ORIGINAL POST: MAY 2014. UPDATE BELOW: OCTOBER 2017.
As regular readers of this site know, I make no bones about my personal politics. I'm very much a progressive Democrat, and my ideology comes out from time to time in my commentary. However, I do my best not to allow that to influence the data or how I present it.
When the enrollment numbers sucked, I agreed that they sucked and recommended that the HHS Dept. be forthcoming with the data anyway. When the Hawaii exchange was still subject to the infamous Heartbleed bug a week or so after it was publicized, I called them on it publicly. When states like Massachusetts subjected a couple hundred thousand of their citizens to a shaky, uncertain "limbo" status due to their exchange being screwed up, I didn't try to cover that over. When a solid case was made that the "3.1 million" young adult figure that the Obama administration has been touting for months may actually be only half of that, I presented the argument, the source, the reasoning and make sure to include the lower figure on The Graph. When the RAND Corp. survey claimed that there have been an additional 8.2 million Employer-Supplied Insurance policies since last fall, I declined to add them to the total due to the bold claim and lack of any collaborating evidence (I still list this figure as a footnote, but am not including it on the Graph).
The numbers are the numbers.
I say all of this because the following is sure to cause quite a bit of controversy...but a) it's related to the ACA, b) it's a serious issue and c) it's horrifying.
Hmmm...this article about Michigan's final ACA exchange tally is very specific about the Healthy Michigan program (Michigan's ACA expansion program), claiming the total is nearly 200K total...but if so, this would be an increase of over 41,000 from just 3 days earlier, which I find hard to believe (though that'd be awesome if it's correct).
199,862 minus the 36,307 who were bulk-transferred over from the existing state program = 163,555. The update from just 3 days ago had the total as 158,654.
HOWEVER, it occurs to me that I may have actually assumed that the 158K figure included the 36K transferees...if it didn't, then this makes much more sense, since the difference over those 3 days is only 4,901 people.
If that's the case, then this is VERY impressive indeed, and I apologize for lowballing the earlier number! I'll go ahead and use the higher number for now; on Monday there will a new official update on the state government site, and I can verify things one way or the other:
"Healthy Michigan" is the plan which specifically refers to ACA expansion in MI only (36,307 of these are actually bulk-transfers from an existing program, already listed separately on the spreadsheet):
Healthy Michigan Plan Enrollment Statistics
Total Healthy Michigan Plan Beneficiaries: 139,774
A few days ago, Michigan's newly-expanded Medicaid tally sat at around 32,000, plus another 54,000 people transferred into the program from an existing state-run one, for a total of about 86,000 people.
Today that number has grown to over 109K:
Healthy Michigan Plan Enrollment Statistics
• Updated every Tuesday at 3 p.m.
Total Healthy Michigan Plan Beneficiaries (including ABW transition prior to April 1): 109,228
Total Enrollment in Healthy Michigan Plan after April 1: 72,921
Yesterday I posted an update for Michigan's just-started Medicaid expansion. Officially the number was about 32K, but there was a reference to "tens of thousands more" transferred over from an existing state-run healthcare program (similar to the 650K LIHP transfers in CA, the 107K transferred from Commonwealth Care in MA and so on).
Today, it turns out that "tens of thousands" actually meant a whopping 53,700 people:
Since April 1, Michigan has received 54,479 applications and enrolled 32,071 Michiganders into the Healthy Michigan Plan. The difference represents those with applications that are pending confirmation, others who were eligible but enrolled in different Medicaid programs or have applications in progress or have been denied. Prior to April 1, MDCH transitioned the previous Medicaid Adult Benefits Waiver population into the program with coverage beginning on April 1. These enrollment activities combined mean that Michigan has already enrolled 85,761 residents into the new program.
This is great news for two reasons...not only has the Michigan Medicaid expansion already shot up another 5K in just the past day or two, but at least 20,000 ("tens of thousands") more people have been added to the Medicaid tally due to bulk transfers (similar to the 650K LIHP transfers in CA, 107K Commonwealth Care transfers in MA and so on):
The Healthy Michigan program has received nearly 55,000 applications since April first. 32,000 Michiganders have already had their applications approved. And tens of thousands more have been moved into the expanded Medicaid program from a different state health assistance program.
Now that my home state of Michigan has finally joined the Medicaid expansion program, the numbers are starting to come out, and are pretty impressive right out of the gate:
The Department of Community Health says that as of 12 a.m. Monday, roughly 27,000 individuals had been enrolled in Healthy Michigan, which is intended to provide health insurance for hundreds of thousands more low-income adults.
So, I just received a press release from Blue Cross Blue Shield of Michigan (BCBSM), which includes a bunch of data covering the full open enrollment period.
The key part for me is this:
DETROIT, April 2, 2014 – At the close of the six-month ACA Marketplace open enrollment period, Blue Cross Blue Shield of Michigan and its HMO subsidiary, Blue Care Network, were selected by more than 300,000 Michigan consumers.
...BCBSM will report final, confirmed numbers later this month once all enrollments are processed and tabulated by the federal government. The results announced today are initial figures based on reporting by the federal government and BCBSM’s records:
180,000 members enrolled with BCBSM and BCN “on-Marketplace,” meaning through Healthcare.gov.
53,000 members enrolled “off-Marketplace,” meaning directly through the companies.
However, this is a bit confusing, because there aren't any other enrollment numbers listed. 180K + 53K = 233K. If the total is over 300K, where are the other 67K?
That's right, Medicaid Expansion finally came to Michigan starting today, April 1st, 2014:
Enrollment began Tuesday for Healthy Michigan, which extends Medicaid eligibility to adults making up to 133 percent of the federal poverty level, or about $16,000 for an individual and $33,000 for a family of four.
By 4 p.m. Tuesday, 11,848 applications had been received, and 4,152 had been automatically approved, according to the Department of Community Health. The state expects 320,000 residents to sign up in the first 12 months. The number could grow as high as 470,000 over time.
I actually have Michigan down as having up to 500,000 people qualifying for expansion, but whatever. I'm not entering this into the spreadsheet or anything yet; I really want to lock down the March numbers before I start up with the April ones. However, it was at least worth mentioning, especially since this is my home state and all... :)
Back when I assumed that I'd be pulling the plug on this website after March 31st, I didn't see the point of keeping track of the states which finally came around and added Medicaid expansion after the end of the Open Enrollment period. Not that I didn't think it was important, mind you; I just assumed that this site would be winding down in early April anyway, so it would be kind of pointless.
However, now that practically every state is extending their enrollment out to April 15 (or beyond, in a couple of cases) for those who started their application before Monday, along with the fact that Medicaid enrollment doesn't have a deadline anyway along with numerous other exceptions, it behooves me to make note of additions to the Expansion party as they come along.
From today's Detroit News, strong anecdotal evidence that Michigan, at least, is already seeing a spike in enrollment activity. The article also notes something that I didn't realize: I knew that anyone enrolling between 3/16-3/31 wouldn't have their policy coverage kick in until May 1st (and I've written about thisseveral times), but I didn't realize that those who do so would have to apply for an exemption from the IRS next year:
Health insurers and advocates are expecting a surge in enrollment for insurance plans Saturday, the deadline to guarantee coverage beginning on April 1.
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:
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.
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!