The December report released Jan. 21 by Covered California shows that from Oct. 1-Dec. 31 the exchange received 1,107,229 electronic applications for health care coverage through both private plans and Medi-Cal. Multiplying that number by 1.8, "based on an average of 1.8 individuals per application," it was estimated that the number of applications represented 1,993,012 individuals.
The 1.8 factor was not used for "completed applications." From Oct. 1-Dec. 31, there were 771,008 completed applications for health care coverage through Covered California (including Medi-Cal) for 1,456,909 individuals. If the 771,008 completed applications had been multiplied by 1.8, there would have been only 1,387,814 individuals. This indicates that individuals, not households, were counted in the completed applications.
From Oct. 1-Dec. 31, there were 500,108 enrollments in a Covered California health plan (this did not include Medi-Cal). Of the 730,449 individuals who were "determined to be eligible for enrollment in Covered California", more than 2/3 enrolled. Clearly these were enrollments by individuals, not households.
OK, in some ways this is gonna make my previous Medicaid analysis (which was confirmed by the CMS a few days later) seem like kid's play, but in other ways it'll actually be far easier to follow. Not only have I prepared multiple screen shots of the spreadsheet involved so you can see exactly what numbers changed and why, but there's far less guesswork on my part as to which cells to keep or eliminate. All of the relevant reports, along with the actual spreadsheet itself (with all 6 worksheets) are linked to at the end of this screed.
You see, while my 6.3M figure from several days ago does match the 6.3M total that CMS announced yesterday, there are still some anomalies, because my 6.3M includes some additional data that's been released since the end of December, while their 6.3M includes the December "direct ernrollment" data for all 50 states that I didn't have access to. There are some additional factors to sort out, and I decided to start from scratch to figure out what they were. What I found surprised me.
If you review page 3 of the latest CMS report (which includes Medicaid/CHIP enrollments through December), you can see that they've added a small but important new paragraph at the bottom:
9 The following states have included renewals in their application data: Nevada, New Mexico, Ohio, and Pennsylvania. These states have included renewals in their determination data: District of Columbia, Iowa, Maryland, Michigan, Missouri, Nevada, North Dakota, New Mexico, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Virginia and Wyoming. Some of these renewals are conducted without the individual submitting a new application, using information already in the system that the individual is asked to verify.
Well, now, this certainly answers a burning question, doesn't it?
If those 14 states (+DC) do include Medicaid/CHIP renewals (aka redeterminations) in their data, then that means, by definition, that the other 36 states don't include renewals.
Yes, this is self-serving and smug. I really don't care at the moment:
Enrollment in Medicaid spiked in December, aided by Obamacare exchanges and an expansion of the government-run health coverage program for the poor in 25 states...
By the end of December, more than 6.3 million people were determined to be eligible for Medicaid or CHIP, the program covering children, through state-run agencies and state-based Obamacare exchanges, according to a Centers for Medicare & Medicaid Services report released Wednesday.
That tally does not include the 750,000 or so people who were determined eligible in Medicaid through the federally-run Obamacare exchange HealthCare.gov.
Adding the two enrollment numbers together equals more than 7 million Medicaid-eligible determinations. But some of the determinations made by HealthCare.gov may be duplicative of state-based decisions.
As it happens, if you look at the Medicaid/CHIP spreadsheet, I deliberately left out about 620,000 Medicaid enrollees from the total because I suspected they would otherwise be double-counted.
When I posted my big Medicaid/CHIP spreadsheet overhaul, I was understandably concerned that I missed something major--that there had to be some factor lost in the messy, semi-overlapping reports from HHS and CMS that would account for big swaths of the 1.7 million "extra" Medicaid enrollments that I've "found" (in reality, those 1.7 million have been gradually accruing ever since the beginning of October, I just wasn't able to pin them down into a tangible format on the spreadsheet & graph until now). As a case in point, after the overhaul, I have California sitting at 1.214 million new additions to Medicaid/CHIP programs.
Today a friend provided a link to a story out of the Fresno Bee from 4 days ago, in which the Cailifornia Dept. of Health Care Services reveals that enrollments in Medi-Cal (CA's implementation of Medicaid) have gone up from 8 million people last year up to about 9.2 million as of now...a difference of about 1.2 million.
I'm not saying that there aren't flaws in my methodology; no doubt there are, but this certainly helps set my mind more at ease.
