Maryland: Net attrition only 0.33% since July; Medicaid up another 22.7K in August

Hat Tip To: 
Alison Walker

The Maryland Health Connection just issued their latest monthly enrollment report (running from 7/27 - 8/23). On the one hand, the QHP tally includes both new additions and dropped/cancelled enrollments this time around, making it useless for adding to my off-season enrollment projection chart...

Enrollment Data
As of August 23, 78,666 individuals have enrolled in qualified health plans.1

As of August 27, 2014, 355,281 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage. We have begun reporting the net changes in Medicaid enrollment. This figure takes into account that individuals lose Medicaid coverage because of changes in household, age and income, as well as redeterminations. Compared to December 31, 2013, the net change in Medicaid enrollment as of August 27, 2014 is +262,737. 

On the other hand, remember that scarily-worded, sky-is-falling IBD article from a couple of weeks ago making it sound like QHP enrollees were dropping their policies by the truckload? 

Well, in addition to the Washington State data (gross attrition of around 7.7% over a 2 month period, net attrition of around 6.1%), the Maryland report does give some additional insight into the attrition rate, because they've included a handy footnote at the bottom:

1 QHP enrollment is unduplicated enrollment minus cancellations of existing policies. In the special enrollment period, changes in circumstances can lead to redetermination of eligibility and cancellation of QHP coverage. As a result, this month, there was a slight decline in net enrollments. 

Slight indeed. Take a look at the QHP totals on the last 4 monthly reports:

That's right: Maryland's exchange has had a net loss of just 264 people since reaching their peak number at the end of July, or just 0.33% of the total to date.

Of course, I don't know if they added 1,000 people and lost 1,264 in August or what, but their off-season average until this month suggests that they added around 3,200 in that time period while losing roughly 3,464. I'd love to have the actual numbers for charting purposes, but ultimately what matters more is that the net drop isn't bad at all (at least in Maryland, so far).

A gross loss of around 3,500 people would be around 4.4% of the total, which is a bit higher than I've been estimating, but is also nearly cancelled by the gross gain, resulting in a net loss of just 0.33%, literally a rounding error.

Meanwhile, Medicaid/CHIP expansion enrollments are up another 22,777 since July, to 259,392 total (after subtracting the 95,889 auto-transferees who have already been accounted for). There remaining 3,300 gain in Medicaid is presumably from people enrolling in "normal" Medicaid.

The new press release also tries to put a positive spin on the fact that all 78,000+ private enrollees will have to manually renew their policies via MD's new ACA exchange this fall, but as I've argued many times before, I don't see this as a bad thing anyway:

Renewals outreach campaign kicks off
Outreach efforts will begin in the coming weeks to encourage all Marylanders covered by qualified health plans through Maryland Health Connection in 2014 to re-enroll for 2015 coverage by applying through during open enrollment.

By reapplying, Marylanders will be able to choose from a broad array of 2015 plans, including plans from a new carrier. Consumers will also have the opportunity to enter their most current household and income information and determine their eligibility for financial assistance for 2015. We encourage Marylanders interested in quality and affordable coverage to see new plan offerings and rates for 2015.