so anal about it anymore (don't worry, the actual spreadsheets will remain as precise as I can make them).

Well how do you like that? Here I go and spend all morning crunching numbers, reviewing different state reports and so forth...and a few hours later the New York Times goes and makes my point for me:

WASHINGTON — One in five people who signed up for health insurance under the new health care law failed to pay their premiums on time and therefore did not receive coverage in January, insurance companies and industry experts say.

Paying the first month’s premium is the final step in completing an enrollment. Under federal rules, people must pay the initial premium to have coverage take effect. In view of the chaotic debut of the federal marketplace and many state exchanges, the White House urged insurers to give people more time, and many agreed to do so. But, insurers said, some people missed even the extended deadlines.

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