California

WASHINGTON: Health Exchange leaders are trying to solve the problems from the first sign-up period

CLARKSTON, WA – Leaders with Washington’s Health Care Exchange are preparing for the second open enrollment period, but at the same time they are still working on resolving billing and computer problems for 1,300 accounts from the first sign-up period.

IOWA: Three health insurers get OK to increase rates

This is very confusingly worded, because it makes it sound like all 3 companies have been operating on the HC.gov exchange when it turns out that only 2 of them have. Wellmark did not participate in the ACA exchange; the 19,000 customers referred to here have off-exchange policies which are still ACA-compliant:

Commissioner Nick Gerhart said today that he has approved premium increases from Wellmark Blue Cross and Blue Shield, CoOportunity Health and Coventry Health.

OK, I've started a new entry since the last one was getting pretty long.

I still have to sort through a bunch of data, but the main takeaway is this:

  • I projected the total California QHP enrollment figure to be around 1.68 million. The actual number is 1,414,668 (as of 4/15...see update at bottom of this page) plus 200,000 off-season enrollments from 6/1 - 9/30 plus an unknown number from the 46 days between 4/16 - 5/31.
  • I have no idea why they left those 46 days out of the press conference. Very odd.
  • There were 200,000 people who enrolled from June 1st - September 30th (122 days), or 1,639 people per day.
  • Assuming the missing 46 days saw a similar rate to the rest of the off-season period, that would be 1,639 x 46 = 75,394 additional enrollees.
  • Assuming this is correct, that's 1,614,668 + 75,394 = 1,690,062
  • That would make my projection 99.4% accurate.

Regular readers know that given the HHS Dept's going radio silent on the total ACA enrollment figures since the last official report was released back in May (which only ran through April 19th), I've been patching together bits and pieces of enrollment data from a handful of state exchanges, plus the occasional snippet of info from other states which has managed to find daylight from time to time.

Based on this, I've been projecting roughly 9,000 QHP enrollments being added per day during the off-season, translating into around 270,000 per month, of which about 90% eventually pay their first months premium. That translates to around 240K paid enrollees being added per month, which in turn is being roughly cancelled out by people dropping their policies after the first few months as they move on to other types of coverage (Medicare, ESI, Medicaid and so forth). Based on these estimates, there should now be a gross total of around 9.6 million enrollments, of which around 8.3 million have paid their first premium, and around 7.4 million who are currently enrolled as of October.

I'm pleased to announce that as ACASignups.net enters its' second year in operation, I've also started writing occasional pieces for healthinsurance.org:

Since 1994, healthinsurance.org has been a guide for consumers seeking straightforward explanations about the workings of individual health insurance– also known as medical insurance – and help finding affordable coverage.

The topic of insurance can be confusing, but we’re here with more information than ever: educational articles, expert health policy analysis, frequently asked questions about reform, a health insurance glossary, and guides to the health marketplaces and other insurance resources in each state.

I can't think of another publication outside of this one where what I do here is more appropriate. Looking at the list of other contributors, I'm honored to join their company.

My debut contribution to healthinsurance.org is an update regarding the citizenship/immigration data situation for Covered California enrollees...and the implications it may have for the rest of the country. Please take a look!

Let's fire up the Wayback Machine® and revisit March 19, 2014, shall we?

Don't Feed the Trolls: A Special Entry for a Special Visitor

...A few days ago, I broke the cardinal rule of blogging and social media: I fed a troll. Specifically, I engaged in a back & forth with a guy who insisted that I don't have any clue what I'm talking about, that I "don't cite my sources" (insane, since every one of my sources is meticulously cited, dated and linked to)...and, in particular, that I'm "lying" about the number of California residents who have "fully" enrolled in exchange-based QHPs in California (and by extension, nationally). If you check the recent Disqus comments you'll see him pop up a few times today.

At first, he was arguing the "But how many have PAID???" line, which I've repeatedly addressed.

Interestingly, he was finally willing to (grudgingly) concede that yes, around 85% of "full enrollments" have indeed been paid to date.

However, he still insisted that the number of "full" enrollments only "counts" if the policy has actually been issued:

G'mar Hatimah Tovah. Yes, I know I shouldn't be posting this on Yom Kippur Eve, but this seemingly minor news item means volumes to me personally.

