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Kentucky

Over the past 7 months, plenty of healthcare reporters, insurance executives and political pundits have started following this site and/or my Twitter feed. For the most part the ones I know of tend to be either of unknown ideology or left-leaning, but there's also a substantial number of Republican, Conservative, Libertarian or other wise right-leaning types, and that's fine.

I've butted heads publicly with a few of these folks. In some cases they've presented honest, intelligent disagreement; in others they've spewed tired, BS talking points. Here's a great opportunity to prove whether you're dealing an intellectually honest hand or not. I present you with the following:

MCCONNELL: KY. EXCHANGE UNCONNECTED TO HEALTH LAW

LOUISVILLE, Ky. (AP) -- Kentucky Sen. Mitch McConnell says he would try to repeal the Affordable Care Act if he's elected Senate majority leader.

But the veteran senator won't say what would happen to the 413,000 Kentuckians who have health insurance through the state's health care exchange.

McConnell told reporters Friday that the fate of the state exchange is unconnected to the federal health care law. Yet the exchange would not exist, if not for the law that created it.

The article claims that these numbers are "through 3/31", but that's obviously an error, since a previous update directly from Kynect made it clear that the QHP number was several thousand lower than that as of early April. Doesn't really matter, however; these are still outstanding results for Kentucky:

At a Capitol news conference Tuesday, the Democratic governor announced that 413,410 Kentuckians enrolled for health-care coverage through the online insurance marketplace called "Kynect" in its first open-enrollment period, from Oct. 1 through March 31.

...He said about 75 percent of the people signing up for health insurance in Kentucky had no previous insurance and that 330,615 people qualified for Medicaid coverage.

Beshear described it as "deeply satisfying" that 10 percent of the state's population "finally has affordable, quality health insurance that gives them assurance that if they get sick or hurt, they'll get the care and they're not in danger of bankruptcy."

...More than one out of every 10 Kentuckians has health insurance through Kynect, Haynes said.

This just in...Kentucky's tally is now up to nearly 80K exchange QHPs and 323K Medicaid enrollees:

BREAKING: 402,407 Kentuckians are enrolled in @kynectky. 322,827 in Medicaid, 79,580 have purchased private insurance. #ACA #kyga14

— Joe Sonka (@joesonka) April 10, 2014

Still ~75% of @kynect enrollees previously did not have insurance. That's over 300,000 Kentuckians who now have health coverage due to #ACA

— Joe Sonka (@joesonka) April 10, 2014

OK, this just adds to the confusion over the "extension periods"...not only is Kentucky joining the "you have until 4/15 if you started by 3/31" brigade, but it appears that they're also allowing people to start the application/enrollment process between 4/4 - 4/11 as well:

Gov. Steve Beshear announced Tuesday that the state will extend its deadline. People will be able to file for health insurance from April 4 to April 11.

The official deadline had been midnight March 31. Gwenda Bond, spokeswoman for the Cabinet for Health and Family Services, said 21,000 people signed up over the weekend, including 12,000 people who signed up Monday. The deadline affected only those signing up for private health insurance, because those eligible for Medicaid can apply at any time.

Because of the high demand, Bond said, state officials decided to add additional days for enrollment or a "special enrollment period." The days between the March 31 deadline and the special enrollment period will allow for some tweaks to the technical system to allow for the extension, she said.

Huh. Good for them, but if that's the case, why not just bump this out to 4/15 and be done with it? Weird.

OK, the kind folks at KynectKY have helpfully cleared up their final 3/31 numbers:

Kynectky Here is what I have. This is as of 7:00AM 04-01-14.Total QHP Enrollments: 77,044; Total MCO Enrollments: 294,221.

UPDATE: I've been so busy plugging these numbers into the spreadsheet that I haven't had a chance to see what the true impact is...and in Kentucky, it's nothing short of amazing:

Obamacare has cut Kentucky's uninsured population by more than 40 percent, signing up roughly 360,000 residents since enrollment opened up on Oct. 1, according to the Louisville Courier-Journal.

Some 75 percent of them -- 270,000 -- were previously uninsured. That means Kentucky's uninsured population of 640,000 has come down by 42 percent.

UPDATE: (sigh) OK, another very slight update:

Wow, a personal response from the KynectKY Facebook Page:

Kynectky Charles Gaba Total QHP Enrollments = 73,080; Total MCO Enrollments = 286,222.

I don't think this is the final 3/31 total, however, since this adds up to 359,302, which was posted as of around 4pm yesterday.

However, they've also just announced another 12K "processed through 8:30am today", so I'm not sure whether those are counted as part of the 3/31 total or not. I'm going to assume that they were entered last night and just took a few hours to actually process fully...therefore they count towards the 3/31 tally (unless they clarify otherwise), using a 20/80 ratio of 2,400 QHPs to 9,600 Medicaid:

Kentucky's last update, as of 3/27, was 70,273 exchange QHPs and 280,113 Medicaid, a total of 350,386.

Assuming the same 24/76 split that the prior update had, that should mean an additional 2,060 QHPs and 6,550 Medicaid added.

