Idaho

There's been a lot of fuss made about 2015 ACA exchange premium rates not being available at Healthcare.Gov until after the election. The presumption, of course, is that this is being done for political reasons. While this may be true, it could also simply be that there's a lot of different policy figures to plug into the federal system, and some states haven't even finalized their rates yet.

That being said, residents of some states can check out the 2015 premiums now and compare them against their current premium:

IDAHO: Idaho is the only state moving from HC.gov to their own exchange. Idaho residents can check out their 2015 rates directly via the state exchange site.

CALIFORNIA: CoveredCA has 2015 rates available right now as well.

VERMONT: Federal Law Raises Questions About Who Can Bid For IT Projects That Support The Exchange

A provision of the Affordable Care Act precluding health insurers or companies in the “same controlled group of corporations” as a health insurer from holding exchange contracts raises questions about Optum working on Vermont Health Connect.

Concerns regarding Optum were raised at the federal level by Sens. Orrin Hatch, R-Utah, and Chuck Grassley, R-Iowa, the ranking members of the Finance and Judiciary committees respectively.

IDAHO: Your Health Idaho to launch sign-up system

Basically just an overview of the new Idaho ACA exchange; ID is the only state moving from HC.gov to their own website for the 2nd year, giving them a unique perspective. Most interesting to me is that they're spinning the "autonomy/states-rights" angle, which was the whole reason for pushing states to set up their own exchanges in the first place:

Well this is a nice surprise date point!

Earlier today I noted that Idaho, which is the only state moving off of Healthcare.Gov onto their own exchange this year, is already allowing people to comparison shop 2015 policy plans. However, I just noticed something else on their new exchange site:

If you are among the 78,000 Idahoans who purchased a health insurance plan for 2014, we are here to help you renew your policy for 2015 on Idaho’s own health insurance exchange.

This is noteworthy because the official April 19th enrollment number in Idaho was 76,061. Assuming a 10% non-payment rate (which has been proven to be about right repeatedly over the course of the off-season period), that means around 68,400 of those enrollees paid their first month's premium. The gross number, of course, should be around 14,000 higher (assuming an off-season gross addition rate of around 87 per day), and of that grand total, it appears that 78,000 are still currently enrolled (otherwise they wouldn't need to renew their policy, would they?)

A couple of weeks ago, I reported that Maryland, which was one of the states which had embarrassingly bad technical problems with their ACA exchange--and which ended up scrapping their platform completely and moving to an all-new system based on Connecticut's excellent platform--was making some very wise decisions for 2015 based on lessons hard-learned from 2014:

BALTIMORE (Tuesday, Sept. 16, 2014) — The second year of Maryland’s health insurance marketplace for individuals and families begins on Nov. 9 when consumers will have access to a newly redesigned website that enables “anonymous browsing,” the ability to compare plans — without registering personal information — before enrolling. This feature is being launched earlier than originally planned to enhance the shopping experience for Marylanders.

Four important stories about the technical situation status on various ACA exchange websites:

Idaho moving forward with state-run Obamacare exchange

Officials in Idaho say they’re undaunted by the well-documented failures of Obamacare exchanges in neighboring states and are moving  full-steam ahead with plans to launch their own web portal this November.

While executives at Cover Oregon and Nevada Health  Link abandon their state-run websites and turn to the federal exchange (HealthCare.gov), Your Health Idaho is headed in the opposite direction.

The state relied on the federal website for the open-enrollment period that ended in mid-April because it had less than 200 days last year set up its own web-exchange when state lawmakers authorized the project. It was one of two states — New Mexico is the other — that had to wait a year for its own site, and exchange officials say the delay has been a plus as they meet with other states to discuss what went right or wrong during Obamacare’s first round.

Holy Cats. For a solidly Republican state which didn't expand Medicaid, Idaho has actually kicked some serious ass when it comes to ACA enrollments (then again, they're also one of only two states--New Mexico is the other one--which are planning on moving from HC.gov to their own state-run exchange next year, so perhaps it's not as surprising as all that). In any event, bravo to Idaho!

Dowd says the Congressional Budget Office wanted to have 40,000 Idahoans sign up through the exchange during the first six-month open-enrollment period. Your Health Idaho exceeded that target by more than 36,000 people.

...She doesn’t know how many of the 76,061 sign ups actually paid for their policies. She also doesn’t know how many of Idaho’s roughly 300,000 uninsured people signed up for a plan. She says finding out how many uninsured people sign up for coverage is a priority for Idaho and will be a question on the state’s portal during the next sign up period.

This article is interesting not so much because of how close I came to the actual situation in Idaho (I had ID woodworkers pegged at around 5,600; the actual number is more like 5K even), but because of how far off Idaho's own official prediction on "woodworkers" was--they were assuming more than 7x that number:

But even without Idaho expanding its program, experts predicted a surge in Medicaid enrollment. A report prepared for the Idaho Department of Health and Welfare by Milliman Inc. predicted that more than 35,000 people would join Medicaid when they learned they already qualified for it. That was known as the "woodwork" group, for eligible people coming out of the woodwork.

The report said the cost of new enrollment — aside from the expansion — would total about $14.8 million in this fiscal year, then rise to between $32 million and $45 million per year over the next decade. That's not quite what happened, at least in these early months, Shanahan said.

"We just haven't seen the large increases we had expected," he said. Only about 35 percent — 5,000 people — of new Medicaid members are from the "woodwork" group, he said.

Yesterday, contributor Stevef101 noted that Blue Cross of Idaho was bragging about enrolling 45K people via HC.gov...more than the total exchange QHPs for the state through the end of February. Today he further notes that the company has enrolled 70,000 people in new QHPs total during the enrollment period...meaning that 25K of them were done off-exchange.

