A decision made more than three years ago by a committee that no longer exists might deal a major blow to Obamacare in South Carolina this summer.
...Former members of the S.C. Health Exchange Planning Committee say they weren’t aware in 2011 that their opposition to a state-based insurance marketplace might jeopardize so many people’s ability to pay for coverage.
“At no point in the committee’s discussion was there ever raised a concern that by opting into the federal exchange we were losing anything — especially subsidies,” said Tim Ervolina, president of the United Way Foundation of South Carolina and a former planning committee member. “I recall a very intense discussion with (former) Sen. (Mike) Rose, who stated that, after reviewing the law, he felt confident that we had nothing to lose and everything to gain by opting into the federal exchange.”
The percentage of Vermonters without health insurance has dropped to 3.7 percent, second lowest in the nation, according to new data from a survey of 4,000 households. Massachusetts, which mandates health insurance coverage, has the lowest percentage of uninsured.
Since the last state-sponsored survey, in 2012, the number of uninsured Vermonters declined from 42,760 to 23,231, according to weighted results.
According to the Kaiser Family Foundation, Vermont's pool of potential private ACA exchange enrollees was around 44,000 people as of last April (ie, right after the 2014 enrollment period ended).
Those who follow this site regularly know that back on November 14th (the day before the enrollment period started), I originally projected 12.0 million even. I bumped this up by another half million on December 12th, after a particularly stellar 3rd week, and that's where it stood ever since: 12.5 million.
Earlier today I posted "Do I Hear 10 Million?", which served as both my estimated of HC.gov enrollments through today (7.45M), as well as noting that total QHP enrollments will likely cross the 10 million mark tomorrow (Saturday, Jan. 31st)...and I also threw in a reiteration of my projections through the end of the 2015 open enrollment period: 12.5 million as of February 15th.
Huh. The actual QHP numbers are fine--that is, Minnesota is still lagging behind where they should be, but they've added 201 over the past couple of days, which is fine given that we're in the slowest part of the enrollment period.
However...what's going on in the lower-left? "Advanced Premium Tax Credits" is the government-ese name for "Tax Subsidies'. In most states they're averaging somewhere between 80-90%...yet in Minnesota, it's less than 50%? What's up with that?
Let's suppose that the Supreme Court, against all logic, legal precedent, reason and decency, does end up ruling in favor of the plaintiffs in the King v. Burwell case and does indeed stop any federal tax credits/subsidies from being provided to people in states which are being run through the federal ACA exchange instead of their own. Let us further assume that this ruling does come out sometime in mid-June, 2015.
Let us further assume that the Republican-held Congress, being the colossal dicks that they are, do not take any action whatsoever--or, more likely, vote on a bill which would fix the "...state exchange" problem but would also have a completely unacceptable poison pill attached (ie, removing the individual mandate altogether, or killing the 80/20 medical loss ratio, or allowing insurance companies to deny coverage based on pre-existing conditions...you get the idea).
Here we go: The Massachusetts Health Connector has issued their weekly report, which confirms 113,887 QHP selections through last night, with 83% of those having paid their first month's premium and thus being fully enrolled. As I projected last week, the overall payment rate has risen by another 7%, and will likely continue to do so (of course, it will then "drop off" again dramatically during the final February surge, only to shoot back up again over the next few weeks as March enrollees start paying up).
Given the official 9.5 million confirmation a few days ago, this isn't going to be as surprising as it might otherwise have been, but it's still an important milestone which should be noted. I was originally estimating that total QHP selections would cross the 10 million mark last night, but after some tweaks I've adjusted this a bit, and am now estimating that we'll cross the 10 Million ACA Exchange-Based QHP Selection total on Saturday, January 31st.
(As a reference point for next Wednesday's "weekly snapshot", I'm also calling for today's HC.gov total to hit 7.45 million).
After that, we're into the February home stretch, which I'm expecting to play out roughly as follows:
Around 10.2 million by February 6th (35K/day)
Around 10.5 million by February 10th (65K/day)
And for the final 5 days, I'm expecting another major "Apple Store"-like surge: An average of 400,000 people per day for 5 days straight, for 12.5 million as of midnight, Feb. 15th.
If you get sick, America, the Republican health care plan is this: "Die quickly." That’s right. The Republicans want you to die quickly if you get sick."
...Consider this question: Should society have as its goal that the government prevents all deaths from any health-related ailment other than natural causes associated with ripe old age? The notion is absurd — to both conservatives and liberals. There are limits to the proper amount of scarce resources, funded by taxpayers, that Washington should redirect toward health care.
So, Mitt Romney, who spearheaded the original version of the Affordable Care Act (aka Obamacare) in Massachusetts a decade ago, and then ran for President on a platform of repealing essentially the same law implemented nationally that he pushed through at the state level, has decided to run for President again.
Some 3 million to 6 million Americans will have to pay an Obamacare tax penalty for not having health insurance last year, Treasury officials said Wednesday. It's the first time they have given estimates for how many people will be subject to a fine.
The penalty is $95, or 1% of income above a certain threshold (roughly $20,000 for a couple). So you could end up owing the IRS a lot of money.
Take a married couple with $100,000 in income - their bill comes to $797, according to the Tax Policy Center ACA penalty calculator.
The penalty for remaining uninsured rises to the larger of $325 or 2% of income in 2015.
OK, this is just an overview of the upcoming tax penalty. Nothing noteworthy. However...
Still, the good news is that it looks as though a certain segment of people have finally started to smarten up; perhaps it was last fall's Ebola panic, because this shift happened before the measles outbreak:
The number of California parents who cite personal beliefs in refusing to vaccinate their kindergartners dropped in 2014 for the first time in a dozen years, according to a Times data analysis.
