Massachusetts

2018 MIDTERM ELECTION

Time: D H M S

Yes, that's right: We're quickly approaching the next big deadline: Private policy enrollment in time for coverage starting on February 1st.

Of the 3 monthly deadlines (January 1st start, February 1st start, March 1st start), this is the one getting the lowest amount of hype, for obvious reasons. The December 15th (or December 18, 23 or later, depending on the state) deadline was a huge deal because millions of people had to be renewed (either actively or automatically) in order to avoid any sort of a coverage gap, while a few million more people new to the exchanges jumped on board in time to start 2015 running. By my estimate, there should have been roughly 8.6 million people whose 2015 policies started on Jan. 1st.

As expected, things have quieted down considerably over the weekend. The confirmed QHP selection tally is 85,981 through January 7th. I'm walking back my "% of QHP determinations" a bit from 50% to 45%, which means that out of 5,390 determinations from the 8th - 11th, they should be a minimum of 2,400 more actual QHP selections by now.

That should mean the total up to around 88,400 as of last night, plus 168,130 people confirmed to have been added to Medicaid (MassHealth).

Hmmm...ok, it looks like I'll have to drop my "QHPs selected as a percent of determinations" rule of thumb back a bit. I figured that MA would be up to around 88K by today; instead they're just below 86,000. Still impressive, though...and the 160K Medicaid enrollments are equally so.

In addition, the payment rate is now up to 72% of the total, up from around 65% a couple of weeks ago. Again, remember that many of these 86K are for February start dates, so the payment rate is a bit misleading (for instance, it's possible that 60K out of 67K January enrollees have paid so far (90%) while only 2K out of 19K February enrollees have paid (11%), or something along those lines).

Again, it's also worth noting that in addition to the 86K QHPs selected, there's another 5,511 waiting for checkout and another 76K people who have filled out all their info and been approved for QHP coverage, but who haven't actually selected a policy yet. Some of these may be duplicates or abandoned accounts, of course, but assuming, say, 80% of them eventually do complete the process, that would bring Massachusetts up to a minimum of 151K QHPs by Feb. 15th. If 90% do so, that's a minimum of 159K...and that doesn't include the additional people who start/complete the process over the 40 days remaining in the enrollment period.

To create today's MA entry, I seriously debated literally duplicating yesterday's and just changing the date:

That's another 2,489 QHP determinations. Again, assume 50% of them followed through and selected a plan and that's at least 1,200 more added, bringing the likely total up to around 87,600 QHP selections to date, plus 160,824 confirmed Medicaid enrollees.

In the post-deadline, post-holiday period, Massachusetts seems to be settling into a pattern: Around 6,000 total eligibility determinations per day during the week, around 2,000/day on weekends. Of those, around 60% of them tend to be Medicaid enrollments, the other 40% for private policies (QHPs, which also include "ConnectorCare" in this case).

Yesterday there were another 6,508 added; 3,760 were immediately enrolled in MassHealth (Medicaid). The other 2,748 were for QHP applicants. As always, assuming at least 50% of those also selected a plan, that should tack another 1,400 to the total, bringing it to around 86,400 or so, while total Medicaid enrollments are now up to over 157K.

As always, assuming a minimum of 50% plan selections out of the QHP eligibility determinations, Massachusetts should have tacked on another 1,600 QHPs yesterday, bringing their total up to around 85,000 to date.

Immediate Medicaid enrollments have crossed 153,000.

Chalk up another (likely) 2,000 QHPs for Massachusetts over the weekend: There were 4,116 QHP determinations from the 2nd - 4th (plus just a handful on New Year's Eve and Day for obvious reasons). Assuming at least 50% of them followed through and selected a plan (which has been pretty reliable so far), that should bring the grand total of QHP selections up to around 83.4K to date.

Meanwhile, Medicaid enrollments are closing in on 150K.

The Massachusetts exchange has released their weekly dashboard report, which includes actual QHP selections and payments, although that data only runs through 12/29.

