Washington State

2018 MIDTERM ELECTION

Time: D H M S

As you can see from the graphic I posted yesterday (and had to revise several times throughout the day), the official enrollment deadline for private policies starting on January 1st, 2015 has now passed for all 37 states operating via HealthCare.Gov, as well as residents of DC, Hawaii and Kentucky. It's certainly possible that any or all of these will announce some sort of "special circumstances" allowance for those who didn't make the midnight cut-off (10pm in Alaska), but I'm assuming those would be done strictly on a case-by-case basis.

OK, so what about the remaining 11 states?

Well, 4 of them (MD, MA, RI & WA) had later deadlines for January coverage all along: Maryland on 12/18 (Thursday) and the other 3 on 12/23 (next Tuesday).

New York and Idaho bumped their deadlines out from yesterday until 12/20 (Saturday), although Idaho had previously claimed that their deadline was 12/23, but are now claiming that it was originally 12/15. I still don't understand what happened there, but so be it: 12/20 it is for ID.

BOOM, there it is: Washington State has been pretty quiet on the update front, due, no doubt, to having to clean up a rather embarrassing screw-up on the part of their IT systems integrator a week or so ago when over 6,000 account enrollments/payments were accidentally cancelled.

However, I'm very happy to report that not only do they appear to have resolved most of this issue (2/3 of the accounts have been restored so far), but they've released detailed, up-to-date data...and it's pretty damned impressive so far:

Updated enrollment totals are included below:

Qualified Health Plans - New: 10,082
Qualified Health Plan Renewals: 45,843
Total: 55,925

Washington Healthplanfinder Business
Accounts Created: 1,550
Total Completed Applications – Link Sent to Employees: 73
Total Enrollments – Employee Plan Selection Complete: 3

*Note: These numbers reflect QHP enrollments through Dec. 10 and Medicaid Enrollments through Dec. 4.

They also reported on the Medicaid (Apple Health) situation:

On the one hand, moving from 2,000 in the first 3 days to a minimum of 6,000 (likely more like 10K, since the 6K refers only to "accounts" not "people") in the first 17 days is a perfectly reasonable point for Washington to be at right now.

On the other hand...well, here's the press release:

Today, the Exchange identified an error affecting 6,000 customer accounts enrolled in Qualified Health Plans. Early analysis indicates that our system integrator, Deloitte, ran an automated enrollment cancellation process in error. The affected accounts, which are a portion of the total number of customers who are enrolled in coverage starting on Jan. 1, 2015, experienced an erroneous cancellation of both their enrollment and payment for 2015 coverage.

Oops.

Well, on the plus side, the rest of the PR makes it clear that a) they're on top of it, b) it's gonna get resolved ASAP and c) it looks like this screw-up was Deloitte's fault, not the actual exchange itself (they call them out by name, which is noteworthy).

This article from the Seattle Times is primarily about the Washington State exchange still having some technical problems, but there's also a key #OE2 enrollment nugget:

Of the 25,000 applications completed on the exchange so far in the first week of the second round, more than 10,000 are for insurance plans while the remainder are Medicaid applications. Officials don’t yet know how many are people renewing their coverage, as opposed to new customers. Roughly 2,000 of the applicants have scheduled their first payments.

There you go: 10K applications, 2K actually selected & enrolled. Since the article was published at around 6pm on Tuesday, I'm assuming that number runs through Monday night.

As I posted last night, most of the ACA exchanges seemed to be running pretty smoothly for the launch this year, with two exceptions: CoveredCA, which was having some sort of serious problems throughout the day (I'm not clear how widespread they were), and the Washington Healthplanfinder, which was actually deliberately taken completely offline after only a few hours, and remained offline until this morning:

The problem was noticed during the site’s first hours of operation on Saturday morning, the first day of open enrollment for 2015 plans. The staff decided to take the site down for repairs at 10 a.m.

The good news is that the issue appears to have been fixed, and it didn't impact too many people (of course, that also means that an unknown number of potential enrollees were lost in the interim). In any event, it looks like we also have an unofficial Day One enrollment number, anyway:

I haven't done these average-rate-increase posts in a while, but this one came across my screen today so I figured I should post about it.

Back in August, Washington State announced that they had final approved rates on the 90 plans being offered on the WA exchange, with an average increase of 1.9%. However, I didn't know what the market share breakdown was at the time, so I couldn't tell whether that was weighted or not.

Well, today they've issued a more comprehensive press release, covering both on- and off-exchange policies (230 total: 90 on the exchange, 140 off of it). The unweighted overall average increase is a mere 1.5%:

OLYMPIA, Wash. - Individuals and families looking for health insurance this fall have 15 insurers and 230 health plans to choose from, starting Nov. 15.

The average approved rate change was 1.5 percent. Originally, the insurers requested an average 8.3 percent increase, but it was lowered after a review by the Office of the Insurance Commissioner.

There's been a lot of fuss made about 2015 ACA exchange premium rates not being available at Healthcare.Gov until after the election. The presumption, of course, is that this is being done for political reasons. While this may be true, it could also simply be that there's a lot of different policy figures to plug into the federal system, and some states haven't even finalized their rates yet.

