2018 MIDTERM ELECTION

Time: D H M S

Oh for the love of...(sigh) Look, I'm all for letting as many people as possible enroll in healthcare coverage, but even I admit that I'm getting awfully tired of having to change the final, FINAL deadline dates.

The Hawaii Health Connector has extended the  initial grace period— which would have ended on Tuesday — given to individuals in need of extra time completing the enrollment application process for health insurance by a couple of weeks to April 30.

Let's just hope they resolve their Heartbleed issue.

Every person counts...up to 8,182 through 4/12:

Total for the period of Apr. 6, 2014 through Apr. 12, 2014

Total since October 1, 2013

29,314 Applications completed in the Individual Marketplace
8,182 Enrollments in the Individual Marketplace

Poll: Is the term "Woodworkers" pejorative? (UPDATED)

In recent weeks, several people have requested that I stop using the term "woodworkers" to describe those who were already qualified for Medicaid prior to ACA expansion but who have only enrolled since October 1st, for a variety of reasons.

The reasons for this may include not being aware that they qualified for Medicaid already; not knowing how to go through the (sometimes cumbersome processof applying/enrolling; feeling a stigma or sense of embarrassment about going on Medicaid; or other reasons. The reason these folks (around 2 million of them by my estimate) are referred to as "woodworkers" is because they've basically "come out of the woodwork" to enroll in every state (not just expansion states) over the past 6 months.

I do not mean to be offensive by using this term, but apparently some people feel it's derogatory. A few people have suggested that I switch to the term "Welcome Mat Enrollees"...as in, the HHS and state agencies have "put out the welcome mat" for these folks by streamlining the process and increasing awareness of the Medicaid & CHIP programs, who qualifies and how to apply.

I'm kind of torn here, so for the moment I'm just putting out a poll to see how regular readers of this site feel about it. I'm not promising that I'll change the description that I'm using, but I will at least take your comments and thoughts on the subject seriously.

I'll leave the poll up until Wednesday evening to see if there's a strong lean one way or the other (or possibly some other descriptive term which seems appropriate).

UPDATE: I see that there are several comments on this topic under other blog entries. I wasn't going to allow comments on the poll itself or not since I felt it might be a contentious issue, but so far the comments and emails I've received have been quite civil, so I'm opening it up for comments. I'll keep the poll open until tomorrow evening.

Leigh McGivern of coOportunity Health has helpfully provided their final (well, near-final...through 4/14) tallies for both on- and off-exchange enrollments. The exchange-based numbers aren't really relevant to me since those are reported by HHS, but the off-exchange QHPs and ESI's are vital:

IOWA

  • Individual/Family members: 18,358 (10,809 on exchange/7,549 off exchange)
  • Small group members: 7,848
  • Large group members: 274

NEBRASKA

  • Individual/Family members: 30,668 (20,308 on exchange/10,360 off exchange)
  • Small group members: 11,292
  • Large group members: 2,774

TOTAL ON EXCHANGE IOWA AND NEBRASKA (individuals/families): 31,117

TOTAL OFF EXCHANGE IOWA AND NEBRASKA (individuals/families): 17,909

TOTAL BUSINESS (employees and dependents) IOWA AND NEBRASKA: 22,188

TOTAL BOTH STATES ON AND OFF EXCHANGE (individuals/families/businesses): 71,214

This represents increases as follows:

This doesn't change the actual total number of Rhode Island's Medicaid expansion numbers, but it does specify the ratio between "strict expansion" and the "woodworker" enrollees...66% to 34%. Interestingly, this is virtually identical to the Washington State ratio (again, 67% to 33%).

This isn't enough to apply to the other expansion states yet, but if it does prove to be the case, that should be helpful in figuring out how accurate my current estimates are. I currently have "strict expansion" at roughly 3.7 million, while "woodworkers" are at 2.05 million. A strict 67/33 ratio would have the "woodworker" number at around 1.82 million...except that the non-expansion states also have some woodworkers as well, which should account for the additional 230K or so.

Figures obtained from the Chafee administration by WPRI.com show that out of the 64,590 Rhode Islanders who signed up for Medicaid from October through March using the state’s new HealthSource RI marketplace, 34% were eligible before the new law expanded the rules for who could sign up.

A few days ago, Michigan's newly-expanded Medicaid tally sat at around 32,000, plus another 54,000 people transferred into the program from an existing state-run one, for a total of about 86,000 people.

Today that number has grown to over 109K:

Healthy Michigan Plan Enrollment Statistics

• Updated every Tuesday at 3 p.m.

Total Healthy Michigan Plan Beneficiaries (including ABW transition prior to April 1): 109,228

Total Enrollment in Healthy Michigan Plan after April 1: 72,921

*Statistics as of April 15, 2014

No breakout between Private QHPs & Medicaid/CHIP yet, but NY State of Health just issued this press release:

ALBANY, NY (April 15, 2014) – NY State of Health (NYSOH), the State’s official health plan marketplace, reported that as of 9 a.m. today, 1,311,271 New Yorkers have completed their applications and 949,428 have enrolled for coverage since the launch of the Marketplace on October 1, 2013. More than 70 percent of those who have enrolled to date were uninsured at the time of application. The Marketplace is well on its way to meeting or exceeding its enrollment goal of 1.1 million people by the end of 2016.