I've spent 5 solid months pain-stakingly piecing together the best projection I could for off-season exchange QHP enrollments, using bits and pieces of data from a dozen or so states...mainly Minnesota, Oregon, Hawaii, Colorado and Washington State. In the absence of official updates from Healthcare.Gov (36 states) or the 2 largest state-run exchanges (California and New York), however, I was never completely sure about how close I was to the actual number, since the data I did have only covered perhaps 8% of the population.

Still, I eventually gave up hope that either NY or CA would bring their numbers up to date, forging ahead with my overall estimate of roughly 9,000 additional QHP enrollments being added daily during the off-season, 90% of those paying for their first month's premium, and roughly an equal number dropping their coverage sometime later...meaning that at any given time during the off-season, roughly 90% of the April 19th "official" number would be likely to still be enrolled and paying up.

Hmmm...now this is interesting. Yesterday it was brought to my attention via Twitter that the Covered California website (or at least the actual off-season enrollment portion of it) had been offline for "2+ weeks". Sure enough, when I took a look for myself, after clicking past the home page, the enrollment section had a message saying that it was offline for maintenance but that I should "check back on September 15th". Of course, seeing how it was Sept. 28th when I read this, that suggests that the maintenance started sometime before the 15th and continued well past the estimated completion date.

@CoveredCA website has been down for 2+ weeks. What are people supposed to do? At least update your home page. #ACASignups #CoveredCA

— Julie Kornack (@jkornack) September 28, 2014

For the most part, this press release from CoveredCA is just a nice overview of the new offerings available on the little-discussed SHOP (small business) ACA exchange. As you may recall, CA was one of the few SHOP exchanges which ever got off the ground at all last year, and even then technical issues resulted in the exchange taking it offline back in February. When I last updated CA's SHOP total, it was at only 4,900 people...however, according to this PR, that number has more than doubled since last spring, and now stands at 11,510:

Sept. 19, 2014

COVERED CALIFORNIA ANNOUNCES INSURANCE PLANS FOR SMALL BUSINESSES IN 2015

Carriers Remain Consistent, but New and Expanded • Choices Are Now Available to Employees

Another Big Number story today on top of the national and Illinois ones. My most recent numbers for California Medicaid expansion had it pegged at around 1.4 million "strict expansion" and around 600K "woodworkers" as of late June. However, that was just an estimate.

This article about a class action lawsuit being filed over the massive Medi-Cal backlog (down to 350K from a whopping 900K back in May) is mostly negative for obvious reasons. However, there's an interesting data point in the middle of it:

According to state officials, 2.2 million new Medi-Cal members were added as a result of the Obamacare healthcare expansion, bringing the total number of participants in the program to about 11 million.

State Department of Health Care Services spokesman Norman Williams said that as of Sept. 1, 350,000 applications remained backed up in the enrollment system. That system has been plagued by computer troubles that have stymied county government efforts to verify patients' Medi-Cal eligibility. 

The backlog was as large as 900,000 earlier in the summer.

OK, I admit that aside from tracking the actual enrollee numbers, I don't know a whole lot about the inner workings of Medi-Cal, California's version of Medicaid. However, if accurate, this just sounds...wrong:

California Governor Brown Still Wants to Steal My Home

I posted a diary here on August 26 about California turning Medi-Cal into a long term loan for recipients aged 55+ by billing their estates after they die for all of their Medi-Cal expenses.  The bureaucrats call that “estate recovery.”  I call it legal theft. A bill to remedy this situation and protect low income property owners has unanimously passed the California legislature. The bill has now gone to the governor to be signed. But he is  planning to veto it!

Today, many organizations are jointly sponsoring a call-in to the governor's office to put pressure on Governor Brown to sign SB 1124.  More information about the call-in is at the bottom of this diary.  But first, some background information.

Back in May, California was contending with a whopping 2.2 million new Medi-Cal (Medicaid) enrollees being added to the system. The logjam resulted in a backlog of 900,000 people.

By July 23rd, the backlog had been reduced by 1/3 to 600K. By August 20th, it was down to 490K. And today, Health Access CA reports that...

Pending backlog now down to 350,000 Medi-Cal applicants (from 900,000)--from the DHCS Medi-Cal Stakeholders Advisory Committee. #ACA #HCR

— Health Access CA (@healthaccess) September 11, 2014

Still a long way to go, but they're getting there...

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.”

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