Ka-Pow! This is the most eagerly-awaited enrollment update we've had in weeks. California has finally let the dust settle on their Christmas-week craziness and have released new, comprehensive enrollment data for both Private QHPs as well as Medicaid/CHIP, and the numbers are impressive indeed: After closing out 2013 with just over a half a million private enrollments (about 1,300 more trickled in in the final 3 days of the year), the first half of January has proven that, while the completely expected post-December drop-off did happen, enrollments are still proceeding at a very healthy pace, as over 125,000 more people enrolled in the first 15 days of the month, more than a 25% increase since New Year's Eve. Broken out, that comes to over 8,300 per day for California alone.
It's also worth noting that with this update, the total Private QHP enrollment figure has now broken the 2.5 million mark.
Meanwhile, Medicaid enrollments have also continued to show a similar 25% gain, up from around 460,000 (or 472,000...see today's Medicaid Spreadsheet update) up to 584,000.
A few days ago I posted an exclusive analysis of the ACA Medicaid/CHIP enrollment data as provided by the official HHS report released on 1/13, the CMS report released on 12/20, as well as the other various sources for ACA-related Medicaid/CHIP enrollment that I've already been posting/linking to since I started this site.
My general conclusion was that the actual grand total number of Medicaid/CHIP enrollments since October 1st, 2013 is actually far higher than the 3.9 million cited by the Obama administration (which was based on the 12/20 CMS report) or even the 4.5 - 4.6 million that both I and Glenn Kessler at the Washington Post have agreed are more accurate up until now.
Last week I took an uncharacteristic gamble by not trusting my instincts about the off-hand "7,000/day in January" comment made by the Deputy Director of NY State of Health; her claim seemed quite a bit off-base compared with the official press release a few days earlier, but I decided that she must know the numbers better than I did, so I went with it.
Today, the newest official numbers were released, and as it happens, I should have trusted my instincts--while the totals are still impressively higher than the prior numbers, they're still lower than the "7K/day" number indicated. In any event, NY is up to 222K private QHPs and about 107K Medicaid/CHIP, which still pushes them above 100% of their CMS projection for the enrollment period.
The newest figures show that as of 9 a.m. Monday, 587,486 people had completed their applications on the insurance exchange and 328,796 went on to enroll in some sort of coverage.
Well, this is a nice bit of good Medicaid-related news after the recent setback: It looks like after dragging their heels, Arizona authorities finally started processing new Medicaid applications, resulting in the number of enrollments skyrocketing. They're now up to over 98,000 from about 40,000 as of December 28th.
As of January 10, 2014, 98,203 adults have been approved for AHCCCS health insurance coverage: 96,834 are childless adults between 0-100% FPL and 1,369 are adults in the new category frin 100-133% FPL.
Very slight number bumps; 800 private QHPs and about 1,300 more Medicaid, but an update is an update.
To date, [acting Cover Oregon directory Bruce] Goldberg said, 65,932 people have enrolled in health insurance through the marketplace. About 23,800 of those are enrolled in commercial health plans. There are almost 30,000 people who have been approved to select their plan but have chosen not to move on in the process, Goldberg said.
The latest Colorado update is significant not just because of the solid numbers (private QHP enrollments up 20% from 12/31 through 01/15, to 63,407; Medicaid/CHIP enrollments up 17.6% to 101,730), but also because the second report devoted to Medicaid expansion specifically states that the 101K does not include redeterminations (ie, renewals of existing Medicaid recipients).
Also note that these Medicaid applications may include more than one person each.
Colorado is now at about 69% of their CMS projection number with 59% of the enrollment period passed.
And from the Medicaid Expansion Report:
**These are new applications for Medicaid or Child Health Plan Plus (CHP+) and do not include redeterminations. An application can include multiple individuals.
Maryland's private QHP enrollments went up about 10% in the first part of January, to 22,512, but the Medicaid numbers are confusing. According to the HHS report, as of 12/28 Maryland had 43,065 people enrolled in Medicaid via the exchange, but this update from the Maryland Health Connection states the number as only 29,517. However, they did also enroll a couple thousand more people via the automatic Primary Adult Care program, which cancels out some of this loss.
I'm not positive what to make of the 60,000 number, but the footnote certainly makes it look like this may be the true number of new Medicaid enrollees after separating out Medicaid renewals. This appears to account for the drop of 13,548, and suggests that (not including the PAC transfers), roughly 32% of all Medicaid enrollees were renewals. Assuming this is the case, these have now been separated out, and like Washington State, Maryland's Medicaid numbers should now be "clean" going forward (I think).