MAJOR UPDATE 3/22/17: As I've noted repeatedly, my estimates of how many people are at risk of losing their coverage has always been based on the assumption of full repeal with immediate effect and, most importantly, no replacement healthcare policy whatsoever. I had to do it this way at first because there was no Republican replacement plan available until a couple of weeks ago. Then, when the AHCA plan was released, I didn't have the time or expertise to properly overhaul my projections accordingly.
Fortunately, the Center for American Progress does have the time, manpower and expertise to do exactly this. They crunched the numbers and, based in part on the recent Congressional Budget Office scoring of the AHCA, put together their own fully-detailed analysis of what impact partially repealing the ACA by passing the AHCA would have on coverage losses.
In light of this, at this point you can pretty much ignore everything below, as it no longer applies; the question is no longer "what happens if the ACA is repealed without anything replacing it?" but rather "what happens if the ACA is partially gutted and replaced with the AHCA?"
Unfortunately, due to the sheer amount of time it would take to do so, and the fact that the House is voting on the AHCA tomorrow (Thursday, 3/23), I don't have time to completely update/overhaul the Google Docs version of this data.
2017 using my known flawed data was running .96% behind 2016 on the January 14th inclusive update. 2017 ended up running 5.25% behind 2016 on Healthcare.gov states. The increment (using favorable to the null hypothesis data) slowdown in pace that can be attributed to Trump Administration actions is 5.25-.96 or 4.29% of enrollment was lost due to the executive order and other Trump administration actions such as shutting down some outreach and advertising in the last eleven days of enrollment.
Before the election, I was assuming the 2017 Open Enrollment Period would rack up between 13.5 - 14.0 million QHP selections...between 6% - 10% more than last year. The HHS Dept. agreed with me, projecting around 13.8 million (an 8.6% increase).
Last year the federal exchange included around 76% of the total enrollments (around 9.6 million). This year, HC.gov added Kentucky, which should have bumped the ratio up to around 77% this year. Assuming 13.8 million total, that would mean roughly 10.6 million enrolling via the federal exchange.
After Trump won and the GOP immediately started the actual legislative process to repeal the Affordable Care Act with preliminary votes in both the House and Senate, I downgraded my projections to around 13.3 million nationally (10.2 million via HC.gov).
Over 700,000 Additional Pennsylvanians Enrolled in Governor Wolf’s Medicaid Expansion Plan
February 02, 2017
Harrisburg, PA – In February of 2015, Governor Wolf expanded Medicaid to ensure that Pennsylvanians can receive affordable, straightforward, accessible healthcare without unnecessary delays and confusion. Today, Governor Wolf announced that over 700,000 Pennsylvanians have enrolled in HealthChoices, Pennsylvania’s mandatory managed care Medicaid program, since expansion occurred two years ago. U.S. Census data shows that the commonwealth’s uninsured rate has dropped from 10.2 percent in 2010 to 6.4 percent in 2015.
NEARLY 158,000 MARYLANDERS ENROLLED IN HEALTH COVERAGE FOR 2017 THROUGH THE STATE MARKETPLACE
INCLUDING MEDICAID, 501,000 HAVE ENROLLED SINCE NOV. 1
BALTIMORE (Feb. 1, 2017) – A total of 157,637 Marylanders enrolled in private health coverage plans for 2017 by yesterday’s deadline for open enrollment, capped by the largest single-day call volume ever for Maryland Health Connection, the state’s health insurance marketplace.
Including Medicaid enrollments, more than a half-million Marylanders have newly enrolled or renewed in health coverage for 2017 through the state marketplace since Nov. 1 when open enrollment began. Maryland Health Connection now covers 1.1 million in all — one of every six people in Maryland.
Hmmm...I'm honestly not sure what this last number (1.1 million covered by the exchange) refers to...they just said it was 158K QHPs + 343K in Medicaid = 501K total.
More than 225,000 people used Washington Healthplanfinder to select Qualified Health Plans – a 13% increase over last year’s total.
The ASPE report for OE3 showed WA's official 2016 tally at 200,691, so 225K would actually only be 12.1% higher, but the press release says it's 13%, so either they're basing it on a slightly lower unofficial 2016 tally, or "over 225K" actually means closer to 226,000.
GOP Rebrands Obamacare Strategy From 'Repeal' to 'Repair'
Some Republicans in Congress are starting to talk more about trying to “repair” Obamacare, rather than simply calling for "repeal and replace.”
There's good reason for that.
The repair language was discussed by Republicans during their closed-door policy retreat in Philadelphia last week as a better way to brand their strategy. Some of that discussion flowed from views that Republicans may not be headed toward a total replacement, said one conservative House lawmaker who didn't want to be identified.
Using the word repair “captures exactly what the large majority of the American people want,” said Frank Luntz, a prominent Republican consultant and pollster who addressed GOP lawmakers at their retreat.
