California

Usually I'm able to track down my data either by myself or with the help of several people who send me data links on a fairly regular basis. This has resulted in my being able to fill in off-season QHP enrollment data for almost 20 states.

However, there are several states whose data has eluded me so far...and unfortunately, this includes the two largest state-run exchanges: California and New York. I've contacted both exchanges; CoveredCA told me that updated enrollment numbers would be released "soon" but that was a good month ago. The New York State of Health exchange flatly stated that they, like HHS, would not be giving out any sort of official off-season enrollment update. There's also the Rhode Island exchange, which hasn't responded to my requests at all. (Update: Never mind that last one; just heard directly from the RI exchange, hopefully they'll be able to provide an update soon...)

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.

First, remember the news from yesterday that the ACA had lopped California's uninsured rate in half, from 22% down to 11% as of June? 22% of 38 million people = about 8.36 million; half of that is 4.18 million.

Next, remember that massive backlog of 900,000 new Medicaid (aka Medi-Cal) enrollees that California was working with as of the end of May?

Well, guess what?

For months, the state has labored under the largest such pile-up in the country, with 900,000 pending cases reported in May—the combined result of unexpectedly high application numbers and bug-ridden computer systems.

A couple of weeks ago there was much ado about a new Commonwealth Fund survey which found that nationally, the uninsured rate had been cut by 25% (from 20% down to 15%). Well, buried in that study was this bit about California specifically:

The percentage of uninsured Californians has been cut in half since the federal health law began expanding coverage nine months ago, according to a new national survey.

In September of 2013, 22 percent of California adults were uninsured. By last month, that number had fallen to just 11 percent, the biggest drop among the nation’s six largest states.

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:

Since I started the ACA Signups project, I've generally restricted my posts to ACA enrollment-specific articles and data. After all, the subject of healthcare is so huge, and there's so many other far better sources for developments in the medical field, etc, that it seems best to stick to the subject at hand.

However, the anti-vaxxer movement, which started as the punchline to a bad joke named "Jenny McCarthy" has ceased to be amusing and has now become flat-out frightening.

From January 1 to June 10 this year, California already had 3,458 cases of whopping cough, which already exceeds the number of cases reported in 2013, and following a surge in the incidence of the disease in the past two weeks, health official found it necessary to declare an epidemic.

A trifecta of updates out of the LA Times today thanks to contributor Brian W; can you count how many GOP talking points take serious damage below:

New data show the number of students without health insurance on California State University campuses dropped by 60% after Obamacare enrollment, defying concerns that not enough young people would sign up for health insurance.

...During the open enrollment period that ended in April, some officials worried that if not enough young, healthy people signed up for coverage, insurance companies would be left with too many sick and expensive customers, which would eventually cause carriers to raise premiums.

According to a poll released Thursday, at the 15 largest CSU campuses, approximately 30% of students were uninsured before enrollment began, and 10% were uninsured after. The drop accounts for 60,000 students who became insured, and illustrates the late surge of young people who signed up for policies.

Meanwhile...

I spent a lot of time the past couple of days hammering on the HHS Dept. for announcing that they're discontinuing their official monthly enrollment reports. However, it also occurs to me that I haven't heard a peep out of most of the state-run exchanges in almost a month either:

This LA Times story from 4/21 is chock full of good news:

First, apparently the ACA is such a "socialist, anti-capitalist" enemy of the free market that the private, for-profit insurance companies are just fleeing for the hills. Oh wait, actually...

Peter Lee, executive director of Covered California, said all 11 current health plans have indicated they plan to return next year. He also said three new plans have submitted letters of intent indicating they may compete on the exchange in 2015.

I was so caught up in the national tally implications, I forgot to actually devote a proper entry to California itself. There's some additional key numbers to look at here:

From April 1-15, 205,685 consumers – including a one-day record of more than 50,000 on the final day – completed their applications and selected health plans through the Covered California exchange, bringing the total to 1,395,929 at the end of the historic, first open enrollment period. The total exceeds the base projection for Covered California for the entire six-month enrollment period by more than 815,929.

