North Carolina

2018 MIDTERM ELECTION

Time: D H M S

A quickie:

Insurance giant UnitedHealthcare this week became the third health insurer to propose selling federally subsidized health insurance in North Carolina, a move that would expand choice and increase competition here.

BCBSNC reports 232,000 QHPs sold on the ACA exchange...but that's out of about 273,000 total enrollees; they've removed the other 15% who haven't paid their premium yet:

The Blue Cross enrollments reflect insured customers who signed up from October through May 1 and are still paying premiums. About 15 percent of customers who signed up never paid a premium and are not included in the 232,000 figure, Burke said. 

So, fine: 85% for Blue Cross of NC. As it happens, NC sold a total of 357,584 policies total, which means BCBSNC sold over 76% of the total.

Now, it's conceivable (but not likely) that 100% of the remaining 84,500 enrollees snapped up by other companies did pay their premiums, but even so, that would only bring the paid percentage up to about 88.5%. So, I think it's safe to say that for North Carolina, 85% is a reasonable "How many have PAID???" figure for the full state until more solid numbers are released.

This number out of NC is a bit squirrelly; I'm not updating the actual spreadsheet with it, but it's still worth at least mentioning:

Overall, Terrell said, the state has received 95,000 Medicaid applications via the federal ACA sign-up, representing 132,000 people, since October 2013. And that number is likely to grow. 

The number of people added to Medicaid/CHIP in NC thru 3/01 via the HC.gov site was 55,691, so this could potentially be a more than 2.3x increase, but they're noted as applications, so presumably some of them will be denied. Still impressive.

(SIGH) OK, in the words of Emily Litella..."never mind..."

It looks like I was right to be suspicious of the seemingly fantastic QHP enrollment numbers reported out of both North Carolina and Louisiana.

Thanks to Jed Graham (via Twitter) for pointing me towards Page 21/22 of the February HHS Report. Normally I only focus on the 3rd and 4th columns ("Determined or Assessed Eligible for Medicaid / CHIP by the Marketplace" and "Number of 
Individuals Who Have Selected a Marketplace Plan", since these are the actual exchange enrollment numbers through the end of that month.

OK, I either have some very good news...or one heck of a misunderstanding here.

Earlier today I updated both New York and Colorado's QHP numbers...and while both were very fine, they were actually down somewhat from last week (large drop for NY, small one for CO). This may actually make sense, as both of these state exchanges have been running very smoothly for months now; it's possible that they've simply started to reach the end of the line in terms of residents actually signing up (or perhaps they'll both experience a final mini-surge right at the tail end this weekend).

However, the apparent news out of both North Carolina and Louisiana has me thrown for a heck of a loop (visit the links for details).

Good gravy. 391,000 people in North Carolina?? They were only at 200,546 as of 3/01. Even if you assume this number includes Medicaid enrollments, that's still only another 55,691 as of 3/01...and NC is not an expansion state. Assuming that 391K includes both...and assuming the same 78/22 split between the two...that still suggests that QHPs have gone up to around 305,000, a 105,115 increase over the end of February, and over 3.8x the February daily rate.

If it doesn't include Medicaid (which seems likely from the wording of the article), then it's a whopping 190,454 increase--a doubling of their 3/01 total, and a near 7x increase over February.

I find either of these rather difficult to believe, so for the moment I'm only entering it into this blog entry. If I can confirm the QHPs as either of these I'll change it tonight or tomorrow.

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.
  • 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!

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