...Statewide, the rate of vaccine waivers for kindergartners entering school in the fall declined to 2.5% in 2014 from 3.1% in 2013. Bigger declines were seen in districts with some of the larger vaccine exemption rates.
Recalcitrant red states have done little — or nothing — to promote Obamacare. Yet their residents are getting health coverage by the millions.
Across the country, efforts to resist or undermine the law persist. Calls for repeal haven’t died down. Most of the states with Republicans in control aren’t running their own insurance exchanges, but their residents are still getting covered and still getting subsidies — unless the Supreme Court in an upcoming case rules that the subsidies are illegal in states using HealthCare.gov.
Fewer workers received employer-sponsored health coverage after the Great Recession than they did before, but don’t put the blame squarely on the Affordable Care Act, a study released Thursday says.
However, I just realized that they also threw in a new QHP enrollee update:
In addition, Lee reported Wednesday that as of Jan. 26, 273,111 consumers had picked a plan during open enrollment.
Add that to the 944K renewals and you have a grand total of 1,217,111 through 1/26.
That's an increase of 44,345 since January 12, or 3,167/day. Of course, this also includes the January 15th deadline, so it doesn't tell me much about the next week or so. For that, I'd have to look at the increase since 1/18 (1,200,427), which is just 16,684, or 2,085/day.
The following numbers are up-to-date as of 11:59pm Monday, January 26, 2015.
New Vermont Health Connect Customers
10,399 individuals have checked out a 2015 health plan. This includes 4,098 individuals in Qualified Health Plans (private health insurance) and 6,301 individuals in Medicaid or Dr. Dynasaur plans.
After a new customer checks out a plan, they must make an initial premium payment and have their selection processed before they have an active health plan. Of the 10,399 individuals who checked out, 8,853 have completed the enrollment process and have an active health plan (i.e., effectuated enrollment). Of those who completed the process, 2,713 are on a Qualified Health Plan and 6,140 are on Medicaid or Dr. Dynasaur.
Renewing 2014 Vermont Health Connect Plans
Unless a customer requested otherwise, all individuals who had an active health plan through the end of 2014 currently have health insurance coverage through Blue Cross Blue Shield of Vermont, MVP Health Care, Medicaid or Dr. Dynasaur. The insurance issuers have their information in their systems and ID cards remain active.
Over at Talking Points Memo, Sahil Kapur has a story which, on the one hand, reveals nothing that most people didn't already know...but at the same time includes some quotes from anonymous Republican staffers which are almost Onion-like in their point-blank candor:
"It's an opportunity that we've failed at for two decades. We've not been particularly close to being on the same page on this subject for two decades," said a congressional Republican health policy aide who was granted anonymity to speak candidly. "So this idea — we're ready to go? Actually no, we're not."
...But conversations with more than a dozen GOP lawmakers and aides indicate that the party is nowhere close to a solution. Outside health policy experts consulted by the Republicans are also at odds on how the party should respond.
Thanks to the massive snowstorm which hit New England (yes, it was pretty bad even if NYC itself only received a glancing blow), it's been several days since the last MA Health Connector update. Today, however, they released a new daily report which covers the past 3 days.
OK, that's 3,922. To get an idea of the drop-off from a deadline day to a post-deadline day, on 1/23 alone (MA's deadline for February coverage), they had 3,440 QHP determinations.
Anyway, assuming at least a 45% plan selection rate, that should be another 1,800 QHPs for Massachusetts, bringing the total up to at least 112,000 to date.
Meanwhile, Medicaid enrollment is now up to over 211K so far.
Last year I assumed, for months, that once March 31st came and went, I'd be free to close up shop. Then they tacked on the 2-week "extension period". Then a whole mess of other stuff happened, and, well, here I am, still chugging along almost 10 months later. This year, however, I was operating on the assumption that once February 15th came along, I'd be able to pull the plug (not saying that I would, just that I'd be free to do so if I wished). However...
Open Enrollment ends February 15. As a retail tax preparer, I'm flummoxed by this. We're barely beginning to see clients--the first ones with nothing but a W-2 are just trickling in the door.
There's several ways of measuring the performance of the states. You could go by sheer number of enrollees, but that's obviously unfair given the massive population differences between them. You can go by enrollments relative to their total population...except that some states have a much higher uninsured population than others, along with huge variations in average income, unemployment and a host of other variables.
In the end, I'm comparing the states across 4 different benchmarks:
1. How they're performing relative to last year's Open Enrollment Period
2. How they're performing relative to the "official" 2015 Open Enrollment Period targets put out by either the HHS Dept. (or the state government/exchange representative in some cases)
3. How they're performing relative to my 2015 Open Enrollment Period targets, and
4. How they're performing relative to the total potential exchange QHP enrollees.
This press release from the Washington exchange about tax credits for 2014 ACA enrollees isn't an official enrollment update, but they do include a rough update about 2/3 of the way down the text:
As of Jan. 25, more than 127,000 residents have enrolled in Qualified Health Plans for 2015 coverage, with approximately 40,000 of those customers signing up for the first time through Washington Healthplanfinder.
127K is about 10K more than they had enrolled as of January 17, or around 1,250/day. At that rate, they'd be likely to add another 26K by 2/15, for 153K total, which would be far short of the 215K that they're targeting (and way short of the 250K I was anticipating for WA). A decent mid-February surge should bring them up to around 175K, and a full surge could max out at 200K even. It's conceivable that they'll even squeak by their own target, but I don't see any way of reaching my own target.
The last 4 weekly HC.gov reports saw 96K (Christmas), 103K (New Year's), 163K (nothing significant) and 400K(the February coverage deadline for most states) on the federal exchange.
