Time to dust off my "$360.00 Solution" post from July 2nd...

Of course, even if the SCOTUS does rule for the plaintiffs in the end, it's very likely that they'll include a note that basically tells Congress "You know, there's an easy way to fix this; just go over section 1401 with a dab of liquid paper and revise the sentence to read "...enrolled in through an Exchange established by the State or the Federal Government" or whatever.

That would be a completely reasonable solution...if there was a snowball's chance in Hell that Congress would do so. Obviously the GOP would never let it go through (assuming that they hold the House and/or take over the Senate), so the clusterf*ck would ensue.

However, depending on what "established by" and "facilitates" are defined as (see section 1311 as referred to in the passage above), it seems to me that there's a different, equally simple (if utterly stupid) possible resolution which would cost no more than $358.20!

Yesterday, in my Big Exclusive Post® about the number of people currently enrolled in exchange QHPs appearing to have dropped down to a bit below 7 million, I noted that based on the 15 states for which I have current enrollment data from September or October (plus 1, Oklahoma, from August), it looks like the national total is right around 7 million on the nose at the moment. However, if you throw Florida into the mix, it drops noticeably, making it look more like 6.8 million.

I also noted that there are two problems with the Florida data: First, that it's had significantly more dropoff (22.5%) from the official April figure than any of the other states listed (with the exception of Nevada, which has had its own technical headaches to the point that it's dropping its exchange entirely).

Even more problematic is that this 22.5% "drop" was supposedly only as of June 30th (it comes from Florida's 2015 policy rate request filing report from the insurance companies operating on the federal exchange).

This makes Florida an incredible outlier; take another look at the chart:

Now that the dust has settled on the 2014 Election...

Last week, after having hunted down the current QHP enrollments for about a dozen states, I tallied them up and concluded that the average "attrition rate" for private ACA exchange policy enrollments was around 2% per month since April, after lopping off about 12% for those who never paid their first premium.

I still stand by this, but an extensive discussion with Jed Graham of Investors Business Daily made me realize that presenting it this way can lead to confusion, because I'm essentially mixing together two different estimated numbers (% paid & attrition rate), each of which may vary widely from state to state, instead of simply comparing the number of people currently enrolled against the 8.02 million who had enrolled (whether paid up yet or not) as of April 19th.

Amazing. Even with things ramping up for #OE2 (Open Enrollment Period 2), and even with the midterm elections overwhelming everything for the past few weeks, Minnesota continues to quietly plod along, racking up the ACA enrollments along the way:

Latest Enrollment Numbers 

November 4, 2014

Health Coverage Type Cumulative Enrollments
Medical Assistance 233,194
MinnesotaCare 80,111
Qualified Health Plan (QHP) 55,813
TOTAL 369,118

That total figure is 5,893 higher than it was a week ago, with the QHPs up 183 and Medicaid/MinnesotaCare up another 5,710.

Onward...

OK, that was unexpected. After a solid month without any updates, last week CoverOregon, being dismantled even as we speak as the state makes the move to HC.gov for #OE2 (Open Enrollment Period 2) suddenly issued a new update. I figured it was their last hurrah before going silent, but it seems they've decided to put out one (or possibly 2?) more updates before going to the Great Beyond:

November 3, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 420,450
Total private medical insurance enrollments through Cover Oregon: 105,661

Oregon Health Plan enrollments through Cover Oregon: 314,789
 

Dental enrollments 
Total private dental insurance enrollments through CoverOregon 1: 20,893

Net enrollments 
Net private medical: 77,288
Net private dental: 13,782

Compared to last week, that's another 606 total QHPs added, plus an additional 3,788 added to the Medicaid tally.

I'll have much more to say about the impact of yesterday's disastrous election on the ACA and healthcare coverage in general tomorrow, but for the moment let me just note something about the GOTV effort here in Michigan, which was focused on getting about 900,000 Democrats who showed up in 2008 & 2012 but not in 2010. Here's how that worked out:

Michigan Votes for Governor, 2010:
Snyder: 1,874,834 / Bernero: 1,287,320 / 3,226,088

Michigan Votes for Governor, 2014:
Snyder: 1,605,405 / Schauer: 1,477,300 / Total: 3,152,616

Schauer actually did receive over 190,000 more votes than Virg Bernero did 4 years ago (about 15% higher), and Snyder's vote tally was down about 270,000 from 2010 (about 14% lower)...but it wasn't nearly enough. Schauer still lost by about 130,000 votes.

I'm kicking myself for not writing up a full post on this issue, since it's the issue which most directly connects today's election to ACASignups-specific issues, but thankfully, Sam Stein and Jeffrey Young have done a fantastic job anyway. The key takeaway is this:

There are two threads of conventional wisdom heading into Tuesday's midterm election. The first is that the election doesn't much matter. Regardless which party controls the Senate, President Barack Obama will still occupy the White House, which means gridlock will remain, if not escalate. The second is that, when it comes to Obamacare, the status quo will remain in place for at least the next two years. Senate Republicans may push for repeal votes. But Obama will veto them. Smaller reforms may pass. But the law will mostly remain intact.

