I haven't posted much the past few days, partly because of a lack of major ACA news, partly because I'm busily playing catch-up with my day job (I do have one, believe it or not), and partly because all the oxygen has been (rightly) sucked out of the news atmosphere the past week or so by the slow-motion trainwreck called "Ferguson, Missouri".
So, I was a bit surprised to see my name and this site figure heavily as a source by Megan McArdle over at BloombergView, in an article called "More Bad News for Obamacare". McArdle has decided to pick up the "Massive Attrition!!" ball which I debunked last week and run with it, citing me as a source several times (including using me as her source for the news of the HHS Dept. dropping off-season enrollment reports)...and yet completely ignoring my entire point:
on net, they expect enrollment to shrink from their March numbers by a substantial amount -- as much as 30 percent at Aetna Inc., for example.
A couple of weeks ago, I posted about how insurance providers in Connecticut requested rate changes ranging up to 12.8%...but the approved rate increase, overall, appeared to only be around 4.5% when weighted by market share. However, that was based on the assumption that the largest provider, Anthem BCBS, would end up with an approved average of around a 6% increase.
Today, it was revealed that Anthem's actual rate changes for 2015 will be an average of 0.1% lower:
Anthem, the state’s largest insurer, initially requested approval to raise rates by an average of 12.5 percent. But the insurance department rejected the proposal and asked the company to resubmit its plan using different calculations.
The result: An average premium decrease of 0.1 percent for Anthem customers.
This is a classic case of one's attitude determining whether this is good or bad news. The headline and lede make a huge deal about 400,000 people having to re-enroll in the Massachusetts ACA exchange this winter...except that I've been pushing hard for everyone to be required to re-enroll once per year anyway regardless of whether their personal incomes/circumstances have changed over the past year or not...which means that to me, it's not only not a big deal that everyone in MA will be required to re-enroll, but it's actually a good thing:
Nearly 400,000 people in Massachusetts will need to reapply for health insurance before the end of the year, and many of them probably do not even know it.
They are people who do not have employer-sponsored health insurance and who instead sought insurance through the state. After the Massachusetts insurance website failed last year, most of them were enrolled in temporary coverage that ends Dec. 31, which is why they must select a new plan.
While the technical overhauls/transfers of exchanges in states like Oregon, Nevada, Massachusetts and Maryland have been taking up all of the "ACA tech problem" news (the former two are moving to HC.gov for 2015; the latter two are completely overhauling their own websites), Hawaii's technical woes seem to always have operated in something of a news vacuum. The Hawaii website problems were always just as bad as some of the other states listed, yet not once have I received any indication of whether they were abandoning their software like OR & NV or fixing it like MA & MD.
Over the past couple of weeks, the answer seems to have revealed itself: The Hawaii Health Connector website has been revamped...as a WordPress-based site. However, this appears to only be the "welcome/info" portal; actually clicking the "Enroll" links takes you to a different domain name at ConnectHawaii.com which seems to be the actual HI exchange.
Not a lot of news this week as the whole country seems to be transfixed by the shooting death of Michael Brown and the insane overreaction by the police in Ferguson, Missouri (as well as the deaths of legends Robin Williams and Lauren Bacall).
However, Minnesota continues to quietly crank along, adding 141 people to the QHP tally and 4,748 to Medicaid in just the past 3 days:
latest enrollment numbers
August 13, 2014
Health Coverage Type Total Enrollments
Medical Assistance 173,953
MinnesotaCare 63,437 Qualified Health Plan (QHP) 53,537
On the one hand, this has nothing to do with the ACA whatsoever.
On the other hand, in a weird sort of way it has everything to do with it.
Last night, the town of Ferguson, Missouri turned into a warzone. I've never seen anything like it...at least here in the U.S. A few days after police gunned down an unarmed black teenager (possibly shooting him in the back) and the refused to release the name of the officer who shot him, I watched live video of the St. Louis County PD very much unallegedly demanding that the news media turn off their cameras, fire tear gas and rubber bullets into an unarmed, fairly peaceful crowd and people's yards and generally terrorize the very populace that they're supposed to be protecting.
And in the middle of this utter mess, White House Principal Deputy Press Secretary Eric Schultz decided it was the perfect time to tweet the following:
Readout of tonight's social gathering coming shortly - spoiler alert: a good time was had by all.
...One of the scariest claims was that premiums were going to shoot up because only the sick and the old would sign up. The danger, of course, was that this would set off the so-called death spiral, where high prices prompt people to drop their coverage until eventually the whole project collapses in failure and shame.
...Here we are five months later, and those insurance officials have begun reporting their premium increases for next year. To put it mildly, those increases do not seem to fit the definition of “skyrocketing."