Add them up and you get 79,842 total QHP selections, of which 55,260 have paid their first premium and are fully enrolled. This may sound like only a 69% payment rate, but remember that many of the remaining 24,582 aren't scheduled to have their current coverage dropped until the end of January and thus aren't even expecting their new policy to kick in until February 1st anyway. As always, the payments are a rolling average, and will ebb & flow until around mid-March (after which they should stabilize at around 88% at any given time).

For example, on Wednesday the 31st, the MA exchange issued a press release which stated that the total number who have paid in time for January 1st coverage is "over 50,000":

Yesterday I officially confirmed 77,548 QHP selections via the MA Health Connector as of midnight Sunday the 28th.

They just released today's daily dashboard report, and the QHP eligibility determinations have gone up by another 6,263 people. Every day since Nov. 15th, roughly 50% of the QHP determinations have gone on to actually select a plan that very same day; the rate has ranged from 45% - 55% but always hovers near the 50% mark. Assuming this is still the case, that should mean at least 3,100 more QHP selections as of last night, for a total of around 80,600 to date.

In addition, MA has confirmed 139,063 new Medicaid/MassHealth enrollees, which have immediate effect.

As a side note, this means that MA has now enrolled more than 2.5x as many people in private plans for 2015 as they did all of last year.

 

OK, I actually have 3 different sources for these Massachusetts numbers, and the dates and classifications overlap a bit so bear with me.

First, we have today's daily MA Health Connector Dashboard report, which states that there have been 148,453 QHP determinations thorugh yesterday (12/29). Assuming 50% of these have selected plans, that's around 74,200 QHP selections to date. In addition, the 134,803 Medicaid (MassHealth) enrollments are already locked in.

However, there's also this story from Felice J. Freyer of the Boston Globe from 12/28 (about a jaw-droppingly poor bit of timing by private, for-profit corporation Dell to install some sort of major software update which caused the payment system to be unavailable for 12 hours on the payment deadline), which pins down the numbers a bit further:

This weekly dashboard report is really just an official breakdown of the numbers I reported a couple of days ago, as it only runs through 12/23, but it's still good to have an official confirmation of everything:

As of midnight last night, the Massachusetts Health Connector just reported:

  • 40,065 QHPs selected and paid for
  • 34,138 QHPs selected but not paid for yet
  • 74,203 QHPs selected total, with a 54% payment rate so far

MA has extended the payment deadline until 12/28, so the other 34K still have 5 days (including today) to make their first payment; if they miss that deadline but still pay up, they'll still be covered starting on February 1st.

Assuming 25,200 of these folks make their first payment by the 28th, they'll hit my 88% "rule of thumb" rate for January. Over 8,100 people made payments yesterday alone, so I'm not terribly concerned about this issue. It'll be interesting to see how many make the cut, given all the "but how many have PAID???" fuss and bother last year (last year, MA & WA were the only states which reported paid only numbers to HHS, but it was still messy in MA's case given their technical problems).

Today is the final day for Massachusetts residents to enroll in a private healthcare plan if they want coverage to start on January 1st. As of last night, they had a total of 248,711 eligibility determinations, of which 131,732 are for private QHP policies (the other 117K have already been enrolled in Medicaid, aka "MassHealth", which is impressive in and of itself).

So, how many of those nearly 132K people have actually selected a plan? Well, since open enrollment started on 11/15, anywhere between 45-55% of total QHP determinations as of that day have also selected a plan. If that was the case here, I'd say that the number is around 50%, or around 66,000, which would be an impressive 4,600 spike over yesterday's confirmed 64.1K.

UPDATE: OK, I've received the official total: As of midnight last night, 67,759 people had selected a policy, or 51.4%. I've also confirmed that about 47% had paid their first premium already...32,000 people, or more than the total enrollees as of last April.

On Friday I discovered that my estimate of roughly 60% of Massachusetts "determined eligible for QHPs" actually selecting a plan was way too high; the actual ratio was closer to 48% overall, meaning that my prior estimate of about 62K QHP selections was too high; the actual number was 53,490 as of Thursday the 18th, which is still excellent, just not as great as I thought it was.

Today I received confirmation directly from the exchange that total enrollments (ie, selected plans) are up to 61,470 as of this morning, which means that the ratio is indeed starting to move up, just later and not as quickly as I had thought (61,470 / 124,403 QHP determinations is just shy of 50%).

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