2018 MIDTERM ELECTION

Time: D H M S

The overall story out of Hawaii is pretty ugly, but the QHP number is actually good news, given what a mess HI's exchange has been: QHP enrollments are up from 4,969 as of 3/08 to 5,400 as of yesterday, an increase of 431. While this isn't exactly worth cheering about, it does raise Hawaii's daily average up from 37/day in February to 46/day in March...a 24% increase.

Tom Matsuda, the interim executive director of the Hawaii Health Connector, told lawmakers at a Senate hearing Monday that the nonprofit is woefully behind its projections of individual enrollment, with only about 5,400 people fully through the process of buying coverage. While that number doesn't count those still in "a backup in the system," Matsuda said, it's far behind the projected pace of 50,000 enrollees through 2014 it would have needed to break even.

The other day I noted that I've made little progress on the Off-Exchange QHP Enrollment Project. Not only have few people volunteered to help (though I do appreciate those who have), hunting down the data itself has proven harder than bullseyeing Womp Rats.

Case in point: Aside from my success with Washington State (I don't deserve any credit--they voluntarily published their data in a press release that I stumbled across), I've contacted 24 state Insurance Commission offices so far (Alabama - Mississippi). Out of those 24, here's the responses:

Yesterday was a pretty big day here at ACASignups--not only did the site get the 2nd most traffic to date (the busiest day was Feb. 13, when the January HHS report came out), but my Twitter feed went a bit nuts as my double prediction of California hitting 1M QHPs and HHS announcing 5M QHPs nationally gained attention; I think I picked up more new Twitter followers yesterday than any day since Sarah Kliff featured The Graph back on December 26th.

Whoa. Not an official update, but Colorado already had 93K QHPs as of Thursday the 13th; they're now at over 100K as of yesterday (the 17th). that's 1,750/day for the past 4 days, or 1,033/day in March so far. It doesn't specify QHPs vs. Medicaid, but CO was already at 135K Medicaid as of 3/01, so yes, these should all be private QHPs.

For comparison, Colorado was at 536/day in February, so CO in March is nearly double the February rate.

More than 100,000 Coloradans purchased health insurance through Connect for Health Colorado. 14 days left to enroll! http://t.co/jXVrGTnHQ0

— C4HCO (@C4HCO) March 18, 2014

It took Ohio awhile to get on board with the Medicaid expansion train, but once it did, enrollments really started to take off; it's more than doubled since 2/20, from 23K to over 54K:

COLUMBUS, Ohio (AP) - More than 54,000 Ohioans have enrolled in Medicaid under an expansion of the taxpayer-funded program.

Gov. John Kasich's administration moved forward last fall with extending Medicaid eligibility to cover thousands more people under the federal health care law. Coverage took effect Jan. 1.

The state's monthly report on Medicaid caseloads shows that 54,031 residents have gained coverage under its extension as of February. That's about 15 percent of the roughly 366,000 people who the state projected would be newly eligible by the end of June 2015.

Now that the Arkansas legislature has finally agreed not to screw over tens of thousands of their own citizens, a few thousand more people have enrolled in their unusual "Private Medicaid Option" (their version of "Expansion", which appears to basically be effectively the same as an entry-level QHP enrollee who receives a 100% tax credit...I think). Anyway, the Private Medicaid Option is up to about 98K plus an additional 13.4K added to "regular" Medicaid; this is up from 94,000 and 11,500 a few weeks ago, for a total increase of 5,844 altogether.

DHS said Wednesday that 207,967 people have applied for the private option and that 137,809 have been found eligible. Of those, 97,934 have completed the process of enrolling in private plans and 13,410 have been determined to be better served by traditional Medicaid.

On top of today's Big News out of California (1M) and the HHS (5M) comes a smaller, but just as significant update from Nevada. They're up from 20,930 paid / 9,085 unpaid (30,015 total) to 22,533 paid / 10,520 unpaid (33,053 total), a total increase of 3,038 (although the Paid rate in NV is down slightly, from 70% to 68%...although again, none of the new enrollees start coverage until April).

The significance is this: The first week of March, Nevada was averaging 211 QHPs/day, virtually identical to February's 212/day. However, with this addition, their daily average has shot up to 323/day, a 52% increase. Even more impressive, if you only include the 2nd week of the month, that's 3,038/7 = 434/day, or more than twice the daily average. The Surge is definitely here, folks.

Update as of 3/15: 33,053 consumers have confirmed Qualified Health Plan selections through Nevada Health Link, 22,533 have paid.