With the 1/15 deadline out of the way, the past week (and the next two) should come in somewhere between the last two: Fairly quiet, but steady and not completely dead. I'm assuming roughly 30K/day on HC.gov (around 40K/day nationally), which should have brought the total on HealthCare.Gov up to around 7.36 million as of Friday, January 23rd.
Whoops. Only 137K for the week; I overshot the mark significantly (off by 53% for the week, or about 0.9% cumulatively). The post-deadline drop-off was more significant than I figured. Crud.
As of January 17th, Rhode Island had enrolled about 28.8K people in private plans for 2015, or around 78% of their "official" target (based on the HHS Dept's "30% higher than last year" target).
RENEWAL UPDATE* As of January 24, 2015, 79% of Year One customers have renewed (selected a plan) for 2015 (75% of renewing customers paid the first month’s premium).
Total New Customers: 7,862 (6,539 paid)
Total Renewed Customers: 20,283 (19,189 paid) Total HealthSource RI enrollments for 2015 coverage: 28,145 (25,728 paid)
Hey, cool! That's a 91% payment rate! Um...except for one thing...somehow they've lost 644 people? Oh, wait...
This morning I noted several new developments in the ongoing King v. Burwell saga (formerly Halbig v. Burwell...and yes, I know that's technically a separate case, but cut me some slack here). However, I forgot a couple more:
Here's a list of people who--to the best of my knowledge--have now been proven not to ever have the slightest inkling, hint, suggestion or thought that federal tax subsidies weren't supposed to go to states which didn't establish their own ACA exchanges at any point throughout the many-year process of the law being crafted, drafted, printed, read, debated, argued about, voted on or signed into law:
Now, technically speaking, that exact number isn't precisely what it was as of January 16, because it includes 1 extra day for 13 of the state exchanges and 2 extra days for California. I have no clue why they did it that way, but whatever. Really, though, enrollment dropped off dramatically for a few days after the 15th, because that was the February-start deadline in 46 states +DC (including California), so I don't imagine more than 10-15,000 of this came in on the 17th or 18th.
Since the day I started this project (before it, really), I've been asking for the HHS Dept. to simply release the enrollment data in as much detail as possible on a frequent basis...and by frequent, I didn't mean "monthly"; that's far too long given the 24-hour, 24-second news and political cycle. For 7 months, the HHS Dept. ignored this plea, followed by another 6 months of not just ignoring it but actually going backwards on enrollment data (ie, cutting off even the monthly reports during the off-season). Fortunately, since November, they've done a total 180, issuing not only "weekly snapshot" reports giving the overall HC.gov enrollment numbers, but more recently breaking these down by all 37 states on a weekly basis. This is awesome!
Remember all last summer and into the fall when I kept pointing out to anyone who would listen that just because the official Open Enrollment period had ended back on March 30th (or April 15th, depending on your POV), there were still a good 9,000+ people per day enrolling via the ACA exchanges due to major life changes?
Of course, those people being added were also being cancelled out to some degree by people dropping their policies (or being dropped whether they liked it or not due to non-payment or immigration/residency issues). From what I could tell, the additions seemed to be outnumbering the subtractions for most of the summer, up until around August, at which point the trend reversed. However, it was difficult to know this for certain until the CMS head unexpectedly mentioned that 7.3 million people were still enrolled as of mid-August (going up!), followed by a drop to 7.1 million as of mid-October (going down!).
Here in Michigan, the official estimates of how many residents are eligible for ACA Medicaid expansion ranged from around 477K to 500K, and over the past month or so, the weekly reports from the official MI Dept. of Community Health "Healthy Michigan" website has pegged the current enrollment total at between 490K - 510K. This led me to assume, naturally, that the program has been essentially tapped out, with close to 100% of those eligible already having signed up within the first 10 months.
Yesterday, however, they posted the weekly update again, and guess what?
Healthy Michigan Plan Enrollment Statistics
Beneficiaries with Healthy Michigan Plan Coverage: 533,110
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)
*Statistics as of January 26, 2015
*Updated every Monday at 3 p.m.
Wow. 533,000 people. So, what's going on here? Well, possibilities include:
Indiana has been given the green light to expand its Healthy Indiana Plan, which would offer insurance to an additional 350,000 Indiana residents who currently lack insurance.
The state will begin taking applications immediately for its so-called HIP 2.0 plan, for which coverage begins Feb. 1, Gov. Mike Pence announced Tuesday morning at a packed speech at St. Vincent Health.
So, what makes this different from standard Medicaid expansion?
Indiana is the only state to apply private market measures, such as requiring participants to make monthly contributions to help cover the benefit.
Anyone who falls below 138 percent of the federal poverty level will now be eligible to enroll in what the state is terming the Healthy Indiana Plan Plus. The plan includes dental and vision benefits, as well comprehensive prescription drug benefits.
Participants in this plan will be expected to make contributions of between $3 and $25 per month, or about 2 percent of the annual income for the year.
In recent weeks, I've turned into quite the Debbie Downer regarding the outcome of the King v. Burwell federal ACA tax credit case, set to be argued this March with a decision expected to be announced sometime in June. This is a far cry from 6 months ago, when I first proposed my apparently naive "Denny's Grand Slam" workaround (has it really been that long?).