This figure is about 16,200 higher than just 4 days ago, meaning NY is averaging around 4K/day. Assuming no final day spike (or drop-off), their final total should come in at around 954,000 people.

Not gonna update the spreadsheet or graph until I get the actual QHP/Medicaid breakout, however, since those are almost always provided within a few hours of the combined number in NY.

I've been shouting from the rooftops about OFF-exchange QHPs for months now (I first added a column for them on January 3rd and had my first significant data update on January 31st), and until recently few in the news media seemed to catch on to the significance of these.

Until a few weeks ago, I had only officially documented about 560,000 off-exchange QHPs, but guestimated that there were easily 4 million or more out there (I had mused off-handedly back in mid-February that the total could potentially be 7.7 million, but decided to backtrack to "4M or more" out of caution).

Nothing major, just another 4,000 people added to NM's Medicaid tally:

An estimated 107,000 New Mexicans have enrolled in Medicaid since the state expanded the qualifications in October to include low-income adults, state Human Services Department spokesman Matt Kennicott said Monday.

...A total of 26,412 New Mexicans had enrolled in health plans through the state insurance exchange by the March 31 enrollment deadline, the state office of the Superintendent of Insurance said in a news release issued recently.

...An additional 10,000 applications had been submitted by the deadline but remained unprocessed, the statement said.

That's right. Thanks to high winds and a mid-April snowfall, I have no electricity today. Expect updates to be few and far between.

--posted from my iPhone

I've been debating whether to post about this since frankly, I'm not entirely sure that I have all the details straight about how this works. If anyone more familiar with this process wants to correct or clarify my description in the comments, please feel free to do so.

OK, so there's all sorts of hand wringing over how much premium rates will increase for 2015 based on the 2014 risk pool. The CBO issued a report yesterday which projects that in spite of all the fretting, the overall average increase will only be a few percent, which is good news if true (although this will no doubt vary from state to state).

However, I recently learned a couple of very interesting things about how the ACA works when it comes to pricing oversight and the "risk corridor" program.

Think Progress has a nice explanation of "risk corridors" (which the GOP hypocritically and wrongly refers to as an "insurance company bailout"):

There are many ways of getting a society to “do the right thing”. Many years ago, as I was driving into San Francisco across the Bay Bridge, traffic was at a crawl – except for two lanes labeled Car Pool. Those cars whizzed by and their drivers didn’t even have to stop to pay the road toll. Life can be so unfair to a lonely guy in a BMW or Porsche.

Above the highway was a billboard advertising, in large letters, the Car Pool Switchboard; its sole function was to hook up people regularly commuting from one place to another at roughly the same time. Saving a few dimes by sharing gas expenses, or even being forgiven a couple of bucks in road toll, may not have seemed like much of an incentive – but getting to work (and home) 20–30 minutes faster each day, most certainly was!

City of Angels

Yesterday I issued a reminder/warning that the March HHS report might stop at 3/29, leaving the last 2 (and by far the busiest) days of the official enrollment period, the 30th-31st to be moved over to the April report.

If HHS did this, the March report would appear to only include about 6.5M exchange QHPs, since another 600K would be moved to April, along with the additional 700K (give or take) enrollments from 4/01 - 4/15 (and even beyond).

Fortunately, if this bulletin from Inside Health Policy is true, wiser heads at HHS have prevailed...and then some!

HHS Eyes April 17 Release Of Latest Enrollment Numbers

On top of today's CBO report projecting a $104 Billion savings on the cost of the ACA over the next decade and their projection of 2015 premiums only going up slightly, this is a bit of unexpected news....

As hundreds of thousands of diabetics get health coverage under the federal law, insurance companies are aggressively targeting this glut of new patients, who are expensive to treat and often lax in taking medications and following their diet.

Insurers are calling diabetics when they don't pick up prescriptions or miss appointments. They are arranging transportation to get them to the doctor's office and some are even sending nurses on house calls in an effort to avoid costly complications that will have big impact on their bottom lines.

Well I'll be damned. Private, for-profit insurance companies actively assisting their customers in trying to stay healthy.

Exactly the way that the law was intended to work, I'd say.

Hoo, boy...this is gonna cause some heads to explode over at FOX News...

The most expensive provisions of Obamacare will cost taxpayers about $100 billion less than expected, the Congressional Budget Office said Monday.

CBO also said it doesn't expect big premium increases next year for insurance plans sold through the health care law's exchanges.

In its latest analysis, CBO said the law's coverage provisions—a narrow part of the law that includes only certain policies—will cost the government $36 billion this year, which is $5 billion less than CBO's previous estimate. Over the next decade, the provisions will cost about $1.4 trillion—roughly $104 billion less than CBO last estimated.

But wait, there's more...

Monday's report also sheds some light on one of the big challenges still to come for Obamacare: next year's premiums. Some critics have warned that premiums could skyrocket next year, based in part on the demographics of the people who signed up for coverage this year.

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