OE4

At long last, the New York State of Health ACA exchange has released hard enrollment numbers for the 2017 Open Enrollment Period:

22 Percent Increase Over Last Year  •  New Yorkers Show Demand for Quality, Affordable Healthcare

ALBANY, N.Y. (January 6, 2017) – NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.4 million people have enrolled in health insurance through December 24, 2016.

With almost a month to go until the end of the 2017 Open Enrollment period, participation in the NY State of Health Marketplace has already increased more than 22 percent since the last Open Enrollment period ended, January 31, 2016. Enrollment has increased in all 62 counties of the state. The overall share of New Yorkers now enrolled through the NY State of Health has reached nearly 18 percent of the state’s population.

OK. Today saw fresh enrollment updates from Rhode Island (nominal), Covered California (impressive) and, most significantly, HealthCare.Gov (which not only covers 39 states, but also finally includes auto-renewals). I now have auto-renewal for 48 states + DC included in the mix, and the numbers are current through 12/31/16 or later for 41 of them. I still have no data whatsoever from Vermont (ironic, given their history of progressive healthcare policy, Bernie Sanders, etc), and only very limited data out of New York (they mentioned 55,000 enrollments over a 3-day period just ahead of the December deadline, but nothing from before or after that).

As i noted last week, with all renewing enrollees accounted for, Rhode Island's ACA exchange is likely to come up short not only of my pre-election projection (40,000 enrollees), but will likely see a drop from last year's 34,670 QHP selections. They had only hit 29,312 QHPs as of Christmas Eve, and have only tacked on another 580 people since then:

INDIVIDUAL AND FAMILY ENROLLMENT • As of December 31, 2016

Hot on the heels of Covered California's update just moments ago, the HHS Dept. has posted their latest bi-weekly Snapshot report. While the extra 2 weeks of data is obvoiusly important, the key number I've been anxiously awaiting is the auto-renewal number, which is finally included in today's report:

Biweekly Enrollment Snapshot  •  WEEKS 8 AND 9, DEC 18 – DEC 31, 2016

8.8 million Americans have signed up for coverage through HealthCare.gov since Open Enrollment began on November 1st.  This compares to about 8.6 million plan selections last year at this time, demonstrating Americans’ strong and growing demand for affordable, quality coverage.  Total plan selections as of December 31st, which include auto reenrollments, consist of 2.2 million new consumers and 6.6 million returning consumers. Among returning consumers, two thirds, or 4.4 million, actively selected a plan, an increase from last year’s already high levels of consumer engagement.

Between the big December deadline (for January coverage) having passed and the holiday season, the actual OE4 enrollment data has been pretty sparse the past few weeks. A few minutes ago, however, Covered California broke the enrollment news drought (no pun intended) with a press release which, while not primarily focused on the actual enrollment data, nonetheless includes a solid update:

Covered California Brings Health Care Within Reach and Shows How Consumers Can Save by Shopping

IMPORTANT: SEE MAJOR UPDATE/CORRECTION HERE!
ACTUAL NUMBER LIKELY TO LOSE COVERAGE: 2.5 MILLION

New York is a little different: For one thing, they haven’t actually released any 2017 Open Enrollment data yet (other than a cryptic “55K enrolled over a 3-day period", which isn't very useful). They should be up to around 200K w/out auto-renewals by now. More significantly, they're one of only 2 states (Minnesota's the other) which features the ACA's Basic Health Plan. Unlike QHPs, which are divided into subsidized and unsubsidized enrollees, the BHP program is entirely dependent on ACA financing, so if the law is repealed, all BHP enrollees are kicked to the curb, just like Medicaid expansion enrollees would be.

OK, this appears to be quickly turning into my next project thing. The methodology here is pretty much the same as the other states; the only major difference is that while I do know the total Medicaid enrollment for each county (as of December 2016), I don't have that broken out between traditional and expanded Medicaid. Fortunately, I have a hard state-wide number for that: Around 398,000, or roughly 20.8% of the state-wide total. I've therefore multiplied each county number by 20.8% to get a rough estimate of the ACA expansion tally for each.