When I wrote about the Halbig case earlier this summer (along with its kid brother, the King case), I was pretty sure that the Supreme Court wouldn't even get around to taking up the case (if they did at all) until next year. However, there's a chance that they might take up the second of these (King v. Burwell) this year after all...although the final decision still probably wouldn't come out until after OE2 is over next spring:

As I noted this morning, between the impending election on Tuesday, the upcoming 2nd Open Enrollment Period (henceforth to be designated "OE2" or hashtag #OE2), and a serious technical crisis with my day job which I've had to spend the past few days cleaning up, I have upwards of 150 ACA/Obamacare-related emails clogging up my In Box.

Most of them are worth a mention, but there's no possible way I can do a full entry/commentary/analysis on most of them, so I'm just doing roundup-style summary mentions:

A new report by Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University examines the challenge of maintaining enriched health care for pregnant women who are enrolled in Covered California and who are also eligible for Medi-Cal, which includes the Comprehensive Perinatal Services Program (CPSP). The CPSP, whose roots are in one of the nation's most successful programs ever developed for low-income pregnant women, makes enriched maternity care available to pregnant women facing elevated health, environmental and social risks on account of their economic status.

As I noted this morning, between the impending election on Tuesday, the upcoming 2nd Open Enrollment Period (henceforth to be designated "OE2" or hashtag #OE2), and a serious technical crisis with my day job which I've had to spend the past few days cleaning up, I have upwards of 150 ACA/Obamacare-related emails clogging up my In Box.

Most of them are worth a mention, but there's no possible way I can do a full entry/commentary/analysis on most of them, so I'm just doing roundup-style summary mentions:

Medi-Cal has no open enrollment period. State health officials are quick to point out that people can enroll for Medi-Cal any day of the year.

But Covered California's three-month open enrollment period starting Nov. 15 is expected to boost signups for Medi-Cal, as well -- even though the open enrollment period doesn't apply to Medi-Cal.

As I noted this morning, between the impending election on Tuesday, the upcoming 2nd Open Enrollment Period (henceforth to be designated "OE2" or hashtag #OE2), and a serious technical crisis with my day job which I've had to spend the past few days cleaning up, I have upwards of 150 ACA/Obamacare-related emails clogging up my In Box.

Most of them are worth a mention, but there's no possible way I can do a full entry/commentary/analysis on most of them, so I'm just doing roundup-style summary mentions:

Consumers in Georgia and three other states who were helped by navigators for the 2014 insurance exchanges tended to be people of color who were not financially secure, a recently released report says.

Navigators, who are specially trained in the provisions of the Affordable Care Act, popularly known as "Obamacare," provide face-to-face, in-person help for consumers seeking information about health insurance policies in the state exchanges, also called marketplaces.

Between the impending election on Tuesday, the upcoming 2nd Open Enrollment Period (henceforth to be designated "OE2" or hashtag #OE2) and a serious technical crisis with my day job which I've had to spend the past few days cleaning up, I have upwards of 150 ACA/Obamacare-related emails clogging up my In Box.

Most of them are worth a mention, but there's no possible way I can do a full entry / commentary / analysis on most of them, so I'm just doing roundup-style summary mentions:

Supreme Court justices have their first chance this week to decide whether they have the appetite for another major fight over President Barack Obama’s health care law.

...The appeal has arrived at the Supreme Court at a curious time; there is no conflicting appeals court ruling that the justices often say is a virtual requirement for them to take on an issue.

No, not because of Halloween, but because I'm dealing with a serious business situation (I do have a day job, remember...)

With the election and the 2nd open enrollment period coming up, the timing couldn't be much worse, but Duty Calls and all that.

There's a metric ton of ACA stuff going on; unfortunately I'll probably have to skip over about 80% of it for the next few days. Sorry!

NOTE: In light of some serious discussion with IBD's Jed Graham and a lot of thought afterwards, I've decided to run the "attrition" numbers two ways: "Current vs. April Paid" and "Current vs. April Total", for reasons I'll explain soon.

The main thrust of this article is general hand-wringing over how the state of Rhode Island plans on funding their ACA exchange after this year, although it's a bit confusing since it sounds like the problem has nothing to do with having the funding and everything to do with having permission to use it:

Enrollment starts on Nov. 15.

Not long after, the state will have to make its own big decision: how to finance the exchange.

Of the $23.4 million in federal funds budgeted for HealthSource RI this year, only $1,353,570 has been spent so far. The state anticipates — but does not yet have — federal permission to spend any of the remaining dollars after Dec. 31.

However, there's one data point that pops up smack in the middle of my current "mini-project", trying to lock down the current QHP enrollments in each state:

Yesterday I posted a whole slew of state-level QHP attrition rates, comparing the number of people currently enrolled in private exchange-based healthcare policies against the official number from back in April.

The numbers ranged from as poor as Florida losing 12% of their enrollments in just 2 months to as well as Maryland and Oregon seeing a 30%+ net increase in enrollees over the past 6 months.

Today I can add Kentucky to the latter list. She couldn't provide an exact current count, but according to the woman I spoke with at the kynect exchange (that's "Obamacare", Mitch!), the number of Kentuckians currently enrolled in private policies via kynect is "right around the same number it was at last spring, between 80-85 thousand".

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