Anyway, today brings three important takes on the case from The New Republic's Brian Beutler, the Washington Post's Greg Sargent and Scholars Strategy Network's Prof. Theda Skocpol which have bolstered my spirits somewhat. First up, Beutler:
NOTE: The source of this guest post by Esther Ferington is a wee bit out of date by now, but it's still an interesting topic and she's done her research, so I figured it should still be posted; I apologize to her for the delayed publication:
Unraveling the "Pediatric Age" Proposal
by Esther Ferington
When HHS rolled out its proposals tied to Open Enrollment for 2016, many of the usual topics made the list (re-enrollment guidelines, start and stop dates for open enrollment, and so on). One that seemed a lot less familiar was "pediatric age":
Pediatric Age. We propose that pediatric benefits be provided until the end of the plan year in which the enrollee turns 19.
So... that was unexpected. And since we're in new territory here, it raises a few questions:
(sigh) I might as well get this out of the way now.
I've been promising for some time to write a post explaining the difference between the CBO's "13 Million QHPs" projection, the HHS Dept's "9.1 million" projection and my own "12.5 Million" projection. I've alluded to this here and there, but a lot of people are still confused, so it behooves me to dedicate a full post to the topic (which I can then add to the menu for quick access).
I was planning on waiting another week or so before writing this, but with the CBO issuing their latest 10-year Budget Outlook, which quietly reduces their "13 million" figure down to 12 million, it seems like now is the time. I'm already anticipating people thinking that this means that my own projection is now higher than the CBO's...which it isn't.
In a nutshell, here's what the different numbers mean:
For the past few months, the estimates of the reduction in the uninsured people in the U.S. has ranged from as low as 8-9 million to as high as 10-11 million, depending on the survey source (Gallup, Urban Institute, the Census Bureau, etc), when it was done (a lot has changed over just the past few months), whether it includes children under 18 or not, whether it includes undocumented immigrants or not and so on.
However, the official number which has been tossed around by both the White House as well as the mainstream media has pretty much settled on an even 10 million of late. It's been used in various press releases and as a talking point in Sunday morning talk shows, and President Obama even used the 10 million figure in the State of the Union.
Last Friday's weekly report for the MA Health Connector had the official QHP selection tally up to 108,051 as of January 22nd. Since then, there have been another 4,751 QHP determinations, of which around 2,100 or more should have actually selected a policy.
Note the huge gap between last Friday (3,440) and the following two days (1,311 combined). This is partly due to the weekend drop-off, but is mostly because Friday was the enrollment deadline for February coverage. Anyone enrolling on Saturday or Sunday won't have their policy start until March 1st anyway, thus the massive drop-off.
Anyway, this should mean that Massachusett's QHP total is now up to at least 110K, while Medicaid (MassHealth) enrollment are now above 200K, at 206,063.
Meanwhile, the MA exchange has also announced that due to the massive blizzard/snowstorm rolling into the area later on today, they're extending the payment deadline for people who enrolled by the 1/23 deadline out to this Friday, January 30th:
If you get sick, America, the Republican health care plan is this: "Die quickly." That’s right. The Republicans want you to die quickly if you get sick."
...Consider this question: Should society have as its goal that the government prevents all deaths from any health-related ailment other than natural causes associated with ripe old age? The notion is absurd — to both conservatives and liberals. There are limits to the proper amount of scarce resources, funded by taxpayers, that Washington should redirect toward health care.
After the one-two punches of both Rhode Island and Vermont moving in exactly the wrong direction (at least before the King v. Burwell SCOTUS decision is announced this summer), my jaw nearly dropped when I read this story out of Texas, of all states:
AUSTIN -- On Wednesday, State Rep. Chris Turner (HD 101-Grand Prairie) filed two bills, HB 818 and HB 817, both creating a state health benefit exchange.
Health Connector Executive Director Maydad Cohen released the updated numbers Friday, the day Gov. Charlie Baker announced he was extending through Jan. 28 the deadline for people to sign up and pay for insurance plans that take effect Feb. 1. The deadline originally was Friday.
Gov. Charlie Baker appointed Louis Gutierrez, a veteran of the last three Republican administrations, to lead the Massachusetts Health Connector.
Gutierrez will replaceJean Yang, who was executive director of the state's health insurance exchange under former Democratic Governor Deval Patrick. Baker, a Republican, was widely expected to bring in his own appointee to head the organization, which has had a difficult year.
The last 4 weekly HC.gov reports saw 96K (Christmas), 103K (New Year's), 163K (nothing significant) and 400K (the February coverage deadline for most states) on the federal exchange.
With the 1/15 deadline out of the way, the past week (and the next two) should come in somewhere between the last two: Fairly quiet, but steady and not completely dead. I'm assuming roughly 30K/day on HC.gov (around 40K/day nationally), which should have brought the total on HealthCare.Gov up to around 7.36 million as of Friday, January 23rd (around 210K for the week).
Now, here's the thing: We're 1/3 of the way through what should be a fairly consistent 3-week period before the final rush kicks in around February 9th/10th. My guess is that whatever the tally was this past week should stay pretty close for the next 2 weeks as well...so if the past week turns out to be higher (say, 250K), the following 2 weeks should each hit that number or higher as well. I'm estimating that the national total should reach the HHS's target (10.4 million) around February 6th.
No, I'm not gonna go into a "Dental Gate"-style rant against the HHS Dept. about this. Without knowing more details about the information in question or how it's being used, this may be another "nontroversy". Even so, it strikes me as being a bit of an unforced error on the part of the administration:
The government's health insurance website is quietly sending consumers' personal data to private companies that specialize in advertising and analyzing Internet data for performance and marketing,The Associated Press has learned.
The scope of what is disclosed or how it might be used was not immediately clear, but it can include age, income, ZIP code, whether a person smokes, and if a person is pregnant. It can include a computer's Internet address, which can identify a person's name or address when combined with other information collected by sophisticated online marketing or advertising firms.