— Nevada Health Link (@NVHealthLink) March 17, 2014

Thanks to contributor deaconblues for sending me this story out of Massachusetts, which puts a bit of a downer spin on the otherwise fantastic one-two punch of hitting 1M QHPs in CA and 5M nationally. The short version? MA fired CGI, won't hit their own twice-extended deadline, and has tens of thousands of people stuck in a weird healthcare coverage holding pattern for...no one seems to know exactly how long:

Massachusetts has chosen to toss out CGICorp., the architect of the troubled Health Connector website, amid an ObamaCare enrollment crisis that threatens to spill into 2015....

HHS just confirmed my post from a few hours earlier today: 

As this historic open enrollment period enters its final weeks, millions of Americans are finding quality, affordable coverage thanks to the Affordable Care Act.  Fernando Valdez and Denise Schroeder were part of a weekend wave of consumers signing up for new coverage and bringing enrollment nationwide to more than 5 million through the Federal and State-based Marketplaces since October 1st.

OK, so what does this mean for the final 2 weeks?

OK, talk about an 11th-hour development: The Hawaii Health Connector, which has been competing with Oregon and Massachusetts for the "worst exchange" award, may have actually turned the corner just in time for the final 2 weeks of the ACA enrollment push.

If this development doesn't turn out to be another false promise (Hawaii's exchange has had several "It's working NOW! Oh, wait..." moments since October), there could be up to 16,000+ people who get piled onto the Hawaii tally over the final two weeks of open enrollment:

The Hawaii Health Connector, in its final stretch of open enrollment, says it has fixed a substantial number of system glitches that have frustrated consumers and stifled enrollment.

Contributor Maurice H. provides a bit of Off-Exchange data from Oregon. He contacted Oregon's Health CO-OP and while they didn't provide exact numbers, they were willing to provide their on-exchange/off-exchange ratios:

Oregon’s Health CO-OP is not sharing specific enrollment numbers, but is happy to give you the percentages of on and off Exchange:

On – 42%  /  Off—58%

Hope that helps.

Fortunately, an article in the Oregonian by the authority on all things Cover Oregon-related, Nick Budnick, provides the other piece of the puzzle:

Policies as of March 6th / Oregon's Health CO-OP: 212

Hmmm. Well, if 212 is 42% of the co-op's total enrollments, that makes off-exchange enrollments...505 people.

OK, not exactly a huge number, but an enrollment is an enrollment...noting it...

I just posted the big announcement out of California: They broke through the 1 million mark on Friday, reaching 1,018,315 QHPs as of Saturday night. This means they've been averaging over 10,600/day in March so far.

It also means, using my projection table, that the national total, which I had predicted would cross 5 Million sometime tomorrow, should actually break the 5 million mark today.

Specifically, the national total should be running around 167% higher than February's rate (33,600/day), or around 56,300/day in March so far. 56.3K x 15 days = 844,500, added to the 4,242,325 to date, for a total of about 5.09 million. I'll assume that this is highballing a bit, so tack on an extra day or so.

Now, they may not announce it until tomorrow, but if I'm correct about this, we should actually be at somewhere around 5.09 million by the end of today (Monday, March 17th).

There we go; I originally projected California to hit 1M last Tuesday or Wednesday, but didn't realize at the time just how bad the mid-February outage had hit the exchange. It ended up taking them 2 extra days to hit the 1M mark (Friday night). Fortunately, it looks like they've bounced back nicely:

Covered California’s enrollment reached the 1-million mark late Friday. By the end of Saturday, enrollment reached 1,018,315 in the health care exchange marketplace. The figure represents the number of people applying for coverage and selecting insurance plans for themselves and their family members through the exchange.

Just as a reminder: Based on my projection model and a little big of educated guesswork on my part, I've estimated that Private Exchange QHPs should be around 4.89 Million as of today, setting things up to cross the 5 Million mark sometime on Tuesday, March 18.

If I'm correct about this, then it means:

  • The rate averaged around 44,000/day for the first half of the month
  • The rate for the second half of March will have to average at least 74,000/day in order to hit 6 Million
  • The rate for the second half of March will have to average at least 141,000/day in order to hit 7 million

Obviously, the 7M target is going to be extremely difficult to reach at this point.

Follow-up from last night's post on Saturday's HC.gov enrollment: The final number ended up being over 40,000:

Enrollment on March 15 at 2pm on the ACA website was 15,000 and counting.

UPDATED – As of 12:01 AM, March 16, 2014, Over 40,000 people signed up on healthcare.gov Saturday and made the deadline for insurance to be effective April 1, 2014.

UPDATED - As of 6:26 PM – Around 23,000 so far for today have enrolled for healthcare.  Almost 300,000 people logged into the healthcare.gov website today, Saturday, March 15, 2014.

Through Friday, I had the daily average for QHP enrollments at around 43,000 (up from the 33.7K/day in February).

Last night I assumed that the total HC.gov enrollments for Saturday (3/15) wold end up being around 32K based on the 6:30pm total of 23K.

Pages