Until this month, Maryland's reports were a bit irritating in two ways: First, they were running a month behind; second, the "thru dates" for the QHP numbers never quite lined up with the Medicaid number for some reason. With today's report, they've corrected both issues, bundling both June and most of July in and matching up the dates:

Enrollment Data
As of July 26, 2014, 332,504 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage.

Beginning this month, we will also report net changes in Medicaid enrollment. This figure takes into account the fact individuals lose Medicaid coverage because of changes in household, age, and income, as well as redeterminations. Compared to December 31, 2013, the net change in Medicaid enrollment as of July 26, 2014 is +273,245.

As of July 26, 78,930 individuals have enrolled in a qualified health plan.

I've already taken apart Heritage Foundation shill Sharyll Attkisson for her mind-bogglingly embarrassing FAIL at trying to claim that the uninsured total has only dropped by 3.4 million since the ACA exchanges and ACA Medicaid expansion kicked in on January 1st, when in fact it's actually around 12 million, give or take...a number which has been proven by surveys by not just one, not two, but five well-respected sources, including Gallup, the Urban Institute, the RAND Corporation, the Commonwealth Fund and the New England Journal of Medicine.

Now, it seems, I'm going to have to tackle the Heritage Foundation itself directly. A couple of days ago they released a study which claims that (here's the Abstract)...

Thanks to contributor Britt M. for pointing me towards an interesting development in the other Federal Tax Subsidy case (ie, the one not named "Halbig"). As you'll recall, last week the DC Circuit Court panel ruled in favor of the plaintiff in the Halbig v. Burwell case, but the same day, the 4th Circuit Court panel ruled in favor of the HHS Dept. on an almost identical case (King v. Burwell).

It was expected that both cases would then move to the full courts of their respective Circuits (DC for Halbig, the 4th for King). In both cases the Obama administration is heavily favored due to the political makeup of the courts.

However, it looks like the King plaintiffs realized this and decided to cut to the chase, skipping past the full 4th Circuit and pushing straight for the SCOTUS. The Obama administration, meanwhile, wants the full DC Circuit to hear their appeal of the Halbig case...after which whichever side loses will undoubtedly push it up to the SCOTUS as well.

Opponents of Obamacare who lost their legal case over federal subsidies last week are now appealing directly to the Supreme Court, CNBC reported, but it is not clear whether the Supreme Court will take the case.

There hasn't been a real QHP update out of Nevada since they shut down their extension-of-an-extension period at the end of May.At the time, their total enrollment figure was still stuck at 47,245, but their paid number had inched up to an unimpressive 35,700 people.

Today, some 2 months later, it looks like that number still isn't all that impressive (I'm assuming "more than 37K" is around 37,100). Adding insult to injury, all of them will have to re-enroll via HC.gov, although to be honest I kind of figured as much; I'd be very surprised if Oregon isn't facing the same issue, and as I've already noted, it's probably a good idea to have everyone re-enroll anyway just to make sure that they aren't surprised by changes in their tax subsidies:

More than 37,000 Nevadans who signed up for health care plans on the state’s insurance exchange will have to do so again.

The decision is the latest in a series of ongoing changes at the exchange as it tries to recover from a tumultuous first year of signing up consumers for plans that comply with the Affordable Care Act.

This is the third 2015 rate change update today; I had already reported on the 25% drop on one of the companies operating on Mississippi's exchange a few weeks ago, but this makes it official, and also reveals that the 2nd provider (there's only 2 on MS's exchange) is only requesting to raise their rates by 6.5%:

A week or so ago, I posted an entry about the requested rate changes for 2015 from the insurance companies operating on the New York exchange (I'm emphasizing "requested" since, again, those changes still have to be approved by state regulators, who have already lopped the average increases down dramatically in both Rhode Island and Connecticut, and I just announced that CA kept them to a quite reasonable 4.3% (weighted) average). The overall unweighted average requested change in New York appeared to be 14.6% increase, which isn't good news at all.

Thanks to contributor Bob H., however, for not only crunching the numbers to give the properly weighted average increase, but also for noting that it turns out that the number of companies listed in the original report (a whopping 42 of them) is slightly overstated, to put it mildly. You see, it turns out that, according to Bob...

This Just In... (emphasis added)

FOR IMMEDIATE RELEASE

Media Line: (916) 205-8403

July 31, 2014

COVERED CALIFORNIA ANNOUNCES RATES FOR 2015;

RIGOROUS NEGOTIATIONS WITH HEALTH INSURANCE COMPANIES KEEP RATE INCREASES LOW AND CHOICES ROBUST

Strong Enrollment for 2014 Prompts Balanced Risk Pool and Competition Between Health Plans; Average Statewide Rate Increase Kept to 4.2 Percent

SACRAMENTO, Calif. — The vast majority of Covered California consumers will see low increases in their health insurance premiums for 2015, and many consumers will see no increase or even a decrease. The statewide weighted average[*] came in at 4.2 percent, with some plans offering weighted average rates that are 8.5 percent lower than current pricing.

