Of course, as I (and others on both sides of the political spectrum) have written about many, many times, not everyone who selects a QHP (either on or off the exchanges) actually pays their first premium, and therefore is never actually enrolled in an active, effectuated policy. This amounted to roughly 12-13% of all QHP selections in 2014, but got a bit better over the next two years as people got used to how the system works and technical improvements were made. In addition, another chunk of QHP selections were scrapped by the HHS Dept. or state exchanges at later points thorughout 2014 for a variety of reasons ranging from legal residency issues to other data matching problems. Again, this percentage has been gradually whittled down as improvements to the system have been made.
New Hampshire has only 5 carriers offering individual market policies, all 5 of which will still be participating in the NH market next year as well. Two of the five (Community Health Options and Minuteman Health) are among the 7 surviving ACA-created Co-Ops.
Even so, NH is proving to be a very tricky state to estimate, because only one of the 5 carrier rate filings includes their actual current rate-impacted enrollment data. As a result, I've had to take my best shot at estimating the market share of the other four. The only way I could think of to do this was to look up the latest NH DOI 2016 QHP Monthly Membership Report. New Hampshire, to their credit, is one of the only states without their own state-based ACA exchange which still actually posts regular reports about how many residents are enrolled in ACA exchange policies. Furthermore, they even break these numbers out by metal level and carrier, making the relative market share easy to calculate.
A couple of days ago I noted that after two years of nothing but doom & gloom (and coming just a week after UnitedHealthcare pulled the plug on the individual market in over two dozen states) there seems to finally be some positive developments, with companies like Centene and Anthem reporting better-than-expected results. They may not be making a profit yet, but at least they aren't losing money hand over fist the way they did the first couple of years.
I also made a brief mention of the Maryland Co-Op, Evergreen Health, which reported their first quarterly profit since launching 2 1/2 years ago.
Consumer operated and oriented health plans in Maryland, New Mexico and Massachusetts will report profits in the first quarter, in a sign that some of the remaining Affordable Care Act-created nonprofits could be finding their footing on the state exchanges.
At the time, I noted that unlike most states, their effectuated numbers seem to have increased from February to March (January doesn't really apply since Open Enrollment was still ongoing at the time):
January 2016 Exchange-Based QHP Enrollment: 49,937 (+33,604 PAP enrollees)
February 2016 Exchange-Based QHP Enrollment: 53,109 (+38,735 PAP enrollees)
March 2016 Exchange-Based QHP Enrollment: 55,212 (+43,732 PAP enrollees)
In a classic case of missing the forest for the trees, I posted two very wonky, detailed entries over the past couple of days about Minnesota and Connecticut's latest enrollment numbers...but completely missed one crucially important data point.
Regular readers may have noticed that I've been posting fairly lightly of late. Now that open enrollment is over and we're deep in the thick of primary season, I'm trying to catch up with the massive backlog which has built up in my day job.
However, there's still a lot of stuff going on; today, for instance, brought some very positive Medicaid expansion news out of two states:
And then there are the portions of the law which have gone, well, not so great, to put it mildly...in particular the non-profit, public/private hybrid Co-Ops, which are the only remaining remnant of the originally much-hoped-for "Public Option". For a variety of reasons, not the least of which was an utterly unnecessary and ultimately pointless stunt pulled by Marco Rubio and other Congressional Republicans (aka the Risk Corridor Massacre), over half of the two dozen Co-Ops nationwide melted down in spectacular fashion last fall, leaving only 11 of them surviving into 2016 after the dust settled.
In light of this, I figured it would be worth posting some positive Co-Op news for a change. First up, Ohio.
(sigh) OK, this one is not related to the Risk Corridor Massacre, since Community Health Options was actually profitable in 2014 and therefore never qualified for any RC payments anyway. Also, unlike the dozen ACA-created co-ops which are in the process of winding down operations by the end of the year, CHO is not going out of business, and in fact is remaining fully operational for 2016.
Maine's Community Health Options said Dec. 9 that it will cut short its sales of individual policies for 2016, in a sign that it is the latest Affordable Care Act-funded consumer operated and oriented plan to encounter financial difficulties.
I admit that given the carnage of the past couple of weeks, I'm almost afraid to post this entry...but I had to write something positive about the CO-OP situation.
With the ACA-created CO-OPs seemingly dropping like flies due to the #RiskCorridorMassacre, I thought this would be a good time to flip things around and look at which CO-OPs are doing well (or at least not badly).
This isn't much, but it'll do for now:
Wisconsin's insurance department says it has no intention of shutting down its #ACA co-op, which appears it will remain solvent next year.
In 2015, New Hampshire’s exchange had five carriers, up from just one in 2014. There will still be five carriers in 2016, although there’s one swap: Assurant/Time is exiting the market (nationwide), but Ambetter (offered by Celtic) is joining the exchange in New Hampshire.
...Two carriers in the exchange – Minuteman Health and Community Health Options – have requested double digit rate increases, although they have not yet been approved. Both carriers are CO-OPs created under the ACA, and both expanded into New Hampshire at the start of 2015, so their claims data for the state is very limited.
This article about New Hampshire reveals 3 noteworthy bits of information: First, it looks like at least one of the 37 HC.gov states will be reporting their exchange enrollments monthly during the off-season, even if the HHS Dept. itself refuses to do so:
The New Hampshire Insurance Departmentrecently began requiring insurance companies selling plans through the marketplace to submit monthly enrollment numbers.
Second, here's the first results of those monthly reports:
According to the latest numbers, a total of 45,504 people had signed up for plans in New Hampshire by April 1
I have a ton of ACA-related stories cluttering up my in-box again; here's some of the more interesting ones, all regarding ACA Medicaid Expansion:
For months now, I've been a bit obsessed with figuring out how my home state's Medicaid expansion enrollment has managed to reach as high as 21% more people than were supposedly even eligible for the program. Estimates last year ranged from 477,000 - 500,000, yet enrollment in Healthy Michigan (Gov. Snyder's name for Obamacare Medicaid Expansion) currently sits at a whopping 579K, less than 1 year into the program.
New Hampshire's ACA Medicaid expansion program got a late start, not kicking off until July 1st of this year. That makes the fact that they've already reached 50% of their total potential enrollment all the more impressive:
State officials had expected 30,000 to 40,000 of the estimated 50,000 eligible adults would sign up in the first year either through the state's managed care program for Medicaid or a program that subsidizes existing employer coverage. As of mid-week, just fewer than 25,300 had signed up.