Update: ACA Roundup: 1.83M Private, 4.0M Medicaid, My Year-End Prediction

From the Daily Kos Archive

NOTE: This was originally posted over at Daily Kos. I've since ported it over here for archival purposes.

Yesterday was, as predicted, rather chaotic on the ACASignups.net front. This morning, the fun continues with a few more last-minute updates. Also, I made my "final" predictions late last night...which I'm now scrapping in favor of a different type of "final" prediction (see below for more on this).

This morning's updates below the fold:

--Washington State (h/t ArcticStones):

Enrollments in private health plans on Healthplanfinder, the state’s online insurance marketplace, surged past 65,000 as applicants hustled to beat the Monday night deadline for coverage beginning Jan. 1, Washington Health Benefit Exchange officials reported Tuesday.

Nearly 69,000 others have completed the enrollment process, but haven’t arranged payment, and another group of undetermined size has begun applications that are in varying stages of completion.
As of Monday at midnight, about 100,800 people newly eligible for health insurance through the state’s expanded Medicaid program had signed up. Almost half of those were transferring from the now-discontinued Basic Health program or were presumed qualified for a federal assistance program for the disabled. An additional 47,500 enrollments were from those who previously qualified for Medicaid under the old rules — primarily children — but had not been signed up. And more than 88,000 people already covered by Medicaid renewed their eligibility.

For private enrollments, Washington is the only state that distinguishes between "enrolled but not paid yet" and "enrolled and first month's premium paid"; every other state, and the HHS, counts you as being enrolled even if you haven't actually paid yet, so that's the criteria I use, although I did separate out the other 69K on the spreadsheet.

For Medicaid, I'm not counting the 88K since they were just renewals, but the 47.5K do count since they appear to fall into the category of people who were already qualified but didn't know about it until the ACA and the state exchange.

In addition, as in several other states, another 47,000 people are being automatically transferred over to Medicaid proper from an existing state program; this is one of the "orange cells" on the spreadsheet.

Also, h/t to sulthernao, who found the actual WA exchange source that gives the precise numbers.

--Maryland (h/t ArcticStones):

Maryland is up to 11,700 private enrollments. Their site is still a mess, apparently, and they're even considering switching over to the Federal exchange at HC.gov. The irony here speaks for itself.

--Connecticut (h/t ArcticStones):

A total of 62,153 residents have now enrolled in plans that start Jan. 1, with more than 34,000 in private insurance plans and the rest in government-funded Medicaid plans, Access Health CT announced Tuesday. Its goal had been to enroll 60,000 people by the end of December.

The state goal was 60K total by December. The CBO projection was (supposedly) 33K private enrollments by 3/31/14. Doesn't matter; CT has already surpassed both numbers anyway.

--New York:

The WSJ has an article this morning (behind a pay firewall) that claims over 188,000 private enrollments as of Sunday night. However, as awesome as NY has been doing (over 25K on Monday!), this makes no sense, since the officially-announced number is 156K as of Monday night:

Despite some glitches, the state’s health insurance exchange has been one of the few bright spots of the troubled Obamacare rollout. Since the exchange went online Oct. 1, 447,990 New Yorkers have completed their applications for health care and 214,077 have gone on to obtain coverage.

Of the 214,077 people who have enrolled, 156,549 have signed up for private insurance and 57,528 have qualified for Medicaid.

Until I receive confirmation, I'm disregarding the WSJ number as some sort of confused reporting or blending of private & Medicaid (even though that number would be even higher).

--Colorado (h/t ArcticStones):

Between Oct. 1 and Dec. 23, 42,771 Coloradans signed up for private health insurance that takes effect January 1, according to a news release from Connect for Health Colorado.

Monday was a record day for shopping volume, with 5,354 Coloradans signing up. Connect for Health Colorado will continue to help people who complete the sign-up process until Friday to receive January 1 coverage. Open enrollment continues until March 31.

--Oregon (h/t lalato):

As of Dec. 23, Cover Oregon had found more than 45,000 people eligible for private health insurance plans. But only a fraction have signed up. According to Cover Oregon, so far more than 12,000 people have enrolled in private insurance plans and more than 24,000 in the Medicaid-funded Oregon Health Plan using the exchange paper application.
Another 100,000 people have enrolled in the Oregon Health Plan using a streamlined process set up by the state to bypass Cover Oregon.

