California

As I noted last week, now that the King v. Burwell debacle is behind us, all options are on the table for the future of the 13 remaining "full" state-based exchanges (Hawaii is in the process of moving over to Healthcare.Gov for 2016, joining Oregon and Nevada). The two additional state exchanges most likely to make the move are Vermont (which is having both serious technical and funding issues) and Minnesota (where neither issue is quite as bad, but still troubling). The other 11 exchanges are in considerably better shape on the technical side, but the financing situation varies widely.

Fortunately, it looks like at least one state exchange has turned the corner, or at least is pretty confident that they're about to: The largest one in the country, Covered California. They just released a report at the Alliance for Health Reform forum; for the most part it's a general overview of CoveredCA's 2015 enrollment situation, rehashing data which was already known (1.3 million currently enrolled, etc.) However, there's a few noteworthy slides which fill out the picture more completely.

This board meeting report from Covered California actually includes a few pleasant surprises! when added to the existing data:

  • The official exchange QHP selection tally in CA as of February 22, 2015 was 1,412,200
  • According to the new report, they've had a total of 117,024 QHP selections since then (through May 10th), including #ACATaxTime enrollments:

  • Add them together and you get 1,529,224 total QHP selections to date (well, as of 5/10, anyway).
  • One interesting side note: CA's final #ACATaxTime tally turned out to be nearly 10,000 higher than expected (they previously reported around 33K with just a couple of days to go in the special enrollment period; apparently a lot of people jumped in at the last second after all)

On the surface, aside from the extra 10K for #ACATaxTime, that doesn't sound too interesting...I already had CA down with 1,503,200 QHPs, so this is just 26,024 higher. Big deal, right?

Except for one thing: I've confirmed that the number below represents actual paid, effectuated enrollments as of March 2015:

The California ACA exchange, CoveredCA, released their 2016 budget today, and the outlook is...well, kind of underwhelming, frankly:

After using most of $1 billion in federal start-up money, California's Obamacare exchange is preparing to go on a diet.

That financial reality is reflected in Covered California's proposed budget, released Wednesday, as well as a reduced forecast calling for 2016 enrollment of fewer than 1.5 million people.

The recalibration comes after tepid enrollment growth for California during the second year of the Affordable Care Act. The state ended open enrollment in February with 1.4 million people signed up, far short of its goal of 1.7 million.

A number of factors contributed to the shortfall, but health policy experts said that some uninsured folks still find health insurance unaffordable despite the health law's premium subsidies.

This just in...

April 28, 2015

MORE THAN 33,000 CONSUMERS UNAWARE OF TAX PENALTY FOR BEING UNINSURED HAVE ENROLLED IN HEALTH INSURANCE THROUGH COVERED CALIFORNIA SINCE FEBRUARY
Those Without Health Insurance Have Three Days to Enroll in Covered California to Minimize Penalty for Being Uninsured in 2015

SACRAMENTO, Calif. — With just two days until the April 30 deadline, Covered California urged consumers on Tuesday to enroll in health coverage and announced that more than 33,000 people who signed up since February indicated they were unaware of the tax penalty for being uninsured. The 33,000 enrollees were among more than 91,000 consumers who enrolled in coverage through special enrollment since open enrollment ended in February.

OK, here's how this impacts the numbers:

Y'know, sometimes I don't even have to add anything myself:

California's insurance commissioner criticized healthcare giant Anthem Blue Cross for imposing an "excessive" rate increase on nearly 170,000 customers statewide.

Dave Jones said Wednesday that Anthem had failed to justify its 9% average rate hike that took effect April 1. Premiums are going up as much as 25% for about 4,000 policyholders.

"These rate hikes have real financial impact on Californians," Jones said. "It means less money for other essentials like food, clothing, housing and education." 

But state officials have no power to stop health insurance rate increases that are deemed unreasonable.

Jones lost his bid to change that last fall when Californians rejected the Proposition 45 rate-regulation measure by a wide margin.

(sigh)

As an aside:

I had read something about this a week or so ago but I didn't really think about the implications at the time.

Now that I've read it...I can't for the life of me figure out why it hasn't gotten more press. Perhaps because it hasn't actually become a law yet?

Calif. Senate bill to give health coverage to undocumented passes committee

SAN MATEO, California— A landmark bill to extend subsidized health care to some 1.25 million undocumented immigrants in California — more than one third of whom are Asians and Pacific Islanders, passed the California Senate’s Health Committee on April 15.

Senate Bill 4, also known as the 2015 Health for All Act, sponsored by Sen. Ricardo Lara (Dem-Bell Gardens) passed 7-0, according to reports by the Orange County Register.

Capital Public Radio’s KXJZ News said the bill was supported unanimously by the committee’s Democratic members, Republican members of the same committee, however, abstained from the vote.

A huge thank you to Hannah Recht for the link to last week's Covered California board meeting dashboard report, which contains this crucial slide:

This is incredibly useful! Not only have they given an updated #ACATaxTime tally (22,659 as of 4/12, up from 18,000 as of 4/05), but they've also given the other off-season QHP enrollments for California since Open Enrollment ended. As a bonus, they've even broken out those other QHPs by the specific reason, which is a first for any exchange report, I believe!