Over 359,000 have applied with #kynect as of 7AM today. Under 9 hours are left in open enrollment. Thousands have applied, so should you.

— kynectky (@kynectky) March 31, 2014

A rough total number (which I suspect we'll see a lot of this weekend...things are moving very quickly now). Assuming a 20/80 split (typical for Kentucky) of the additional 17,600 total, this should mean roughly 3,500 more QHPs and 14,100 more added to Medicaid, to around 69,500 and 280,500 respectively.

We've been seeing a tremendous increase in the number of people applying and approved each day," says Gwenda Bond in the Kentucky Cabinet for Health and Family Services.  "We've been seeing about 3,100 each day and I suspect that's even higher this week."

According to the state, an estimated 350,000 uninsured Kentuckians have enrolled in Medicaid or private coverage.

UPDATE: OK, someone provided the hard numbers, thanks:

One final update for today, just under the wire: Kentucky reports that QHPs are up to 66K, Medicaid up to 266.4K. That's an increase of 1,509 QHPs and 8,911 Medicaid enrollments in 4 days. A slight slowdown from last week, but March is still well above 2x February's rate.

In KY, 49% of those enrolled in #kynect are under the age of 35: 266,388 have qualified 4 Medicaid; and 65,964 purchased private insurance.

— kynectky (@kynectky) March 25, 2014

 

Thank you to new contributor JTP for this CNBC article, which finally brings some clarity to the "how many already had insurance?" question.

Until now, the only hard numbers available were from New York and Kentucky, which were reporting 70% and 75% of all enrollees as not already having insurance respectively. However, these numbers included both exchange QHPs and Medicaid enrollees, which made it difficult to parse what percent of QHP enrollees only didn't have insurance prior to their enrollment.

This article is more specific: The number for NY QHPs is 59% of QHP enrollees (vs. 90% of Medicaid), and in KY is, surprisingly higher, at 75% for each!

This just in...KY was at 60,837 QHPs as of 3/13, so this is an increase of 3,618 in 7 days. Medicaid is up to 257,477 from 239,453, an increase of 18,024.

As of 6:00 p.m. on Thursday 3/20/2014

321,932: Kentuckians are enrolled in new health coverage, including Medicaid and private insurance

257,477 have qualified for Medicaid coverage and 64,455 have purchased private insurance.

But wait, there's more (from the Kynect Facebook Page):

More than 321,000 Kentuckians are now enrolled in new healthcare coverage through kynect, and that number is expected to keep growing in the final 10 days of open enrollment. A preliminary analysis has found that approximately 75 percent of all enrollees report that they did not have insurance before signing up for healthcare coverage through kynect.

OK, the cutesy title is kind of a misnomer; my two previous entries didn't use that title originally...but they should have, and do now.

March 31st is supposed to be the final day to enroll in QHPs via the exchanges...but it's looking more and more as though that won't quite be the case in not two, not three...but possibly up to seven states now, including a couple whose websites have been working smooth as silk??

On March 7th I pointed out that due to Massachusetts having some 154,000 people stuck in health insurance limbo, they've been granted some sort of temporary extension, twice...out to as far as June 30th in some cases...

OK, I already had Kentucky down with 60K QHPs / 240K Medicaid; just just straightens the numbers out precisely:

300,290 Kentuckians are enrolled in new health coverage through @kynectky. 239,453 in Medicaid, 60,837 purchased private insurance. #ACA

— Joe Sonka (@joesonka) March 14, 2014

No breakout between Private QHPs & Medicaid yet, but KY Governor Steve Beshear just announced that Kentucky has broken the 300K mark, adding an impressive 20,000 new enrollees in the last 6 days:

Congratulations, Kentucky! 300,000 people now enrolled in affordable health care through #kynect. Sign up by March 31 .@kynectky

— Steve Beshear (@GovSteveBeshear) March 13, 2014

Their last update had them at 57,090 QHPs and 223,378 Medicaid/CHIP, 280,468 total, so this is an increase of at least 19,532.

KY has recently shifted towards roughly a 17.5% QHPs / 82.5% Medicaid split. I'll assume a 15/85 with the newest batch for now, which brings the totals to 2,932 QHP / 16,600 Medicaid, for totals of over 60,000 and 240,000 respectively.

OK, as noted a little earlier, I underestimated the February HHS Report for Exchange-based Private QHP enrollment by about 4.2%:

  • My Projection: 902,800 (4.202 million total)
  • Actual Enrollments: 942,833 (4.242 million total)

I'm perfectly happy to have underestimated. As for where the extra 40,000 enrollments came from, my initial guess would be that California, in particular, started ramping up their big March blitz a bit earlier and more successfully than I figured, which, again, I'm absolutely fine with. Update: Nope, actually, California's numbers plummetted in the 2nd half of Feb due to that ugly technical outage; see below for details.

I'm busily plugging the new enrollment numbers into the spreadsheet even as I type this, and will be updating with various notes and observations, so keep checking in.

OK, I've entered the QHP data; a couple of things to note:

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