California

Between my son being sick for the past 4 days (he's better now, thanks!), losing my internet connection for 2 days (it's back up now, thanks!) and just generally being swamped with work, I don't have time to give these stories the attention they deserve, but they're all worth checking out:

D.C.’s health exchange is still hampered by delays, glitches 11 months after launch

While Democratic partisans tout the latest conventional wisdom that Obamacare is finally going strong, the experience of many ordinary people who apply for it says otherwise.

The ongoing delays and irritation that consumers endure while navigating the District’s health insurance exchange offer a window into the reality on the street.

More health insurance options increase choice — and possibly confusion

Chad Terhune of the LA Times has a great story about how CoveredCA is ramping up their efforts for the 2nd year of open enrollment. It's a good read overall, but one number in the opening sentence leapt out at me:

Looking to avoid the pitfalls and confusion that surrounded the launch of Obamacare, California is gearing up to get 1.2 million people to renew their health policies for next year.

This caught my eye because the total QHP enrollment number for California was actually 1,405,102 as of 4/19.

Now, Peter Lee did state that 85% of that number had paid their first month's premium as of just a week later, by 4/27...and as it happens, 1.2 / 1.4 = 85.7%, so it's possible that this is what the "1.2 million" refers to.

(Note: I said Anthem may stink. Then again, maybe they don't. That's kind of the point of this entry)

The following letter to the editor appeared in yesterday's Fresno Bee, supposedly written by a "William Haskel of Fresno, California":

I signed up for Anthem Blue Cross to meet the May deadline. My previous employer also was Anthem Blue Cross, with prescription drug benefits. As I am starting a new business, I chose to go with Covered California through Anthem Blue Cross. The same company, without the drug coverage — or so I thought. Here's what I got:

Cost $845 a month, $5,000 deductible.

Family physician doesn't take the plan.

Wife's gynecologist doesn't take the plan.

Dermatologist doesn't take the plan.

Dentist doesn't take the Covered California dental plan.

So for $10,140 in annual premiums and $5,000 deductible, I am now searching for new doctors for my family.

This is flat-out wrong and should be stopped/fixed immediately:

A worrisome trend is emerging among some Californians who thought they were safe and secure under Covered California: Their plans are being canceled without consent and sometimes without notice.

...A growing number of Californians with Covered California plans are learning – sometimes through happenstance – that their plans no longer exist. Some, like Manahan, are getting shunted into Medi-Cal. Others are dropped outright.

...Covered California acknowledges that it is yanking some people off of its plans and putting them on Medi-Cal, months after they signed up or submitted income information.

We’re “in the process of manually verifying the documents provided by individuals who were conditionally eligible for obtaining health care coverage through our agency,” says Covered California spokesman James Scullary. “Through that process, some customers will receive notices indicating they are now eligible for no-cost or low-cost Medi-Cal coverage.”

Three more quick hits...the third one really deserves its own entry, but frankly, I'm too exhausted today and want to get it off the books, so...

Vermont: STATE SIGNS $9.5 MILLION CONTRACT EXPANDING ROLE OF OPTUM IN HEALTH CARE EXCHANGE

Vermont signed a revised contract with the tech firm Optum that expands its role in Vermont Health Connect’s operations.

Optum already had a contract worth $5.6 million for consulting work, and the latest deal, signed Aug. 15, is worth an additional $9.5 million for a total of $15.1 million.

 

...At latest count, Optum has helped the state halve its backlog of coverage changes and information errors from a high of more than 14,000 to roughly 7,000. Also, close to 4,000 people are having billing issues with Vermont Health Connect. There is some overlap between the two groups, Miller said.

Minnesota exchange gets new marketers

The news that MNsure is switching to a new ad team isn't that noteworthy, but check out the reasoning (in bold):

ATTENTION DEMOCRATIC CANDIDATES...

OK, a couple of caveats here: First, yes, it's California; obviously this isn't exactly representative of states like, say, Oklahoma or Alabama. Second, CoveredCA had a much smoother rollout last fall than HC.gov did (and some of the other state exchanges are still struggling with serious technical issues).

Having said all that, California does still have over 12% of the total U.S. population, and they do tend to be early adopters historically. With that in mind...

The nation’s new health care law is surging in popularity in the Golden State, according to the Field Poll, which finds more Californians today — of all political stripes — support the Affordable Care Act than at any time since it was signed into law four years ago.

And by a two-to-one margin, they praise the successful way it’s been rolled out in the state, compared to the federal government’s glitch-ridden system.

Still more now say they’re satisfied with the way the health care system is working in the state, compared to a year ago.

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.

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