California

With all the focus on fixing the problems with the individual/group healthcare exchanges, there's been far less attention paid to the more-troubled SHOP (Small Business) exchanges. The administration had already announced that the HC.gov version (covering 34 states*) wouldn't be launched at all until this fall, and 2 of the state-run exchanges (Oregon and Maryland) recently announced that they'd be offline until well after the end of the March enrollment period as well.

Today, Covered California announced that while their SHOP exchange has been operational (with a small number of enrollments to date), they're shutting it down until this fall as well. This leaves 14.5 state-run SHOP exchanges in operation (and yes, that's 14.5, not 15...Washington State's SHOP is only running in 2 counties at the moment).

Still, the press release does give a slight bump in CA's SHOP enrollment before they stop taking new signups: 4,490 individuals covered, plus another 1,200 being processed, for a total of 5,690. That's where it'll stay through the end of the March enrollment period unless they reverse themselves between now and then.

...in which we find the third ACA-created SHOP (Small Business Health Options Program) addition of the day. 2,155 employees is a pretty miniscule number (especially for the largest state in the country), but it's something. Note that it says "2,155 employees", which most likely means about double that when you include dependents, but as always, I'm leaving it here unless I find specific sources stating otherwise.

A total of 289 small employers have signed up for coverage through Covered California’s Small Business Health Options Program, better known as SHOP. These employers will provide coverage to a total of 2,155 employees.

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.

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.

For California, we presently have data through the December 23rd. However, at the last minute, California extended its deadline to 12/27. This means that we are still waiting for four days of enrollment data! Keep in mind that just prior to the deadline, California was seeing 20,000 private plan enrollments daily.

It that rate continued unabated, we could be looking at as much as 80,000 signups beyond the 428,000 already registered. During the three days December 20–22nd more than 77,000 Californians enrolled in private plans. Granted, this is speculation – we won’t know until Covered California releases its figures.

An important develepmont is that Covered California extended its deadline for paying health insurance premiums to January 15th. Payment was originally due Monday the 6th. The extension also relieves pressure on insurers who were inundated with hundreds of thousands of new customers in December.

As part of its effort to reach minority uninsured, California has made paper applications available in Spanish, Chinese, Vietnamese and Korean.

Mississippi: Private up to 2,000 from 802 (h/t Steve Mullinax, aka rsmpdx)

Transcript from Jeffrey Hess of Mississippi Public Radio, NPR Audio:

Only two insurance companies are offering plans in Mississippi, and they only overlap in four of the state’s 82 counties. However, those two companies appear to be betting that the web site problems and skepticism about the exchange in general are passing. One of the two companies, Humana, launched a late-December ad campaign to drive more people to the site, says spokesman Mitch Lubitz. “There’s been a ramp-up as the HealthCare.gov web site has gotten easier to use and there have been other options for people to go on and get information and enroll.” Mississipi’s Insurance Commissioner Mike Chaney says the improvements to the enrollment process are good, but he’s still skeptical they’ll be able to get enough people signed up this year. “From zero to ten, I’d give it a confidence level of about a three.” Hess: “That’s still not very good.” Chaney: “That’s not, but it’s better than where I was, a one, a week before last. “Chaney says the unofficial count is around two thousand people enrolled, but he says if the confidence trend continues upward, his confidence will rise to a five.”

Washington State (h/t ArcticStones):

Enrollments in private health plans on Healthplanfinder, the state’s online insurance marketplace, surged past 65,000 as applicants hustled to beat the Monday night deadline for coverage beginning Jan. 1, Washington Health Benefit Exchange officials reported Tuesday. Nearly 69,000 others have completed the enrollment process, but haven’t arranged payment, and another group of undetermined size has begun applications that are in varying stages of completion. ... As of Monday at midnight, about 100,800 people newly eligible for health insurance through the state’s expanded Medicaid program had signed up. Almost half of those were transferring from the now-discontinued Basic Health program or were presumed qualified for a federal assistance program for the disabled. An additional 47,500 enrollments were from those who previously qualified for Medicaid under the old rules — primarily children — but had not been signed up. And more than 88,000 people already covered by Medicaid renewed their eligibility.

For private enrollments, Washington is the only state that distinguishes between "enrolled but not paid yet" and "enrolled and first month's premium paid"; every other state, and the HHS, counts you as being enrolled even if you haven't actually paid yet, so that's the criteria I use, although I did separate out the other 69K on the spreadsheet. For Medicaid, I'm not counting the 88K since they were just renewals, but the 47.5K do count since they appear to fall into the category of people who were already qualified but didn't know about it until the ACA and the state exchange. In addition, as in several other states, another 47,000 people are being automatically transferred over to Medicaid proper from an existing state program; this is one of the "orange cells" on the spreadsheet. Also, h/t to sulthernao, who found the actual WA exchange source that gives the precise numbers.

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