The Kaiser Family Foundation estimated that WV has 143,000 residents eligible for Medicaid expansion. This means the state has now enrolled nearly 89% of them:

"The fast-track enrollments, on average, cost West Virginia about $6.50 less than would a full Medicaid application," the report states, estimating the staff worker received $14 dollars per hour.

Multiplying the 71,860 people who enrolled by that dollar amount provided a savings of roughly $470,000, according to the report. The state spent $200,000 in IT upgrades that also allowed it to mine the SNAP data base for potentially eligible residents. Subtracting those costs, the report argues the state saved about $270,000.

Bowling said the most up-to-date data show about 128,000 people have joined Medicaid through the expansion, much more than the roughly 91,000 anticipated to sign up. She said that success means the state probably won't send out another round of letters, but the numbers keep rising as those eligible may sign up at any time.

Some days I forget just how friggin' HUGE the state of California is...

Part of the delays can be attributed to high demand. In California, as in many of the 26 states that opted to expand Medicaid eligibility under the Affordable Care Act, people turned out in much higher numbers than projected. The state health department said it now expects 2.2 million people to enroll in Medi-Cal by next month -- 300,000 more than estimated last fall.

Roughly 1.4 million of those applicants were newly eligible for Medi-Cal, which was expanded under the Affordable Care Act, commonly called Obamacare, to serve people who earn up to 138 percent of the federal poverty level. About 600,000 more were previously eligible for coverage but had not enrolled. Experts say the massive outreach campaigns across the country helped alert many of these people to their eligibility.

While the massive backlog issue is a serious problem, this story does give some nice solid numbers to plug into the Medicaid spreadsheet for the largest state in the country:

A nice unofficial update from Kentucky...but again, no QHP/Medicaid breakout. As I did last time, I'm going to play it cautiously and assume 90% Medicaid & 10% QHPs; since the combined total was around 421,000 last time, this brings the totals up to around 87,000 exchange QHPs and 363,000 Medicaid enrollees;

Sebelius later tweaked Sen. Mitch McConnell of Kentucky by pointing out that Kentucky’s state health insurance program, the Kentucky Health Connector, now has 450,000 people enrolled in it and many of them had no health care before.

OK, I could be dead wrong about this; if so, I've provided a second Hobby Lobby-related item to justify having this blog entry. Let me put the 2nd item out there just in case:

The Washington State Insurance Commissioner just issued an interesting immediate response to the SCOTUS Hobby Lobby decision...interesting, because I'm a bit surprised that a state insurance commissioner (which I generally thought of as a fairly non-partisan job...although this jackass from Georgia obviously proved me wrong on that one) would post something like this, especially so quickly:

FOR IMMEDIATE RELEASE – June 30, 2014

Media contact: Public Affairs (360) 725-7055

Kreidler: Supreme Court dealt a blow to women’s reproductive rights today 

OLYMPIA, Wash. – Today, the U.S. Supreme Court issued a ruling that threatens women’s access to contraceptives in Burwell vs. Hobby Lobby Stores, Inc.

Chris Conover has responded to both of my items from yesterday. Let's take a look:

Let’s start with this howler: “Actually, the Obama administration never said that they’d reach 7 million paying customers by March 31st.”Seriously? Has Mr. Gaba really not read the September 5, 2013 memo from Marilyn Tavenner (chief of Centers for Medicare and Medicaid Services) titled Projected Monthly Enrollment Targets for Health Insurance Marketplaces in 2014? Table 2b of that memo clearly shows an enrollment target of 7,066,000 for March 31, 2014. End of story.

The other day, Paul Krugman posted a short blog entry over at the New York Times in which he laid out 6 of the biggest anti-ACA attack points which have been, in his view, completely obliterated by reality:

1) "No one will sign up!"
2) "But how many have PAID????"
3) "OMG!! 5MM POLICIES CANCELLED!!!"
4) Rate Shock
5) "Not enough YOUNG INVINCIBLES to avoid a DEATH SPIRAL!"
6) "Overall healthcare costs will skyrocket!!"

In response, Chris Conover has posted a piece over at Forbes which claims to rebut Prof. Krugman point by point, basically calling him full of beans on 4 points and "generously" giving him a split decision on 2 others.

The other day, Paul Krugman posted a short blog entry over at the New York Times in which he laid out 6 of the biggest anti-ACA attack points which have been, in his view, completely obliterated by reality:

1) "No one will sign up!"
2) "But how many have PAID????"
3) "OMG!! 5MM POLICIES CANCELLED!!!"
4) Rate Shock
5) "Not enough YOUNG INVINCIBLES to avoid a DEATH SPIRAL!"
6) "Overall healthcare costs will skyrocket!!"