As noted earlier, let's assume that "over 50,000" means, say, 50,100. To put this in context, they're saying there were (205,685 - 50,100) = 155,585 QHP enrollments in the first 14 days (about 11,100/day)...followed by 50,100 on the last day. That's 4.5x the rate it had been.

Holy Crap on a Stick!

From April 1-15, 205,685 consumers – including a one-day record of more than 50,000 on the final day – completed their applications and selected health plans through the Covered California exchange, bringing the total to 1,395,929 at the end of the historic, first open enrollment period. The total exceeds the base projection for Covered California for the entire six-month enrollment period by more than 815,929.

Let's assume that "over 50,000" means, say, 50,100.

To put this in context, they're saying there were (205,685 - 50,100) = 155,585 QHP enrollments in the first 14 days (about 11,100/day)...followed by 50,100 on the last day. That's 4.5x the rate it had been.

Until this, I was estimating that the national 4/01 - 4/15 average would be around 45K - 55K/day nationally during the extension period, or around 675K - 825K total, for a grand total of around 7.77- 7.93 million exchange QHPs total. I settled on 7.78M as my "official" projection to be on the cautious side.

According to L.A. Times reporter Chad Terhune, CoveredCA has confirmed enrolling another 70,000 people in private QHPs in the first 9 days of the extension period. They had 1,221,727 as of 3/31, so that brings their total to 1.29 million as of last night:

#CoveredCA added 70,000 (on top of 1.2M) who picked a plan in the 9 days of the "grace period" since March 31 to April 15. @charles_gaba

— Health Access CA (@healthaccess) April 10, 2014

#CoveredCA exchange: 70K more enrolled since 3-31 deadline after extending sign-ups to 4-15, adding to 1.2M already in #ACA

— Chad Terhune (@chadterhune) April 10, 2014

OK, this is why CoveredCA was holding off on announcing their numbers: Peter Lee had to testify before Congress today anyway:

Enrollment in Covered California private health insurance plans hit 1,221,727 through March 31. In fact, March was the highest single month of enrollment, with more than 416,000 people signing up for a health insurance plan.

...Medi-Cal enrolled approximately 1.9 million people through the end of March, including 1.1 million through the Covered California portal and county offices, approximately 650,000 former Low Income Health Program (LIHP) members who were transitioned to Medi-Cal by the California Department of Health Care Services (DHCS) and 180,000 individuals who applied through the state’s Express Lane program.

In addition...

OK, in addition to the appx. 7.041 million enrollments on the Federal exchange (HC.gov), I've brought CO, CT, DC, HI, KY, MD, MN, NY, RI and WA completely up to date, with all QHP data through midnight on 3/31 (some of the Medicaid/CHIP data is still missing, but that's a lesser concern at the moment).

However, I'm still missing the following exchange QHP data:

  • California: 22 hours (that's right...the current tally runs thru 2am on 3/31)
  • Massachusetts: 3 days (current is thru 3/28)
  • Nevada: 2 days (current is thru 3/29)
  • Oregon: 3 days (current is thru 3/28)
  • Vermont: 1 day (current is thru 3/30)

I can't tell you how frustrating it is to be this close to full data while still missing it.

So, how much is actually missing? Well, if these states were running at their prior average March daily rate, it would be

  • CA: 11,754
  • MA: 512 x 3 = 1,536
  • NV: 427 x 2 = 854
  • OR: 502 x 3 = 1,506
  • VT: 775
  • Total: 16,425

However, this obviously doesn't apply since the final weekend and especially yesterday were insane.

Without the final day's numbers, this update is both helpful and frustrating, because it's so close yet so far away. The QHP number is actually somewhat lower than I had thought a few days ago (not that I'm complaining; HC.gov more than took up the slack, and CA was going nuts on the final day anyway...which is why I'm so anxious to get the data from the 31st):

Consumer interest in Covered California has been strong, with 1,209,791 Californians signing up as of 2 a.m. March 31. From March 24 through 2 a.m. March 31, 155,988 individuals signed up for coverage. During the same week, 389,840 accounts were started — including 123,787 on Saturday and Sunday, as consumers hurried to meet the deadline.

“We’ve set records on accounts created five of the past six days,” Lee said.

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