New York

Over the weekend, I threw some cold water on the ACA enrollment momentum theme with a one-two punch: First, I pointed out that the February report will only include 4 weeks of data (2/02 - 3/01) vs. January's 5 weeks (12/29 - 2/01); then I looked into the actual data to see if this story from Yahoo Finance was correct in suggesting that enrollments have dropped off even on a daily-average basis since January.

Ah, just in time to help clear up my confusion about the New York situation from over the weekend: The latest tally has NY with a total of 266,177 private QHP enrollments, up 14,871 from 251,306 a week earlier. Medicaid enrollment via the exchange is up to 189,865 from 160,915, an increase of 28,950.

This is noteworthy for a couple of reasons. First of all, this gives some additional, solid data to plug into my weekend "NY Enrollment Number Mystery Project" that I've written a couple of posts about the past few days. Connected to this, however, is something which may be cause for a bit of concern--up until now, New York has been bucking the tide and averaging around a 60/40 split in favor of private QHP enrollments. Today's additions, however, reverse that with the numbers switching to 34/66 in favor of Medicaid enrollments:

Another 44,000 people enrolled in a health insurance plan through the state's exchange over the past week, pushing the total to 456,042, according to the state Department of Health.

Earlier today, I pointed out some potentially bad news for total ACA enrollmentthat February's enrollment tally is likely to be a good 20% lower than January's for the simple reason that the February HHS report is only going to include 4 weeks' worth of data, while January's included 5 weeks. Nothing neferious or evil going on here, just measuring 28 days instead of 35 (for the record, the final report for March will include 30 days' worth of data (March 2nd - 31st)).

While writing up the main part of the entry, however (which addressed a Yahoo Finance article which claims that February enrollments will be way down for a variety of unrelated reasons), I noticed something very curious about New York's enrollment numbers. I went into this in the earlier entry but decided that it's important enough to merit it's own full repost.

Here's the official enrollment numbers from the October, November, December and January HHS Reports...and the most-recent official press release from the NY State of Health Exchange:

Ahead of the full January report expected from the HHS Dept. sometime this week, the NY State of Health (New York's exchange) gave out two key numbers. Total enrollments have gone up by over 8% in the past week (from 380,747 to 412,221), which is a nice bump...but the more significant news (politically speaking) is the announcement that 2/3 of those were not previously insured.

ALBANY (Feb. 10, 2014) – NY State of Health (NYSOH), the State’s official health plan marketplace, reported that as of 9 a.m. today, 696,880 New Yorkers have completed their applications and 412,221 have enrolled for coverage since the launch of the Marketplace on October 1, 2013. Sixty-six percent of New Yorkers who have enrolled to date were uninsured at the time of application....

"We are thrilled to see that more than 412,000 people have enrolled for quality, low-cost health insurance and nearly 697,000 have completed applications since the Oct. 1 launch of the marketplace. Also, 66 percent of enrolled New Yorkers were uninsured when they applied,” Donna Frescatore, executive director of NY State of Health, said.

In my prior estimated breakdown, I had NY private QHP's as 237, 411 and Medicaid/CHIP at 106,785. Turns out I was only missing 3,800 on the private side, but they've added an additional 30,000+ more on the Medicaid/CHIP side.

Of the 380,747 who have signed up, 241,242 people have enrolled in private health plans and 139,505 have enrolled in Medicaid.

I should note that just as the Private QHP number doesn't include direct off-exchange enrollments, neither does the Medicaid/CHIP tally; when you add those, the new Medicaid enrollment total comes to over 330,000 for New York.

OK, no press release or private/public breakdown yet, but the home page of New York's health exchange website is displaying a total of 351,605, up from 328,796 as of January 20.

Assuming the same 67/33 split that their previous exchange enrollments have followed, that means roughly 15,400 private enrollments and another 7,409 added to Medicaid/CHIP. I'll adjust these numbers as appropriate once a formal press release comes out.

In addition, this is the first update that takes us beyond January 23 (the date of the "3 Million" announcement), so only about half of that 15,400 will be subtracted from the "Not Broken Out Yet" amount. And with that, we've moved onto Week 17.

The story itself is pretty negative on the SHOP Small Business exchanges--apparently the Federal one (at HC.gov) won't be ready until this fall--but it at least gives the SHOP enrollment number for New York.

Exchanges in larger states aren’t doing much better with their business plans. In New York, about 5,000 employees of small businesses have enrolled in the SHOP exchange, James O’Hare, a spokesman for the state’s Department of Health, said in an e-mail.

Last week I took an uncharacteristic gamble by not trusting my instincts about the off-hand "7,000/day in January" comment made by the Deputy Director of NY State of Health; her claim seemed quite a bit off-base compared with the official press release a few days earlier, but I decided that she must know the numbers better than I did, so I went with it.

Today, the newest official numbers were released, and as it happens, I should have trusted my instincts--while the totals are still impressively higher than the prior numbers, they're still lower than the "7K/day" number indicated. In any event, NY is up to 222K private QHPs and about 107K Medicaid/CHIP, which still pushes them above 100% of their CMS projection for the enrollment period.

The newest figures show that as of 9 a.m. Monday, 587,486 people had completed their applications on the insurance exchange and 328,796 went on to enroll in some sort of coverage. 

A few days ago the New York exchange released an oddly-worded press release which mixed some numbers through December 24 with other numbers through January 12. My reading of it at the time was that the state had added roughly 53,000 (private QHP + Medicaid/CHIP combined) since 12/30.

However, today, the Deputy Director of the NY exchange stated that they've been enrolling "about 7,000 per day" total in January...which adds up to 98,000 if you assume that runs through yesterday, the 14th. Even subtracting the extra 2 days, this means her number is 31,000 higher than yesterday's press release, but I'm not about to argue with the Deputy Director of the exchange, so another 98K it is. Assuming this breaks down roughly 72% Private QHP to 28% Medicaid/CHIP (as prior numbers have in NY), that comes to about 70.6K private and 27.4K public.

In addition, this pushes New York over the top in terms of their original CMS projection of 218,000 private QHP enrollments by March 31st. They should easily double that number by the end of the enrollment period, and could potentially hit 2.5x at this rate.

Still waiting for clarification of the distinction between private enrollments and Medicaid/CHIP expansion on the new additions, but assuming they're a similar ratio to the prior enrollments, it should be roughly 38,500 private and 14,500 Medicaid/CHIP. If that ratio is close, this means that New York has essentially reached their March 31st private enrollment projection of 218,000 (give or take a few thousand).

Bonus: It was also revealed during NY State Senate testimony today that a whopping 40% [Ed: 30%, thanks to DwightKSchrute for the correction] of enrollees are under 35, and another 16% are between 34-44. This should go a long way towards quieting the ""young invincibles" aren't signing up!" ACA attack point.

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