In response, Chris Conover has posted a piece over at Forbes which claims to rebut Prof. Krugman point by point, basically calling him full of beans on 4 points and "generously" giving him a split decision on 2 others.

Yesterday I finally got around to actually plugging the post-4/19 data to date into a spreadsheet to clarify my earlier "off-season" estimate of 200K - 300K exchange QHP enrollments per month (it was actually more like 230K - 330K).

Today, Maryland issued their latest report, which brings their data up through May 31st. After entering the new data, the overall projection chart has jumped dramatically and now stands at between 270K - 360K per month:

As I noted this morning, the Maryland Health Exchange has released an updated enrollment report running through the end of May (the June report will be out at the end of July):

As of May 31, 300,310 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. 
 
As of May 31, 72,207 individuals have enrolled in a qualified health plan. 

Compared with the previous report, MD had a 4,300 QHP increase from 5/10 - 5/31, and an increase of 4,450 since the end of the open enrollment period. This means that they're averaging around 106 per day, or 31% of their average rate during open enrollment...which has had a significant impact on the Off-Season Projection Chart that I started posting yesterday (as you can see, MD had been only running 2% of the OE rate until now).

Not sure how I missed this yesterday; thanks to Steve C. for the heads' up:

The Obama administration on Thursday plans to issue much-anticipated instructions for Americans to reenroll for next year in the new federal health insurance marketplace — a set of rules intended to make it easy for consumers but that nevertheless will require some people to reapply through HealthCare.gov to preserve their subsidies or coverage.

Under the rules, people will need to do very little to remain in their health plans if their incomes and covered family members are not changing and their plans are offered again for 2015.

All 17 of the insurance companies participating in the federal ACA exchange this fall for Year Two of open enrollment have released their preliminary rate requests for 2015. It's important to stress preliminary, since the rates still have to be approved by the HHS Dept. Update: State insurance commissioner.

There could be some sticker shock, but some welcomed price cuts as well, when consumers go shopping for insurance this fall on the Michigan Health Insurance Marketplace, according to numbers the state released earlier today.

Overall, it appears that Michigan’s proposed average rate increase of just 2.2% is modest compared to changes in some other states, according to an ongoing analysis by consultant PricewaterhouseCoopers that so far has compared insurance pricing on more than a dozen state marketplaces.

That means the average premium cost in Michigan — $326.74 — remains lower than the national average premium of $360.

...At least four companies propose boosting premiums 9% or more, while others plan to slash those monthly costs by double-digit percentages. (See table: 2015 Michigan health insurance rates)

I gave a general overview of the reasoning behind my 200K - 300K per month off-season QHP enrollment estimate a couple of weeks ago, but I didn't get around to actually plugging the numbers into a spreadsheet and running the calculations until today. Here's where things currently stand:

As you can see, just as I did with my enrollment period projections (which were consistently proven to be 99%+ accurate), I'm using the data provided by the state-run exchanges since April 19th as the basis for my "off-season" projections. Unfortunately, not only is the HHS Dept. refusing to provide their monthly enrollment reports during the off season (which I've ranted about several times), but New York isn't doing so either (I already asked), and so far there's no word from California, Connecticut, Rhode Island or Vermont.

Only 58 more QHPs but, interestingly, 104 more people on SHOP plans...

Connector Updates for June 21, 2014

32,802 Applications completed in the Individual Marketplace
9,586 Individuals and families enrolled in the Individual Marketplace
643 Employers applied to SHOP Marketplace
965 Employees and dependents enrolled via SHOP Marketplace

Over the years there have been a whole mess of court cases challenging the ACA, either en masse or sections thereof, and most of them have either been dismissed or absorbed into the law. The most famous of these was NFIB v. Sebelius, otherwise known as "the SCOTUS decision which upheld the ACA overall but made Medicaid expansion optional instead of mandatory."

Basically, the SCOTUS ruled that Congress couldn't enforce the individual mandate using a financial penalty, but it was all good because it isn't really a penalty, it's a tax, which Congress has every right to impose. Yup, the entire law hung in the balance over the semantics of a single word, which happens more often in court cases than you'd think.

However, there's still a half-dozen assorted cases left to be decided, and while most of them nibble around the edges of the law, one of them could potentially cause an epic clusterf*ck if it's successful: Halbig v. Burwell.

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