New York: One more important point regarding the rising "Previously Uninsured" Percentage

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:

A total of 230,624 people enrolled for individual coverage [Ed: includes Medicaid] by Dec. 24, which was the deadline for Jan. 1 coverage. Of those, Frescatore said, about half were not insured at the time of enrollment.

So, this means that in New York, at least, the "Not Previously Insured" ratio has gone up as follows:

  • Through 12/24: 50% of 230,624 (115,312) - about 50% of them total
  • Through 02/10: 66% of 412,221 (272,066) - This means that 156,754 of the 181,597 enrollees from 12/25 - 2/10 were previously uninsured...over 86% of them
  • Through 02/17: 69% of 456,042 (314,669) - This means that 42,603 of the 43,821 enrollees from 2/11 - 2/17 were previously uninsured...over 97% of them, or a minimum of 92% of Private QHPs.

Once again, I have no idea whether New York is in any way representative of the country overall...but if it is, this gives us some guidance on the overall trend. IF New York is accurately representative, and if the breakdown is relatively stable between private & Medicaid enrollments, this means that the "Previously Uninsured" numbers should be something like the following:

  • October, November, December - perhaps 50% of 2.15 million = 1.075 million previously uninsured
  • January - perhaps 75% of 1.15 million = 863,000 previously uninsured
  • February - probably 90% out of, say, 700,000 = 630,000 previously uninsured
  • March - probably at least 95% out of (unknown number, depends on strength of the expected "March surge"...assume 1.0 - 1.5 million?) = perhaps 0.9 - 1.4 million previously uninsured

The bad news is this would mean that total exchange enrollment came up a bit short of even the lowered CBO number of 6 million. The good news is that, If the above estimates are close, at the end of the enrollment period, we would be looking at a total of somewhere around 3.5 - 4.0 million newly (privately) insured (not including new Medicaid/CHIP enrollments), out of around 5.5 million total exchange-based enrollments, or around 70%+.

This leaves about 2 million people who fell into the "OMG!! 5 MILLION POLICIES CANCELLED!!!" category. What about the other 3 million people? Well, I suspect that the vast majority of them either a) have noncompliant policies which were granted a one-year extension by the Obama administration, or b) simply moved over to ACA-compliant policies directly through their insurance company. I've only found about 124,000 of these total so far, but that's because these enrollments are only given out voluntarily by the insurance companies...and most of them obviously either don't like giving out that sort of data, or will only do so if asked directly. There are a couple hundred companies involved, and I've only contacted about a dozen...and of those, only 2-3 have been willing to give out their direct enrollment data.