A few days ago, I posted an article over at healthinsurance.org which delved into the mysterious world of OFF-exchange QHPs...ie, people who just enroll in a private, individual/family healthcare policy the old-fashioned way, by contacting Blue Cross, Aetna, UnitedHealthCare or whoever directly instead of going through one of the ACA exchange websites.
I also posted an accompanying piece here which noted how hard it is to lock down these enrollment numbers, since the carriers aren't generally required to provide that information publicly except in a general sort of way (and even then, usually only once a year or so). Only Oregon and Washington State really post off-exchange data with any sort of frequency, and only Oregon is doing so weekly.
OK, that's 92,886 QHPs total, or 208/day since the December 15th deadline. At that rate, they'll likely add a minimum of 5,000 more by 2/15 if there's no mid-February surge; more likely they'll add between 10-15K more, for a total of perhaps 108K at the outside, just barely hitting the HHS Dept's target (107K), but coming up short of mine (130K)...but we'll have to see...
MNsure will release 2015 enrollment metrics weekly, and will present a more robust metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. During weeks that MNsure is closed on Friday, the enrollment metrics update will be released earlier in the week.
Health Coverage Type Cumulative Enrollments
Medical Assistance 44,308
MinnesotaCare 17,506 Qualified Health Plan (QHP) 44,130
TOTAL 105,944
* (actually as of 1/22)
OK, let's see here...that's exactly 400 more QHP enrollees since 1/19, or 133/day, although they've averaged 194/day since New Year's Eve.
At that rate (with no mid-February bump), they'll add another 4,600 by 2/15, or 49K, well short of their target of 67K. However, it's more likely to be more like double or even triple that when you include the final surge, for a total of perhaps 58,000 or so. Reaching their internal target may still be feasible; reaching mine (75K) seems very unlikely at this point, but anything's possible.
As of Jan. 22, 185,199 Marylanders have enrolled in quality, affordable health coverage for calendar year 2015, since the 90-day open enrollment period began Nov. 15. That includes 93,806 people enrolled in private Qualified Health Plans (QHP) and 91,393 people enrolled in Medicaid.
As of Jan. 21, the total number of Medicaid and MCHP enrollment is 1,281,999. Compared to Dec. 31, 2013, the net change in Medicaid enrollment as of Jan. 21, 2015 is +241,337. This figure takes into account that individuals lose Medicaid coverage because of changes in household, age and income, as well as redeterminations.
OK, that's 2,669 in 11 days, or 242/day. This is down substantially from the prior week or so, but it includes the days leading up to and following the 1/15 deadline for February coverage (when they'd drop off again), so that doesn't really mean much.
This is an incredibly depressing post for me to write. Last month I received word that CoOportunity Health, one of the 23 co-ops set up as part of the ACA to offer competition with the Big Boys, had run into serious financial trouble and was being yanked off of Healthcare.Gov (they were operating in Iowa and Nebraska, both of which are on the federal exchange).
Anyway, as of December 10th, my contact at CoOportunity was unaware of any issues; they reported that everything was going great. On Christmas Eve, I was tipped off about CMS dropping CoOportunity from the exchange completely, but there wasn't a whole lot of detail given as to what had gone wrong beyond vague references to quarterly financial statements, cash flow and annual audits.
And there you have it: As I've been expecting all week, not only has the MA Health Connector broken the 100K milestone, they blew past it, with 108,051 private policy selections as of last night (the Medicaid number is still hovering just below 200K, but that doesn't include yesterday; they should have easily tacked on another 5,000 to put MassHealth over the top).
In addition, the overall payment rate continues to climb, reaching 76%...but likely much higher when you consider that about many of the 108,000 total aren't scheduled to have their policies kick in until February anyway. I know that at least 50K of those who paid were for January-start policies, so it could easily be something like: 50K paid / 57K (January) + 32.2K paid / 51K (February), which would mean 88% of the January enrollees are paid up + 63% of the February enrollees so far. The larger point is that we won't know the real payment rate until late March (over a month after the enrollment period itself ends), so there's nothing to worry about for now.
A few days ago I posted an article about how Rhode Island is having trouble scraping together the $19 million or so that they need to operate HealthSource RI, now that the federal funds have pretty much dried up and the exchange has to pull its own weight. Some exchanges were set up with a funding mechanism in place (generally by charging either the insurance companies operating on the exchange, or the enrollees themselves, some sort of tax or fee), but others, like Rhode Island, were funded with federal dollars but never got around to setting up a way to pay for themselves after that funding stopped.
Anyway, a Republican state legislator in RI came up with an ingenious solution: Dump the exchange, even though it's functioning perfectly well. The reasoning is that the federal exchange, Healthcare.Gov, is operating more efficiently, so why not just do what Oregon and Nevada had to do this year (due to technical problems) and add themselves to the pile of 3 dozen states already being run through HC.gov?
Today's update makes that even more clear: Another 2,976 QHP determinations likely means at least 1,300 more QHP selections, which should bring the total up to around 98,800 through last night. Another 1,200 today should put them over the top...and that's quite likely since the numbers should be ramping up further today (MA's February-start enrollment deadline is tomorrow).
For the record, this also means that Massachusetts has now officially enrolled 3x as many people in private policies as they did all of last year.
The Medicaid (MassHealth) side, meanwhile, isn't an estimate--those 195,549 people are enrolled immediately as I understand it. 4,500 more today and they've hit the 200K milestone.
*Well, ok, not all of them...they aren't breaking out zip codes with 50 or fewer enrollments in the interest of privacy...which is kind of ironic given my earlier entry today, but whatever.
I haven't done anything with this file yet, partly because I'm swamped with work (I do have a day job, remember), but mainly because I don't really get into the sub-state level stuff; I already have my hands full with the state-level data.