Long-time readers may recall that last June, I tore Sharyl Attkisson to shreds for a rather idiotic story she wrote over at The Daily Signal (a front for the right-wing Heritage Foundation), in which she used some absurd math to try and claim that the ACA had only increased the number of Americans with health insurance by 3.4 million, when it was actually closer to 11-12 million people at the time (now up to around 14-15 million).

A few months later, I again laid into her for a rather lame "Obamacare Raised My Rates 36x!!" tweet that she sent out which, while not actually proven false, certainly didn't include any supporting evidence, details or context whatsoever.

Yeah, you just knew I couldn't resist: For all my "I'm on vacation this week!!" protests, this tidbit just wouldn't be denied:

Tax Experts Team Up with Covered California To Urge the Uninsured To Get Health Care Coverage

More Than 18,000 Californians Have Taken Advantage of Limited Special-Enrollment Opportunity; Consumers Are Encouraged to Sign Up by April 30

...“The Affordable Care Act is clear: All who can afford health insurance must buy it, and the good news is that it is more affordable than ever before,” said Covered California Executive Director Peter V. Lee. “It’s important for Californians without health coverage to sign up now to avoid the increasing tax penalty they will face in 2015 if they remain uninsured.”

Lee said that more than 18,000 consumers have taken advantage of the special-enrollment opportunity since it began Feb. 23.

Now that the King v. Burwell Supreme Court oral arguments are out of the way (with radio silence expected until they announce the decision sometime in June) , the next Big Development to keep an eye on ACA-wise is...Tax Season! There will be plenty of stories about how many people have to pay back some/all of their 2014 tax credits, how many will receive additional tax credits...and, most germane to this site, how many additional people enroll via the exchanges to avoid having to pay (most) of the higher tax penalty next year for not being covered in 2015 during the Tax Filing Season Special Enrollment Period (SEP), or #ACATaxTime as I prefer to call it.

A couple of weeks back, CoveredCA reported that they had renewed 944,000 2014 QHP enrollees, and added another 474,000 new enrollees for 2015, for a grand total of around 1,418,000 private policy enrollees (payments pending, of course). Like every other state, CA tacked on an "overtime" period for people who were waiting "in line" by the 2/15 deadline but hadn't completed the process. I was assuming this might push their grand total up to perhaps 1.5 million or so.

Today, CoveredCA released their final official numbers, and they're...underwhelming:

Obamacare: @CoveredCA says newly enrolled 2015 was 495K, total enrollment including renewals is 1.41M #ACA

— Chad Terhune (@chadterhune) March 5, 2015

@charles_gaba yes, slight change. Renewal figure went from 944K to 913.3 as of 2-26

Long-time followers of this site know that I attempt to track every person who gets enrolled in healthcare coverage through the Affordable Care Act, whether it's via individual/family exchanges, Medicaid expansion, off-exchange QHP enrollments...or the SHOP (Small Business) exchanges. They'll also recall that last year, due to the massive technical problems which most of the exchange websites faced, only a handful of SHOP exchanges were even usable, much less actually signing people up. The exchanges were, for the most part, so busy scrambling to get the individual enrollment side working properly that they pretty much put the SHOP exchanges on the back burner. Only about a half-dozen states had theirs running at all, and the total enrollment topped out at only around 83,000 people nationally.

"Regular as clockwork...or a time lock..."
(bonus points if you can guess the movie)

COVERED CALIFORNIA OFFERS CONSUMERS  A CHANCE TO MINIMIZE THEIR TAX PENALTY  BY ENROLLING IN A HEALTH INSURANCE PLAN

New Category Created for Special Enrollment Allows Those Unaware of a Tax Penalty for Being Uninsured to Sign up for Coverage by April 30

SACRAMENTO, Calif. — Covered California is offering a special enrollment opportunity for consumers who did not know or understand there was a tax penalty for being uninsured in 2014 or who learned they may face a penalty for 2015.

“For the first time, health care and taxes now are linked arm in arm,” Covered California Executive Director Peter V. Lee said. “The law requires everyone to be insured, and if you’re not, you may face a significant financial penalty when you file your taxes this year.”

From Feb. 23 until April 30, 2015, consumers are eligible to apply for health coverage during special enrollment by attesting that they did not realize there was a tax penalty. To attest to this fact, they can select “Informed of Tax Penalty Risk” when filling out an application at CoveredCA.com.

California originally announced that they'd allow 5 extra days for people who were Waiting In Line as of midnight on 2/15 to complete their enrollment (through 2/20).

They just updated this to tack on 2 extra days, matching Healthcare.Gov (February 22nd):

You Have Until Feb. 22 to Get Across the Finish Line for Health Coverage

Open enrollment for private health coverage through Covered California in 2015 is now over, but Medi-Cal enrollment is year-round (read more below). If you started the process of enrolling in a Covered California plan by Feb. 15 but did not complete your application, you may complete it by Feb. 22 with the assistance of a certified enroller, and you need to pay your first premium payment on that same day in order for your coverage to take effect March 1, 2015.

This Just In...

Overall 1.4 million in @CoveredCA now, over 3 million newly enrolled in Medi-Cal. Big impacts on health coverage from the #ACA. #Obamacare

— Health Access CA (@healthaccess) February 17, 2015

At #ITUPconference, #CoveredCA director Peter Lee notes that 2nd open enrollment closed 29 hours ago: newly enrolled 474,000! 36K on Sunday.

— Health Access CA (@healthaccess) February 17, 2015

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