New York

Ka-pow! This is the other big state exchange number I've been looking for this week (after California, of course). The New York State of Health exchange hasn't put out an official press release yet, but within the past hour they quietly updated the home page of their website with the new total enrollment number: 666,397.

Lame "Mark of the Devil" jokes aside, this represents a nearly 13% increase over just 8 days ago.

Eureka! I just received an explanation from the New York Dept. of Health of the mysterious 40,000 QHP enrollment discrepancy between the February HHS report and the New York State of Health press releases--apparently the additional 40K are newly-added enrollees in NY's Child Health Plus program, which is privately operated (and thus not included under Medicaid/CHIP) but is also technically not an official "Qualified Health Plan" by the technical definition.

According to the NY DOH, the higher NYSoH enrollee numbers include both the technical QHPs as well as enrollment in the state's CHild Health Plus program. This program covers kids up to 19 years old, with subsidies given for families up to 400% of the FPL. Therefore, children who fit this criteria get enrolled in Child Health Plus instead of actual QHPs.

They've specifically confirmed that "over 40,000 additional children have been enrolled in Child Health Plus through the Marketplace."

The February HHS Report included some especially confusing numbers out of the two largest state-run exchanges, California and New York, as both seemed shockingly low given how successful they both seemed to be doing in the first half of the month.

In the case of California, they were kicking serious ass in the first half of February, averaging around 7,200 QHP enrollments per day. Unfortunately, a few days later the CoveredCA exchange was hit with a very nasty technical problem which brought things to a standstill for not the 3 days that I thought, but 5 days. Result? The daily average dropped from 7,200/day in the first half to only 2,800/day for the second half of the month:

Enrollment in Obamacare coverage slowed last month in California, hurt by a recent website outage.

New federal data show 868,936 Californians signed up for health insurance in the state's exchange through March 1.

I ran into a similar issue a month ago, and thought I had straightened it out, but there's a major disconnect between the official HHS numbers for New York and the NY State of Health press release data.

According to HHS, New York only enrolled 33,328 people in February:

However, here's the official QHP enrollment numbers according to NY State of Health:

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!

While it's great to see an official press release instead of just the number on the website, and it's also great to see that the new number is 32,000 higher than 5 days ago, it's rather irritating and strange that nowhere in the press release do they break out the QHP/Medicaid numbers.

ALBANY (March 10, 2014) – NY State of Health (NYSOH), the State’s official health plan marketplace, reported that as of 9 a.m. today, 908,595 New Yorkers have completed their applications and 590,639 have enrolled for coverage since the launch of the Marketplace on October 1, 2013. More than 70 percent of those who have enrolled to date were uninsured at the time of application. Over the last week alone, enrollment has increased by more than 55,000.

Fortunately, the New York Daily News is reporting that breakout as :

There hasn't been any sort of press release yet, but the total enrollment figure on the home page of the New York health exchange shot up over 11% today, from 501,205 up to 557,840, a jump of over 56,000 people.

I don't have the Private QHP/Medicaid breakdown yet, but the ratio has quickly shifted from 60 private/40 public through early February to a 23/77 split in favor of Medicaid a couple of weeks ago. I'm going to error on the side of caution and assume that this trend has continued, so I'm going with a 20/80 split for the new additions until the actual numbers are released. I'll be more than happy to be overly cautious on this if the breakout is more favorable to private QHPs,  however.

In any event, a 20/80 split would mean the 56,635 additional enrollees break out as 11,327 Private QHPs and 45,308 Medicaid/CHIP, for totals of 288,008 & 269,832 respectively.

OK, I'll have to pull the numbers apart a bit because this story with New York's latest enrollment tally has some overlapping dates and numbers:

More than 800,000 New Yorkers have completed applications to enroll in New York's health-care exchange since Oct. 31, and 501,205 have officially enrolled, a 22 percent increase since Feb. 10, the state Health Department said today....

The state said that 70 percent of those who have enrolled were uninsured at the time of application. But the state didn't immediately say how many of those lost insurance because of the federal Affordable Care Act.

Of the total 501,205 people enrolled, the state said 276,681 chose private insurance plans, while 224,524 qualified for coverage under Medicaid, the government-sponsored health insurance program for low-income Americans.

This morning I noted that New York has seen a dramatic increase in the percent of their ACA enrollees who were previously uninsured, rising from 66% of the total on 1/10 up to 69% as of yesterday. While a 3% increase doesn't sound like much, this is especially notable because, as I demonstrated, it means that between 92 - 100% of the newest enrollees were previously uninsured (probably around 95%), since that's what it would take to raise the overall enrollment up with such a comparatively small number of additional enrollments.

However, I forgot another, earlier NY update which fills in this picture even further. Back on January 13, there was another press release which noted that as of December 24, 2013, about 50% of the 230,624 New York enrollees were previously uninsured:

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.

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