Still, there's a ton of interesting ways that you can slice & dice up this data, and huge kudos to HHS/CMS/HC.gov for the impressive leaps in transparancy this fall: First the weekly snapshots; then the state-level weekly snapshots; and now, this QHP-by-zip-code database.
David Ramsey has the full skinny on the unpleasant situation in Arkansas, where their "private option" Medicaid expansion program, which was always weird with a beard to begin with, is very much at risk of collapsing altogether:
Well, here we go again. The legislature is once again ready to debate the private option – the state’s unique version of Medicaid expansion, which uses funds available via the Affordable Care Act to purchase private health insurance for low-income Arkansans. Gov. Asa Hutchinson will take a long-awaited position on the policy in a speech at UAMS tomorrow morning. Then it will be up to the legislature. Health insurance for more than 200,000 Arkansans is at stake. Here are some keys to remember as the debate unfolds tomorrow and in the coming weeks.
The short version: The AR program has to be re-approved by the legislature every year, and requires a 75% majority to do so, so it's a wonder that it's survived this long, frankly.
Obamacare’s individual mandate is beginning to creep into outreach about signing up for health insurance this year.
The message is coming from two directions. Some outreach groups will move in the coming weeks to clearly mention the risk of rising penalties as they urge people to get covered before the enrollment season ends Feb. 15. And people who are getting an early start on their 2014 taxes — tax preparers say they expect the year’s first big surge in early February — will get a reminder of fines they may face for being uninsured last year and how much larger those fines could be one year from now if they say “No thanks” to Obamacare.
...But the mandate fines are going to start hitting home. As people start working on their 2014 tax forms, they will be able to see precisely how much they could pay in penalties for being uninsured last year. And it’s often more than the $95 they heard about.
No, I'm not gonna go into a "Dental Gate"-style rant against the HHS Dept. about this. Without knowing more details about the information in question or how it's being used, this may be another "nontroversy". Even so, it strikes me as being a bit of an unforced error on the part of the administration:
The government's health insurance website is quietly sending consumers' personal data to private companies that specialize in advertising and analyzing Internet data for performance and marketing,The Associated Press has learned.
The scope of what is disclosed or how it might be used was not immediately clear, but it can include age, income, ZIP code, whether a person smokes, and if a person is pregnant. It can include a computer's Internet address, which can identify a person's name or address when combined with other information collected by sophisticated online marketing or advertising firms.
Hot off the presses... HealthSource RI has posted their latest enrollment report; the new numbers are modest, but the payment data is rapidly improving; they're up to an 84% payment rate and the other 16% still have 6 days (from the 17th) to pay up.
DEMOGRAPHIC, AND VOLUME DATA THROUGH JANUARY 17, 2015
RENEWAL UPDATE As of January 17, 2015, 81% of Year One customers have renewed (selected a plan) for 2015 (72% of renewing customers paid the first month’s premium).
Total New Customers: 7,660 (5,646 paid)
Total Renewed Customers: 21,129 (18,460 paid) Total HealthSource RI enrollments for 2015 coverage: 28,789 (24,106 paid)
...Renewed Customers
2015 vs. 2014 Selection by Plan, by Metal Level and by Insurer
With the release of the latest data from HC.gov less than an hour ago, here's where things stand:
At least 33 states have now reached the "official" 2015 QHP enrollment target laid out for them by either the HHS Dept (10.4 million nationally) or, in some cases, individual state governments/exchanges. Again, this means roughly 30% more enrollees than the April 19, 2014 total, but in some cases it's higher or lower (for instance, Florida only targeted enrolling about 9% more people this year than last, while New York is hoping to nearly double their 2014 total...and Massachusetts is a whole different game).
Another 6 states (Connecticut, New Hampshire, Ohio, Tennesse, Texas and Wisconsin) are all within striking distance (90%+) of HHS's target; all should easily break through over the next 3 1/2 weeks.
The states which are lagging include Colorado, Minnesota, Rhode Island, Vermont and Washington State, which are all below 75% of the HHS/official goal as of their most recent update. Bear in mind, however, that some of these states are missing more data than the other states, so they may have made up some ground since the number shown.
Yestetrday I noted that the MA Health Connector should be closing in on 100,000 QHP selections, having likely reached around 96.5K. They've since added 2,107 QHP determinations, which should mean roughly 950 more, bringing the state up to around 97.5K as of last night. MA's deadline for February 1st coverage is coming up on Friday, so there should be a mini-surge over the rest of this week. Medicaid enrollments have now reached 191K.
The DC exchange doesn't post updates often, but when they do it's simple, to the point data...and as a bonus, they're one of the few exchanges to include SHOP data (probably because they're one of the few where SHOP enrollments are above 4 figures, thanks to the weird ACA rule requiring Congressional staffers to enroll using it).
From October 1, 2013 to January 11, 2015, over 74,100 people have enrolled in health insurance coverage through DC Health Link in private health plans and Medicaid:
In my latest healthinsurance.org exclusive, I take a look at the off-exchange policy enrollment situation...and just like last year, I think a whole lot of people are going to be shocked when they realize just how many people are signing up for ACA-compliant Qualified Health Plans directly through their carrier.
In addition to this writeup, I'll be revisiting the off-exchange issue soon; I've already contacted 49 state insurance commissioner's offices (Vermont & DC don't have off-exchange enrollments anymore) to see how many are tracking those numbers on a more than annual basis.
Of course, this might have proven to be an exercise in futility. Aside from Oregon (and Washington State, though I have to confirm that for this year), the following should give you an idea of how tall an order this is:
9,454 individuals have checked out a 2015 health plan. This includes 3,791 individuals in Qualified Health Plans (private health insurance) and 5,663 individuals in Medicaid or Dr. Dynasaur plans.