...The average national increase of 7.5 percent is “well below the double-digit increases many feared,” [PwC] HRI Managing Director Ceci Connolly wrote in ane-mail.
Needless to say, this is quite a bit different than the scenario the Hill laid out in March. A 7.5 percent average increase is somewhat smaller than the 100 percent increase the newspaper was predicting only five months ago.
The only caveat here is that the 7.5% average only covers 27 states; according to PwC researcher Caitlin Sweany, the overall average is actually a bit higher:
I just received a press release from the Centers for Medicare & Medicaid Services (the HHS division which actually operates the federal ACA exchange). The short version: Out of around 970,000 citizenship/immigration data matching issues as of May, they've managed to successfully resolve 450,000 of them and are in the middle of processing another 210,000.
Unfortunately, this means that 310,000 people still have their status in limbo, so they're re-contacting all of them by mail to resolve whatever their issues are by the end of September, or they'll have their policies cut off:
FOR IMMEDIATE RELEASE Contact: CMS Media Relations
August 12, 2014 (202) 690-6145
Federal Health Insurance Marketplace: Send in Requested Documents Now to Keep Marketplace Coverage
Administration has closed approximately 450,000 citizenship and immigration status data matching cases and another 210,000 are in progress; warns remaining consumers to respond quickly or their Marketplace coverage could end
ObamaCare exchange statistics should clear up any doubt as to why the Obama Administration has been tight-lipped about enrollment since celebrating 8 million sign-ups in mid-April.
Reality, evidence suggests, could require quite a come-down from those lofty claims.
The nation's third-largest health insurer had 720,000 people sign up for exchange coverage as of May 20, a spokesman confirmed to IBD. At the end of June, it had fewer than 600,000 paying customers. Aetna expects that to fall to "just over 500,000" by the end of the year.
Yup, on the surface that does look pretty bad. Or, at least, it would, if a) that was representative of the trend as a whole and b) if I hadn't already addressed the "attrition" factor several times in the past.
OK, I still have to plug the numbers into the spreadsheet, but here's the major takeaways:
Across the 49 states (including the District of Columbia) that provided enrollment data for June 2014, states reported that approximately 66 million individuals were enrolled in Medicaid and CHIP. [actual: 66,112,314]
602,210 additional people were enrolled in June 2014 as compared to May 2014 in the 49 states that reported both June and May data.
...approximately 7.2 million additional individuals are enrolled in Medicaid and CHIP, a 12.4 percent increase over the average monthly enrollment for July through September of 2013.
Among states that adopted the Medicaid expansion and whose expansions were in effect in June 2014, Medicaid and CHIP enrollment rose by over 18.5 percent compared to the July- September 2013 baseline period, while states that have not, to date, expanded Medicaid reported an increase of approximately 4 percent over the same period.
These enrollment counts are in addition to the enrollment increases from the nearly 950,000 individuals who gained coverage as a result of the Affordable Care Act before open enrollment began. Seven states implemented an “early option” to expand Medicaid coverage to adults with incomes up to 133 percent of the FPL between April 1, 2010 and January 1, 2014, using new state plan authority provided by the Affordable Care Act or a Section 1115 demonstration building upon that authority.
When we last checked in on Arkansas, they had enrolled 185,000 people in their unusual "Private" Medicaid option program via the ACA. That number has since grown to over 192K:
According to the latest information released by the Department of Human Services today, 192,210 Arkansans have gained coverage via the private option, the state's unique version of Medicaid expansion which uses Medicaid funds to purchase private insurance for low-income Arkansans. This includes both beneficiaries enrolling in a private plan and those deemed medically needy and routed to the traditional Medicaid program (around 11 percent of the total).
In this case it's important to note that these folks have actually gained coverage already. That is, this doesn't include people still "in process" etc. With appx. 225,000 Arkansans eligible for the program, that means AR has reached over 85% of the total possible.
Mitch McConnell just had 71,000 more headaches dumped on him.
OK, I can't embed the video and even the link above just goes to the general Hardball video archive page, but on MSNBC's Hardball this evening, Kentucky Governor Steve Beshear gave an updated total for ACA enrollments via the Kynect exchange: 521,000 Kentuckians. The exact quote, about 2 minutes into the segment:
“The numbers speak for themselves...from the time we opened up our healthcare exchange on October 1 at 12:01am, Kentuckians started swarming all over that website, and today, 9 months later, 521,000 Kentuckians, almost 1 in 10 Kentuckians have signed up for affordable healthcare coverage.”
He repeated the 521K number not once more but twice; obviously this was the key talking point he wanted to emphasize. Unfortunately, as has been typical for Kentucky since the end of open enrollment, he didn't break out QHPs from Medicaid/CHIP enrollments.