Hey, all. Just some assorted notes in no particular order...
- OK, so the 1-year anniversary of ACASignups.net came and went a week or so ago without any major announcement from me...although the fact that I've started writing occasional pieces for healthinsurance.org should count. I've posted 3 entries so far and the feedback has been very positive from both them and their readers so far.
- I had been mulling over writing a book about the experience of the past year, and I may still do so, but at this point the 2nd open enrollment period is coming up too quickly for me to deal with that; if I was going to do so, it probably should have been over the summer. However, I'll keep it in mind over the next few months and will revisit it after the 2nd OE period (OE2) closes in February.
- I still have to update/overhaul the FAQ on the website; obviously it's a wee bit out of date at this point. Also, while I haven't been sending mailings out very often during the off-season, I do plan on nightly (or at least weekly?) "digest"-style mailings from 11/15/14 - 2/15/15, so if you want to be removed from the mailing list, just click the link at the bottom. FWIW, the mailing list has grown to over 400 members since I opened it up to all visitors.
- Obviously as we approach the midterm elections, my posts have become far more political & partisan in nature. I've felt a need to push back against the increasingly nonsensical lies and misinformation being thrown around about the ACA as election day approaches. I'm aware that some on this list lean Republican and are disappointed in this trend of late; if I lose part of my support base as a result, so be it. I've never tried to hide my personal partisan leanings, and I still do my best to make sure that the actual data and my analysis of that data is as unbiased as possible. Please feel free to call me out if I do post something factually incorrect or out of context. The whole thing will be over in 8 more days, anyway.
- After the 8 million (total) milestone was announced, the ACA mostly faded as a major attack point by the GOP over the summer. There was some "hope" by the Republicans that they'd have a new Obamacare chew toy to play with here and there--the Halbig court decision, the alleged "rate shock" for 2015, and the ugly legal/technical messes in Oregon, Massachusetts, Maryland and Nevada. However, the first one was cancelled out just hours later and will probably remain in limbo until next summer; the second has, for the most part, turned out to be a nothingburger (except in a few states such as Alaska, North Carolina, Louisiana and Kansas); and the last are all more localized issues for now. The biggest ACA-related trend, in the final weeks of the campaign, have been Republican candidates trying to have it both ways by bashing "Obamacare" while praising (or at least claiming to support) the same Medicaid expansion provisions that many of them fought against just a year or so earlier.
- Over the past few weeks, actual core enrollment data itself has effectively dried up, even by off-season standards. Over the summer, the only states issuing regular updates were Minnesota, Oregon, Hawaii, Maryland and Colorado. Since the end of September it's been down to just Minnesota, which continues to be the odometer state of the ACA. This makes sense, since 3 of these 5 states are making radical overhauls to how their enrollments will be handled for Year Two, and the other two (along with the other dozen or so state-run exchanges) are understandably more worried about preparing things for November 15th than worrying about my spreadsheet. MNsure deserves a special shout-out for continuing to keep the numbers rolling along even as they slow to a crawl.
- I can't be sure of this since Minnesota is the only state even providing the data for the moment, there definitely seems to be a slowdown in actual enrollment additions, even taking the "off season" factor into account. This makes sense as well...unless you're in desperate need of healthcare coverage this very second, at this point it makes much more sense to hold off until November 15th (especially since people who enroll between 10/16 - 11/14 will only have their policy enabled for a single month, December, anyway). If you can stick it out until January 1st for your policy to start, might as well wait another 19 days to enroll.
- You may also notice that I've started to slow down the pace of my entries. This is partly because once we're past the election, things will heat up quickly, so I'd prefer to take a breather while I can. The other reason is that I'm trying to wrap up a couple of big Day Job projects before OE2 kicks in. This also means that I'm having to take a pass on a good 2/3 of the articles/links that people have been sending me, although I do try to at least bundle a bunch of these together in "Quick Hit" batches.
- I have no idea how the reporting process is going to work for OE2. Last year there were 36 states run through Healthcare.Gov and 15 states running their own exchange. This year, 2 of the state-run exchanges are moving to HC.gov (Oregon and Nevada), while 1 of the Fed-run exchanges is moving off of it (Idaho), meaning the tally will be 37 Fed to 14 State. Last year, some states issued reports weekly; others did it every two weeks, or monthly, or whenever they happened to feel like it. Some posted detailed press releases, others (like Nevada) just gave a couple key numbers via Twitter. Some reported "How many have PAID!!!!" while most didn't bother (or didn't know yet). Some broke out Medicaid/CHIP, others lumped them all together. I'm desperately hoping that there will be some regularity, consistency and clarity this time around...but then again, if every state (& HHS) did that, most of the point of this website would be gone anyway, so perhaps I shouldn't wish so hard :)
- Of the 14 remaining state-run exchanges, 2 of them are completely overhauling their software platform (MA and MD). I believe Minnesota has worked out most of their technical problems while keeping the existing infrastructure in place (I could be wrong about this). Most of the others (CA, CO, CT, DC, KY, NY, RI & WA) were either running pretty damned well in the first place or had comparatively mild technical issues to work out. That leaves Vermont and Hawaii as the biggest mysteries from my perspective. Vermont took their entire exchange site offline a month ago to fix, but I haven't heard anything about their progress. Hawaii, meanwhile, replaced their old front-end website portal with a simple WordPress site. While the actual enrollment link takes you to a different interface, I have no idea how much tinkering around they've done behind the scenes.
- Idaho should be very interesting indeed, as they're the only state moving off of the Federal exchange and onto their own system. Hopefully they've learned a lot about what to do from Kentucky, Connecticut and Rhode Island (and about what not to do from Oregon, Massachusetts, Maryland and Nevada), and will be able to hit the ground running.
- I'm still trying to decide how to (or whether to) break out new 2015 enrollees from existing 2014 enrollees. The problem here is that I have no idea how the exchanges or HHS plans on reporting these--my guess is that again, some will break them out while others don't or can't. In the end I don't suppose it really matters one way or the other.
- Oh, yeah: I'm still accepting (and occasionally shilling for) the odd donation, if anyone still feels so inclined ;)
- FINALLY, a lot of people have been asking me to pull a Nate Silver and post my official predictions for the OE2 tally. I do plan on doing so...but not until after the election. I promise to post my thoughts on this sometime between November 5th and November 15th, so...stay tuned!! :)