After a new customer checks out a plan, they must make an initial premium payment and have their selection processed before they have an active health plan. Of the 9,454 individuals who checked out, 7,981 have completed the enrollment process and have an active health plan (i.e., effectuated enrollment). Of those who completed the process, 2,506 are on a Qualified Health Plan and 5,475 are on Medicaid or Dr. Dynasaur.
Renewing 2014 Vermont Health Connect Plans
Unless a customer requested otherwise, all individuals who had an active health plan through the end of 2014 currently have health insurance coverage through Blue Cross Blue Shield of Vermont, MVP Health Care, Medicaid or Dr. Dynasaur. The insurance issuers have their information in their systems and ID cards remain active.
I was rather surprised to see another update from MNsure today, since they've generally been issuing weekly updates on Fridays this year, but they decided to issue a special press release to trumpet attaining the 100,000 enrollment mark:
MNsure tops 100,000 Total Enrollments
Less than four weeks remain before February 15 open enrollment deadline
ST. PAUL, Minn.—Today, MNsure announced more than 100,000 Minnesotans have enrolled in comprehensive, affordable health insurance coverage since November 15, the start of the 2015 open enrollment period.
“We are encouraged by this news, as well as the fact that so many Minnesotans are obtaining the health insurance coverage they need through MNsure,” said CEO Scott Leitz. “As we enter the final weeks of this open enrollment period, we’re stepping on the gas to make sure all Minnesotans know about the benefits of MNsure.”
After an extended break for the MLK Jr. Day weekend, the MA Health Connector's daily dashboards are back in business.
Friday's weekly report gave the latest hard QHP total: 93,262 through 1/14. Over the following 5 days, there were an additional 7,321 QHP determinations made. Using the 45% rule of thumb, that means Massachusett's QHP total should be up another 3,300 or so, for a total of 96.5K through last night.
There's one very odd thing here, though...what the heck happened on Sunday the 18th? Yes, enrollments are normally much lower on weekends, but only 657 total including Medicaid enrollments? I've seen that sort of drop on Thanksgiving, Christmas and New Year's, but this was just a Sunday (and MLK Day wasn't until a day later, where the numbers are a bit low but not by that much).
Anyway, given that MA's enrollment deadline for February coverage is coming up in 3 days, they should be able to break the 100K milestone easily in the next few days.
Meanwhile, their Medicaid (MassHealth) enrollment tally is up to 188K, and should similarly break the 200K mark within the next few days as well.
Again, I know this is a few days old, but I've been playing a bit of catchup lately. You know how the King v. Burwell case (aka Halbig v. Burwell, effectively...same case, different U.S. Circuit, but King is the one going to SCOTUS) is entirely based on the claim that Congress intended for the IRS to only dole out tax credits to people who enrolled via state-based exchanges, not through the Federal exchange?
The Congressional Budget Office wrote 68 reports about the Affordable Care Act during the session that Congress debated the law. Not one of them, a new analysis from Harvard University's Theda Skocpol, ever explored the possibility of limiting insurance subsidies to the state marketplaces after the law's full implementation.
The Associated Press reported Sunday that newly elected Republican. Gov. Asa Hutchinson is expected to address the program, which uses Medicaid dollars to pay for private coverage, in a speech this week. Arkansas's plan must be re-approved every year.
The program is contending with Hutchinson and a batch of newly elected Republican lawmakers who ran against it. The funding must be approved by three-fourths of the state legislature every year. As TPM previously reported, getting approval in 2014 required a significant amount of horse-trading and deal-making under Democratic Gov. Mike Beebe.
...Even if Hutchinson agrees to keep the so-called private option, he is expected to propose more conservative-minded changes. Senate President Jonathan Dismang told the AP that Medicaid expansion "is not going to exist in its current form."
The number of Americans struggling to pay medical bills fell last year for the first time in nearly a decade -- the latest sign that Obamacare is making health care more affordable.
Sixty-four million people, or approximately 35 percent of the U.S. population, said they had trouble paying bills or were stuck paying off medical debt in the past year, according to a new survey by the Commonwealth Fund released on Thursday. That was down from 75 million people, or 41 percent of the population, in 2012. This marks the first time that figure has fallen since 2005, when Commonwealth started keeping track.
Sean Parnell has posted a fairly negative story on the Rhode Island exchange, HealthSource RI. This is fairly unusual, because Rhode Island's exchange is actually one of the better ones...it operated fairly smoothly both last year and this year, and they're the only state which willingly followed the "no autorenewal" advice which I was giving to all of the exchanges way back in June (a few other states didn't allow autorenewals either, but that wasn't their choice...the new software platform wasn't compatible with the old software).
The problem in Rhode Island is that no matter how smooth and drama-free the exchange's operations have been, the actual numbers just haven't been up to snuff:
During the first eight weeks of open enrollment, 121,650 people enrolled in private coverage through Connect for Health Colorado and 47,724 in Medicaid and 2,272 in CHP+. Connect for Health Colorado also enrolled 20,580 individuals in dental plans.
“The enrollments in Medicaid and Connect for Health Colorado show that Coloradans are attuned to the importance of having health insurance coverage,” said Susan Birch, Executive Director of the Colorado Department of Health Care Policy and Financing. “Whether Coloradans have health insurance coverage through private insurance or through Medicaid, health coverage is the first step to better health.”
Colorado's last update ran through New Year's Eve, totalling 113,864 QHP enrollees, or 362 per day since the 12/15 deadline. That gives a nice apples-to-apples comparison to the new number (7,786 higher), which averages 519 per day...up over 40% per day since the holiday period.
