Massachusetts

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

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!

Last month there was news out of Massachusetts of some sort of extension being granted to "bring the state’s health care system in line" with ACA regulations. At the time I didn't pay much attention to it, thinking that it only related to administrative procedures or somesuch.

However, it turns out that there's actually 154,000 people who are currently enrolled in a sort of healthcare batter's box, being placed on hold until MA's screwed-up exchange is able to absorb them into the system via proper ACA-compliant QHPs (or Medicaid/CHIP...not sure about that yet):

Unable to immediately enroll applicants in new, private plans under the Affordable Care Act, state officials extended existing state coverage for about 124,000 individuals, and granted temporary state coverage to about 30,000 new applicants. Those individuals were supposed to move onto new plans by March. 31; the federal waiver gives officials another three months to do that.

So why am I bringing this up today, 3 weeks after that story broke? Because a contributor called my attention to this story out of Oregon:

Massachusett's ACA exchange website is still undergoing massive technical problems, but there's been significant progress made in processing a mountain of paper applications. The immediate impact isn't that significant (11,000 total enrollments = only 2,861 more than the Feb. 1st tally), but the article suggests that another 50,000 applications should be getting pushed through the system any day now... 

Officials running the state’s troubled health insurance marketplace reported progress on Friday toward addressing its most immediate problem -- a massive backlog in processing applications...

As a result, people were urged to file paper applications instead, both to replace expiring policies and to enroll for the first time. The nearest-term problem has been simply processing 72,000 applications, many of which come from uninsured residents....

Overall, a spokesman for the marketplace said that there have been about 11,000 people who have newly enrolled successfully for coverage since October, almost all in unsubsidized coverage.

As contributor deaconblues put it, "First mention I've heard of 30K new people being enrolled into Medicaid (in addition to the 130K transitioned from the CommonwealthCare plans)."

Before delving into the website issues, Patrick said Massachusetts still has the highest coverage rate in the nation at 97 percent and faced unique challenges to implementing the ACA because of past health reform efforts. He noted that on Jan. 1 130,000 subscribers to coverage through the Connector were successfully transitioned to new plans under the expansion of MassHealth and 30,000 new adults and children were enrolled in the Medicaid program.

For Massachusetts Health Connector’s Board of Directors, which is meeting today, the key question is: How bad do things have to be – and for how long – before the consequence is a brutal decision?

We know that MITRE, a private contractor, was hired to do a technical review of the flawed website of the Massachusetts state insurance exchange. MITRE is the same company that pointed out certain vulnerabilities in HealthCare.gov that have later been fixed.

CGI, which has been responsible for development, failed to deliver a working website. Worse than that: after three months, there is still no indication that CGI has the competency required to fix the website.

The prior MA update was extremely confusing; this one is more straightforward but is still pretty fuzzy. As far as I can tell, Massachusetts increased their private enrollments by 24% from Dec. 30 to Jan. 7...but that only brings them up from 3,759 to 4,676. There's another 22,000 or so enrollments in semi-limbo which appear to be approved but not fully processed due to the technical problems they continue to have.

The Republican/MassLive.com previously reported that as of Dec. 30, only 497 people were enrolled in permanent subsidized health insurance plans. The state was providing temporary insurance for another 22,000 new enrollees while it worked to process their applications. The state had extended coverage for existing customers of its Commonwealth Care plans through March 31.

Lefferts said that as of Jan. 7, 4,676 people enrolled in both subsidized and unsubsidized plans through the Health Connector, up from 3,759 as of Dec. 30. He did not have a breakdown of how many of those were subsidized. Individuals whose plans are not subsidized have until Friday to pay their premiums, so that number is likely to tick up.

Massachusetts is a mess. I've been debating how to handle this; for private enrollments, it looks like I need to combine 497 subsidized, 3,262 unsubsidized (the previous number) and 22K temporary plans, which are apparently qualified/approved but haven't been processed yet. This adds up to 25,759 total, but the article refers to a lower number of 24,256. Given the confusion, I'm using that as the total and listing it below the other number in italics, which I normally use for "unpaid" enrollments. This brings the new tally to 3,759 fully enrolled and 20,497 "semi-enrolled"...I think.

The Medicaid number is more straightforward: 130K transferred automatically from a state-run public health program over to Medicaid proper.

As of Dec. 30, only 497 people had successfully enrolled in new subsidized health plans throughMassachusetts' health connector.

State officials have put another 22,000 people on temporary insurance plans, paid for by the state, while the connector processes coverage applications.

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.”

Yesterday morning's big news, of course, was that the Federal ACA exchange (covering 36 states) is now up to over 1.1 million private healthcare plan enrollees. Today brings 4 new state-level updates...and a teaser for two others you probably weren't expecting to see.

New York:
Today's big news is in New York, which announced that they're up to a total of 241,522 enrollees in either private plans or Medicaid/SCHIP expansion. They haven't broken out the number yet, but based on the split in the previous update (156K private, 58K Medicaid/SCHIP) I'm going with a 73% private / 27% Medicaid split until more specific info is released. This increases NY's private enrollments to 176K, up 20K from last week. h/t to Buenaventura for being the first to notify me.

Connecticut:
Connecticut issued a formal press release which includes their final 12/23 deadline enrollment tally for 1/1/14 plan coverage. The total is only slightly higher than what I had (34,295 instead of 34,000 even); the noteworthy part of the announcement is that they've confirmed ACASignups.net's declaration of CT as the first state to surpass their original CBO enrollment projection. CBO had them achieving 33,000 private enrollments by 3/31/14; instead they've managed to break through that number in less than half the 6-month enrollment period. Given the poor October performance of the ACA exchanges as a whole, this is an amazing development.

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