Six-thousand people responded to the program, and at last count, 70,000 Idahoans signed up for insurance during the first open enrollment period.

"All of this publicity, people really starting to talk about what insurance can do for them, really made a big difference in getting people covered," said Zelda Geyer-Sylvia, President and CEO of Blue Cross of Idaho.

Note that this doesn't change the high-end potential total of 7.8 million from the Rand Corp. study, it just fills in the documented number within that a bit further.

Not an official update, but Idaho was already at 43,861 as of March 1st from all 4 companies operating on the exchange, so over 1,000 more than that total from just 1 of the four companies bodes well for the official total, which will probably come out next week:

About 45,000 people applied for health-insurance plans from Blue Cross of Idaho through the state's insurance exchange, Your Health Idaho, over the past six months.

The insurer announced its enrollment numbers Thursday.

Your Health Idaho is expected to release total enrollment for exchange plans soon. Open enrollment ended March 31.

Four companies — Blue Cross, SelectHealth, PacificSource and the Regence BlueShield of Idaho sister company BridgeSpan — sold plans on the exchange.

Additional note: 45K just happens to be my own "fair share of 7M" target for Idaho, so a single insurance company has hit the target. The other three are basically gravy.

UPDATE: On the down side, I was off by 4% this time around.

On the up side, I UNDERESTIMATED:

Actual Feb. enrollments: 942,833, for a total of 4,242,325 thru 3/01/14.

Sarah Kliff at Vox just announced that the February HHS report is expected to be released today at around 4:00pm. A few items in anticipation of that:

  • As I've noted several times, I'm projecting the report to total around 902,000 exchange-based private QHP enrollments for the month of February (technically 2/02 - 3/01)
  • If accurate, this would bring the cumulative total of exchange-based private QHP enrollments to 4.202 million (from 10/1/13 - 3/01/14)
  • From the data I have, the average daily enrollment rate in February was almost identical to that of January, which had about 1.146 million QHP enrollments. HOWEVER, the January report included five weeks of data (12/28 - 2/01), while the February report will only include four weeks (2/02 - 3/01). Therefore, even at the same daily average, it'll be about 20% lower no matter what.
  • Don't be surprised if Peter Lee of CoveredCA decides to steal some thunder by announcing that California has enrolled 1,000,000 QHPs all by itself either today or tomorrow. However, that would include the past 10 days, while the HHS number will only run thru 3/01.
  • If you want to get REALLY specific, call it 902,800 and 4,202,292.
  • I've been dead-on target 6 times in a row without hyping up my projections beforehand. This time I am hyping myself up beforehand, so I'll probably be way off...but as long as I've UNDERestimated the tally, I'll be perfectly fine with that...
  • The report will be released in about 5 minutes, but my kid gets home from school in about 10, so it'll be a good 20 minutes before I can really post anything. Feel free to follow Sarah Kliff of Vox in the meantime!

Eureka! That rarest of things, a mid-month enrollment update from a federally-run exchange state! Idaho reports hitting 38,000 private enrollments, up from 32,899 as of February 1st (I'm sure this is private enrollments only, because they were already at over 16K Medicaid enrollments as of 2/01. It's a short article and the whole thing is a gem, so here it is verbatim:

Idaho’s state-based health insurance exchange has now enrolled 38,000 people in health insurance, state Department of Health & Welfare Director Dick Armstrong told lawmakers today. And another 56,000 are “in the queue,” in the process of enrolling. “Our original target was 42,000,” he said, for signups by the end of the open enrollment period at the end of March. “Very rapidly, Idaho’s enrollment … has come up.”

When the exchange opened and faced problems due to computer system hang-ups in Washington, D.C., initial enrollment numbers were very low. “Everybody was just wringing their hands,” Armstrong said. “This is a breath of fresh air, to see that the enrollments are picking up this rapidly.”

As a follow-up to Friday's news that Idaho has hit around 20,000 private enrollments comes this story about the status of those enrollments from the actual insurance companies' perspective. While the major thrust of the article is the unusually long payment deadline extensions that have become necessary due to the technical and paperwork confusion caused by the Federal HC.gov exchange, as contributor Witgren notes, there's two important points which are quite telling.

First, in Idaho, at least, it appears that at least 75% of those 20K people have made their first payment. While you can certainly spin this as being "25% are deadbeats" if you want to, this certainly goes a long way towards disproving that the "OMG!! NOBODY IS ACTUALLY PAYING!!!" meme that the ACA opposition has been shouting about.

Secondly, it appears that, according to the insurance companies themselves, having a large percentage of new policy purchasers not make their payment until the last possible moment is standard for the industry as a whole, and has been for a very long time.

Who would have thought that it would be Idaho, of all states, that would mark the first significant milestone since hitting the 2.1 million mark a around Christmas? In any event, the spokeswoman for Your Health Idaho announced that ID has shot up from just 1,730 private enrollments at the end of November to a whopping 20,000 people "in time for January 1st". Since the final January deadline for Federal exchange states was Christmas Eve, I assume this means that an additional 18,270 people enrolled from 12/01 - 12/24, increasing Idaho's total 11-fold.

Of course, most of those 18K new people will probably have to be taken out of the HHS's non-specific "1 million" enrollments which haven't been officially broken out by state, but even after doing so, the total number of private enrollments now still sits at just over the 2.2 million mark.

At the same time, since Idaho's CBO projection for 3/31/14 was only 40,000 people to begin with, this means that just like that, they've jumped up to 50% of their target.

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