That being said, residents of some states can check out the 2015 premiums now and compare them against their current premium:

IDAHO: Idaho is the only state moving from HC.gov to their own exchange. Idaho residents can check out their 2015 rates directly via the state exchange site.

CALIFORNIA: CoveredCA has 2015 rates available right now as well.

WASHINGTON: Health Exchange leaders are trying to solve the problems from the first sign-up period

CLARKSTON, WA – Leaders with Washington’s Health Care Exchange are preparing for the second open enrollment period, but at the same time they are still working on resolving billing and computer problems for 1,300 accounts from the first sign-up period.

IOWA: Three health insurers get OK to increase rates

This is very confusingly worded, because it makes it sound like all 3 companies have been operating on the HC.gov exchange when it turns out that only 2 of them have. Wellmark did not participate in the ACA exchange; the 19,000 customers referred to here have off-exchange policies which are still ACA-compliant:

Commissioner Nick Gerhart said today that he has approved premium increases from Wellmark Blue Cross and Blue Shield, CoOportunity Health and Coventry Health.

According to the last official HHS enrollment report from back in May, as of April 19, 2014, Washington State had enrolled 163,207 people in private policies via their ACA exchange. Of those, 8,310 people never actually had their coverage start due to non-payment (WA requires payment of the first month's premium as part of the enrollment process, so I'm not sure what happened in these cases, but presumably there was some sort of credit card account approval glitch, insufficient funds in debit card accounts and/or the like).

In any event, that means the actual paid tally as of 4/19 was 154,897, or 95%, which is pretty darned good.

Well, a couple of days ago the WA exchange issued a press release regarding the renewal process for 2015, and included 2 key data nuggets. First up:

Between my son being sick for the past 4 days (he's better now, thanks!), losing my internet connection for 2 days (it's back up now, thanks!) and just generally being swamped with work, I don't have time to give these stories the attention they deserve, but they're all worth checking out:

D.C.’s health exchange is still hampered by delays, glitches 11 months after launch

While Democratic partisans tout the latest conventional wisdom that Obamacare is finally going strong, the experience of many ordinary people who apply for it says otherwise.

The ongoing delays and irritation that consumers endure while navigating the District’s health insurance exchange offer a window into the reality on the street.

More health insurance options increase choice — and possibly confusion

Wow! The WA Health Benefit Exchange, which hasn't issued an actual enrollment update since the end of the Open Enrollment period, just came through in a big way:

OLYMPIA, Wash. – Washington Healthplanfinder today announced 11,497 Washingtonians have taken advantage of special enrollment periods since March 31 that allow them to enroll through wahealthplanfinder.org if they have a qualifying life event outside of the standard open enrollment period. The next open enrollment period starts on Nov. 15, 2014 for coverage beginning in 2015.

Data also shows that nearly 700,000 residents are now enrolled in new free or low-cost health coverage options, with more than 147,000 customers currently enrolled in Qualified Health Plans. Including customers who are renewing their existing Medicaid coverage, more than 1.28 million residents have enrolled in health coverage through wahealthplanfinder.org.

The Washington State Insurance Commissioner just released a chart listing all of the companies operating on the exchange this fall (including 3 new ones, bringing the total to 12), how many plans they're each offering, the requested rate change and the approved ones for most of them.

Unfortunately, they don't include an actual enrollee breakdown, so I can't tell whether this is a weighted or unweighted average. Judging from the numbers provided, it looks like an unweighted average would be just 0.1%, so I'm guessing that the 1.9% mentioned in the press release is weighted, but I'd be more confident of this if they included how many people were enrolled by each company.

(h/t to Josh Z. for pointing out the uncertainty here)

In any event, the original average requested increase was 8.6% (4.8% unweighted), so this is still great news either way.

In addition, the total number of plans has doubled from 46 to 90:

90 health plans approved for next year’s Exchange with a record low 1.9 percent rate change – Exchange Board set to certify plans on Aug. 28

Even in states whose ACA exchanges have operated pretty smoothly such as Connecticut and Kentucky, there's bound to be some technical problems. Washington State is no exception. As a result, the WA insurance commissioner has announced that anyone who tried to enroll earlier but has struggled with billing, payment or other technical issues (WA is one of only 2 states that run payments through the exchange and require the 1st months premium to be paid before even reporting the enrollment) can now give it another shot or make whatever changes are necessary without requiring a "qualifying life event" to do so:

The Washington Health Benefit Exchange (the Exchange), also known as the Washington Healthplanfinder, is making progress to correct the enrollment and payment difficulties that have affected some consumers. Those fixes are continuing, but may take additional time to resolve.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

ARKANSAS:

Mark Pryor shows Democrats how they should campaign on the Affordable Care Act in a red state. You don't have to mention Obamacare (which technically doesn't even exist), you don't have to even mention the Affordable Care Act. You do have to personalize what the law actually means for real people with real medical issues which were fixed or improved by the law:

Read more on this ad & angle from Greg Sargent of the Washington Post.

VERMONT:

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