These are the most comprehensive numbers I've seen for Oregon, which has the most screwed up website (thanks, Oracle!) of any state; their problems make the October HC.gov problems seem like a walk in the park. Anyway, while this update only bumps the private enrollments by 1,000, the Medicaid numbers just shot up by around 50K or so.


CoveredCA, after kicking serious ass for the past few weeks, ran into major technical issues on Monday, the (original) enrollment deadline for January coverage. They had everything working again on Tuesday, but have issued an important message for those who tried but failed to complete their enrollment the day before:

Good evening! If you started an application December 23, but haven't completed it, you now have until Friday, December 27 at 8pm to finish for coverage starting on January 1. However, you cannot complete your application online as part of this extension. Instead, please call our service center at 1-800-300-1506, or work with a Certified Enrollment Counselor or Agent - you can find one at this link. Happy Holidays, and get covered!

Meanwhile, CA is well over 400K private enrollments; I have them up to around 450K on the spreadsheet.

Add 'em all up, and my new current tally is:

1.83 million private enrollments

4.01 million Medicaid/SCHIP expansion

Finally, last night I gave 2 private enrollment predictions: 1.95 - 2.0 million as of midnight last night (the new official enrollment deadline for January) and one for New Year's Eve of 2.3 - 2.35 million.

However, given the ever-changing enrollment deadlines (HHS made it 12/23, then 12/24, and now is saying that, like CoveredCA, they'll "work with" people who were partly enrolled by 12/24 to get them covered for 1/1/14), and the fact that Oregon and Minnesota have extended their own deadlines even further (12/27 for OR; 12/31 for MN), I'm merging both of these into a new, single prediction:

2.1 Million Private Plan Enrollees who will be covered starting January 1st.

Update: OK, one more very tiny update, this time out of...ALASKA??

Enroll Alaska’s Chief operating officer Tyann Boling said Tuesday the insurance brokerage has enrolled more than 700 people thus far. That’s a big step up from November, when the company had signed up only 107 people.

OK, those numbers aren't for all of Alaska, they're just those enrolled through this particular organization, but it's still rather telling. The Nov. 30 total for Alaska as a whole was only 398 people; assuming a similar 7:1 ratio, they should be up to around 2,600 total by now.

Of course, this would really be taken out of the 750,000 "unspecified" enrollees at the bottom of the spreadsheet, but it's still such a tiny number relative to the total that I'm not worrying much about that; it's just amusing to have this one tiny update in the midst of the others.

On a separate note, one of the big new talking points of ACA detractors is "FINE, a lot of people have ENROLLED, but how many have actually PAID???"

Here's a simple response:

1. Actually, Washington State DOES break enrollments out between "enrolled but not paid" and "enrolled and paid". In their case, about 48% of their 134,000 private plan enrollees have fully paid.

Assuming this is a typical spread across the other states, it should be roughly 875,000 enrollees who have paid already.

2. Having said that, I'm not sure I understand why this is such a point of concern. My wife and I fall into the category of "enrolled but not paid yet"...but that's only because BCBSM (Michigan) hasn't happened to actually bill us yet. They will do so on the 28th, and we'll pay. This is pretty typical of a lot of insurance policies. We're still fully enrolled--we have our insurance cards and everything.

If you buy a new car with one of those "$0 down!" deals, you still get to drive the car home that day and the auto dealer still books the sale in their inventory system, so I really don't see what the fuss is about.

Now, having said that, I'm sure that some percentage of enrollees will be deadbeats, but that's typical and expected in any retail, free-market situation. If it's an unusually high percentage, that could be worthy of concern, but is a separate issue from how many are actually enrolled.

The only legitimate issue here I can think of would be if a high percentage of enrollees CAN'T pay because of technical issues between the exchange websites and the insurance company sites in getting their billing/payments processed. That's legit because of the lingering technical problems some sites have, but again, that's yet to be seen.

Meanwhile, the insurance companies are on record as saying that they're willing to accept payments up through January 10th for coverage retroactive to January 1st under the circumstances, so that's still not an issue right now.