Like Texas, I'm also no longer expecting Arizona to beat last year's Open Enrollment total by much. Assuming 209K QHP selections, there should be around 125K indy market enrollees and 399K Medicaid expansion enrollees who'll be in a world of hurt post-repeal, or roughly 524,000 altogether.

(sigh) OK, after doing this for Michigan earlier today, I said that I wasn't gonna do this for every state, and I'm not...but the irony is that the 19 non-expansion states are actually easier to compile this data for than the expansion states...because you can't rip away healthcare from someone you never provided it to in the first place. Anyway, someone requested that I do a county-level estimate of how many people would likely lose their healthcare coverage in Texas under a full repeal of the Affordable Care Act, so here it is.

Regular readers (and Twitter followers) know that for the past month I've been heavily pushing my state-by-state analysis projecting how many people I expect to lose their healthcare coverage if/when the Republican-held Congress follows through on their promise to repeal the Affordable Care Act. As noted in that post and the various links within it, part of the projection is very specific and confirmed (ie, the exact number of Medicaid expansion enrollees), while the rest is more speculative. For one thing, I don't know exactly how many people will have enrolled in ACA exchange plans, because we're still in the middle of the open enrollment period; even then, the percentage of those enrollees who will be receiving APTC assistance is still unknown as well...and even then, not all of those folks will be receiving substantial subsidy assistance which would make or break their ability to keep their policy.

This is just a minor update from a few days ago, but the article does a nice job of breaking the numbers out so it seems worth closing the year out with this Access Health CT update:

The numbers below are as of the end of day on Dec. 29 are:

Me, September 12, 2016:

Remember, the ACA's Medical Loss Ratio rule (80% of all premiums have to go towards actual healthcare, leaving only a 20% maximum margin for administrative/operational costs) already does a pretty good job of keeping carriers from outright gouging enrollees...although that only comes into play when the carriers would otherwise be spending less than 80% on healthcare claims. In cases where they're already spending more than 80%, it's kind of moot...and for the past couple of years, many carriers are at 100% or higher, which is the main reason some of them are pulling out of the market next year in the first place.

In other words, unlike other "retail" markets where more competition is generally considered to automatically help keep prices down, there's only so much that more players can do in the individual health insurance market. If everyone is already losing money, adding one more to the mix isn't gonna make anyone else drop their rates further.

I just noted this morning that Rhode Island's enrollment numbers for 2017 are coming up significantly short of not only my own admittedly unrealistic hopes (I was hoping RI would buck the national trend and beef up enrollment by 15% this year), but is likely to actually come up lower than last year's 33.9K by several thousand people.

Fortunately, the opposite is proving to be the case in Massachusetts:

Through yesterday, we had 240,745 enrolled in January 2017 coverage...these are people who paid their bill. There are an additional 11,803 people who selected a plan but haven't paid for it yet. That's a total of 252,548.

That's, 252,548 QHP selections as of 12/28/16, of which over 95% have actually paid their first monthly premium (well above the 90% payment national average).

Rhode Island is one of three states (along with Washington and Massachusetts) which allowed people to enroll for January coverage as late as December 23rd. RI's numbers have also included auto-renewals for some time now, so today's report includes everyone whose 2017 policies will kick off effective this Sunday, January 1st:

INDIVIDUAL AND FAMILY ENROLLMENT  •  As of December 24, 2016

Oof. I've been compiling a lot of charts and graphs the past week or so based on what I thought were the most comprehensive 2017 enrollment numbers available to date. The biggest data gaps are Vermont and New York, neither of which has released any enrollment data yet...or so I thought.

However, I somehow completely forgot this post from the thick of the original December 15th deadline:

In the past three days, more than 55,000 New Yorkers have enrolled or renewed coverage through NY State of Health. The Customer Service Center has answered more than 1,000,000 calls since the start of Open Enrollment on November 1 and an average of 46,000 calls a day this week. The NY State of Health website has also experienced high traffic reaching 12,000 users in peak hours.

...This is also the first time this enrollment period that NYSoH has released any actual enrollment data: 55,000 renewals + new signups. Unfortunately, that number only includes 12/12 - 12/14...no earlier numbers are included. Still, I'll take what I can get...

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