Taking a little break from the Halbig nonsense to get back to the core purpose of this website...

The Graph is starting to get pretty unwieldy at this point. The scale has been changed from Weekly to Monthly, and things are getting pretty squished horizontally with the addition of August to the right side. The overall range remains somewhere between 23 - 28 million, with the main increases being on the QHP side and minor tweaks (some up, some down) in the Medicaid, SHOP & other areas.

The only other notable change is that I've removed the "depending on payment status" qualifier, since I've already removed the 10% of exchange QHPs who definitely aren't paying up for a variety of reasons.

OK, I've proven time and time again that overall, roughly 90% of ACA exchange QHP enrollees do eventually pay their first month's premiums, although it may take a bit longer for some of them to do so. The problem with the exchanges (or individual insurance companies, or the state insurance commissioners or whomever) releasing a flat "XX% have paid as of such-and-such date" is that it's misleading, since anyone who has enrolled within the past 2 weeks likely won't have their policy actually start for up to a month or longer, and even those who enrolled more than 2 weeks ago may just be starting their coverage now. In other words, it's a rolling average, which increases as time goes on for the earlier enrollees, but drops as time goes on for the newest enrollees.

The Vermont update which I just published is a perfect demonstration of this. As of July 22nd:

Finally, a solid update out of Vermont; thanks to Morgan True of VT Digger for pointing me towards the most recent Vermont Health Connect report as of just a week or so ago:

There's a lot going on in the table above. For one thing, this demonstrates, again, how stupid it was to hyperventilate about "How many have PAID???" back in February or March, when a good 40% or more of the people who would eventually enroll wouldn't even have their policies kick in for weeks or even months yet. Note that of those whose policies started between January 1 - May 1st, over 95% have paid their first premiums by now:

There's been a recent batch of insurance rate change requests reported across various states which has gotten a lot of press. However, as I noted a couple of weeks ago, there can be a big difference between what the insurance companies ask for and what the state insurance commissioner approves. This is one of the most important (and least-written about) aspects of the ACA: Insurance companies can no longer just jack up their prices however much they feel like; those rates have to be approved by the insurance commissioner for the state they're operating in if they want to sell their wares on the exchange.

Yesterday I posted an article in which I attempted to coin the term "Halbig Conspiracy!!®" (complete with not one, but two exclamation points). However, others including Kevin Drum of Mother Jones and Brian Beutler of the New Republic prefer the term "Halbig Truthers®", which I have to admit rolls off the tongue better, so I'll go with that instead.

In any event, last night Drum made a (tongue-in-cheek?) offer to give $10 to anyone who:

...can point out a conservative who so much as suspected that subsidies were limited to state exchanges prior to March 2010. Surely that's incentive enough? Let's start digging up evidence, people.

This led to a brief Twitter exchange in which Vox's Adrianna McIntyre offered to match Drum's $10, and I upped the ante (um...sort of) by offering up my collection of mint-condition official Todd McFarlane "Spawn" promotional action figures to sweeten the pot (I was a movie theater manager in a prior life and these were left over after the live action movie bombed in 1997).

Thanks to Paul Mullen for this find: A rare update out of North Dakota. Lots of useful data, but kind of frustrating because of the apples/oranges comparisons:

As of July 6, 9,953 North Dakota residents were covered by private insurance plans obtained through the federal marketplace, up from 8,374 reported at the committee’s last meeting May 14, according to Insurance Department figures.

That’s still lower than the 10,597 enrollment figure cited by the Obama administration in April, in part because the state counts only those who have actually paid their first month’s premium. Either way, enrollment fell short of the administration’s projection that 11,000 North Dakotans would enroll in private plans through the marketplace during its first six months.

Greg Sargent over at the Washington Post has done an excellent job of looking at the reality behind what I'm terming the "Halbig Conspiracy!!®" (note: if you choose to re-post this, I ask you to include both exclamation marks), by looking at the actual history of the federal exchange in the earlier drafts of the ACA bill:

...But documents from the Senate committees that worked on versions of the bill in 2009 — combined with a close look at the history of the phrase itself, and interviews with staffers directly involved in the drafting of the statutes — strongly undercut the argument that the law did not intend or provide subsidies to those on the federal exchange.

...1) The first Senate version of the health law to be passed in 2009 — by the Health, Education, Labor and Pensions Committee — explicitly stated that subsides would go to people on the federally-established exchange. A committee memo describing the bill circulated at the time spelled this out with total clarity.

No, I don't plan on posting Minnesota updates every day, but I'm still amazed that they seem to be having no problems doing so with their (supposedly) "faulty" exchange website, while the HHS Dept (as well as the New York exchange) has made an official policy decision not to post any updates for (presumably) the full 7 month off-season period.

In any event, MN's total enrollments went up another 1,200 from Sunday to Monday, with 67 more QHPs and 1,147 more Medicaid enrollees:

latest enrollment numbers

July 28, 2014

Health Coverage Type Total Enrollments 
Medical Assistance 162,449
MinnesotaCare 58,838
Qualified Health Plan (QHP) 52,859
TOTAL 274,146

 

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