I'm actually a bit surprised that NY State of Health is the first state exchange out of the gate with final enrollment numbers, but good for them:
Press Release: NY State of Health Announces Enrollment Surges: More Than 3.6 Million New Yorkers Secure Health Coverage
Feb 1, 2017
Nearly 50,000 sign up during final two days of Open Enrollment
An additional 800,000 New Yorkers enroll through the Marketplace since January 2016
ALBANY, N.Y. (February 1, 2017) -- NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.6 million New Yorkers enrolled in comprehensive health coverage through NY State of Health, a 28 percent increase from 2016.
“New York continues its commitment to bring affordable, comprehensive health coverage to New Yorkers” said NY State of Health Executive Director, Donna Frescatore. “New Yorkers now have access to affordable health insurance coverage, giving hundreds of thousands of previously uninsured individuals economic and healthcare security.”
Politically, the big unknown is whether or not Paul Ryan and Mitch McConnell will get away with trying to pin the blame for this on the Democrats/the law itself. That's why they've been pushing the "Obamacare is already in a death spiral!" claim hard for the past few weeks, even though it quite simply isn't.
...So, if this does end up in a worst-case scenario, Trump's "stop enforcing the mandate altogether!" order here could end up causing that death spiral even if the GOP doesn't technically end up repealing anything legislatively. The carriers would start announcing that they're bailing next year as soon as this spring (remember, the first paperwork for 2018 exchange participation has to be filed in April or May), and McConnell/Ryan would simply say, "See?? We told you it was collapsing all by itself! We didn't touch nuthin'!!"
I've stated many times over the past few weeks that between the GOP actively starting the legislative repeal process with preliminary votes, Trump actually taking office, his executive order within hours of doing so instructing the HHS Dept. to actively sabotage implementation of the ACA, and the last-minute yanking of TV advertising for the final few days of Open Enrollment that there's simply no way of making a solid prediction about what the final enrollment tally will end up being.
However, based on previous yearly patterns and spot-checks of HealthCare.Gov and the buzz from some of the state exchanges earlier today, I'm still gonna take a shot: I expect the final QHP selection tally to come in...pretty damned close to last year's 12.7 million, actually.
Officially, I'm giving it a range of anywhere between 12.4 - 13.0 million, with around 9.5 - 10.0 million of that coming via the federal exchange (which covers 39 states this year, including Kentucky) and the remaining 3 million or so being courtesy of the 12 remaining state-based exchanges.
Connect for Health Colorado® Extends Enrollment Deadline in Response to Surge in Sign-ups
Posted on Tuesday, January 31, 2017
DENVER — Connect for Health Colorado® today announced it is giving consumers who attempt to enroll by the Jan. 31 deadline three more days to complete their enrollment.
Individuals who began the enrollment process by midnight Tuesday will have until 6 p.m. Friday, Feb. 3, to choose a health insurance plan that will be in effect March 1, 2017. Friday will be the last day to purchase coverage this year, except for customers who experience a qualifying life change event, such as marriage, divorce, having a child, losing your employer-sponsored insurance, or moving to Colorado.
I've received confirmation from CMS that this "in line by midnight" grace period ONLY applies to those who CALL THE FEDERAL EXCHANGE at 1-800-318-2596and LEAVE THEIR CONTACT INFORMATION.
In other words, it does NOT appear to apply to those who are using the website application/enrollment process only; you have to CALL HC.gov and leave your number to qualify.
Every Open Enrollment Period to date, most of the ACA exchanges have ended up offering some sort of deadline extension and/or "in line by midnight" overtime grace period to allow people who started the enrollment process by the deadline additional time to wrap up their paperwork and complete the process.
I'm typing this at 9:40am on Tuesday, January 31st, 2017.
The 2017 Open Enrollment Period ends at Midnight tonight (I'm assuming that's Eastern time).
That means you still have just over 14 hours to enroll for a Qualified Health Plan for the rest of 2017. If you enroll today (and pay your first month's premium), your policy will go into effect starting March 1st, and as long as you keep paying your premiums, should remain in effect until December 31st.
Many people are understandably concerned or outright scared about what will happen to their coverage given the insanity swirling around the Trump Administration, the Republicans in the House and Senate actively taking steps to repeal the ACA and so forth.
Now, I've already said many times that 2018 coverage options are likely to be a complete disaster thanks to the massive uncertainty and sabotage being deliberately created by both Donald Trump and the GOP. For the current year, 2017, it's a different story.
The Washington Health Benefit Exchange is alerting customers that tomorrow, Jan. 31 is the deadline to sign up for 2017 health and dental coverage through Washington Healthplanfinder.
Individuals and families have until 11:59 p.m. tomorrow to select a plan that is good for the remainder of the year. Residents who fail to secure coverage by the deadline could be required to wait until the following year to sign up for health and dental coverage.