As we’ve said many times before, it really pays for returning customers to the Obamacare insurance marketplaces to shop around for a 2015 health plan. Recent data from the federal government shows that a surprising number of people are doing just that.
More than 30 percent of federal marketplace customers who re-enrolled for 2015 did so by actively returning to Healthcare.gov and picking a plan, according to Health and Human Services Secretary Sylvia Mathews Burwell. That’s still less than half of all customers, but it far exceeds what you might expect based on consumer behavior in other public health insurancemarketplaces.
I put together a year-over-year overlay 1/3 of the way through open enrollment (right after the 12/15 deadline) and again at around the halfway point, both of which were pretty well-received, so now that we've crossed the 2/3 mark I've done an updated version.
I was going to use 1/15 as the cut-off date, but since the HHS "weekly snapshots" run through Fridays, I wanted to avoid the confusion of 2 different projection numbers, so I included the extra day to line this up with my 1/16 projection of 9.5 million QHPs even.
At the 2/3 point last year (around January 9th), total QHP selections were at around 3.7 million, versus the 9.5 million who should have enrolled for 2015 as of Friday night, or almost 2.6x as many. This gap will obviously close quickly once we move into the home stretch, but this period should still end with roughly a 50-60% increase over last year.
The following are, again, ACA/healthcare stories which I simply never had time to do write-ups on. Some of these are several weeks old, so please forgive any outdated-ness:
The Supreme Court on Monday rejected a 2-year-old legal challenge to a central provision of ObamaCare from a conservative doctors group.
The case, which was led by the Association of American Physicians and Surgeons, sought to strike down the law’s individual mandate, which fines individuals who fail to purchase health insurance.
The plaintiffs’ argument had been rejected twice before: first by a district court judge in 2012 and then by the D.C. Circuit Court of Appeals in March 2014.
As I reported Wednesday, brokers and small businesses using the D.C. Health Link exchange say the website is plagued with technical problems that have led to ongoing delays and frustrations. Among the problems: frozen screens, lost enrollment information, repeat error messages and other glitches. They also described ongoing delayed responses when they've reached out to the help resources for D.C. Health Link.
California's Obamacare exchange rejected a bid from the nation's largest health insurer to start selling coverage statewide next year.
The Covered California board adopted new rules Thursday that sharply limit where industry giant UnitedHealth Group Inc. could offer policies to individuals.
I haven't checked in on the Medicaid/CHIP enrollment situation in awhile, but with last week's revelation that California's Medicaid enrollment is a whopping 500,000 higher than previously thought, I probably should have done so earlier.
Well this one was unexpected: It's not a formal press release, but this story from the Hawaii Reporter--which actually has a pretty negative slant to it--is chock full of actual, current enrollment data points for Hawaii...and they're pretty good, relatively speaking.
None of the numbers are precise--they're all rounded off...but it's still a breath of fresh air from the Aloha state, and brings the number of states which haven't provided renewal data down from 3 to two (of course, the other two are California and New York, but still...)
...The Connector had about 1,000 people enrolled at this time last year. As of Thursday, that number had grown to 16,000.
...More than 365 small businesses, with 2,400 enrollees, have joined the Connector through the Small Business Health Options Program, or SHOP, in part because of tax deductions available to them, Kissel said.
So, that brings their total up to 91,430 as of...um...well, "the last week alone" suggests 7 days, which would mean either 1/07 - 1/13 or 1/09 - 1/15 (which would leave a 2-day gap). Fortunately, they then followed up with this:
Two months of open enrollment down & more than 125,000 Kentuckians have newly enrolled 4 health coverage or renewed their plans thru #kynect
Over the past month or so, the "Healthy Michigan" program (our name for ACA Medicaid expansion) has been bouncing around between 490K - 505K...a bit higher one week, a bit lower the next as people move on and off of it.
However, given that the estimated maximum number of Michiganders eligible for the program is somewhere between 477K - 500K depending on your source, it's unlikely to go much higher than that. I'll keep a close eye on it for the next few weeks, but assuming it continues to jostle above/below the 500K mark, I'll consider Michigan to be effectively "tapped out" and will likely stop reporting it every week.
Last week, with autorenewals added into the mix, MNsure was sitting at 41,704 QHPs as of January 5th. They just posted another update running through last night (the date of the numbers is actually as of the night before, as made clear from the corresponding press releases):
Latest Enrollment Numbers: January 16, 2015
MNsure will release 2015 enrollment metrics weekly, and will present a more robust metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. During weeks that MNsure is closed on Friday, the enrollment metrics update will be released earlier in the week.
Health Coverage Type Cumulative Enrollments Medical Assistance 38,405
MinnesotaCare 16,056
Qualified Health Plan (QHP) 43,461
TOTAL 97,922
I was burned a couple of weeks in a row by overestimating the actual private policy (QHP) selections to date in Massachusetts by around 5% or so. Last week I downshifted a bit (from 50% of eligibility determinations to 45%), resulting in an estimate of around 90,700 QHPs as of Tuesday.
Today the MA exchange released their weekly dashboard, with official QHP selections, and sure enough, I'm back on target: 93,262 QHP selections as of Wednesday the 14th, in addition to 178,912 Medicaid (MassHealth) enrollees.
As for the payment rate, on the surface it appears to be just 72% (67,265 out of 93,262). However, remember that the 93K figure includes 19,000 people who are enrolling for coverage starting in February. We know this because of this update from December 30th:
Of the 74,203 people who selected plans by the Tuesday deadline, 51,888 paid their first month’s premium by Friday.
I've updated The Graph again, bringing things up to the end of the day today (Friday, January 16). After a 3-week "quiet period" (made even quieter due to both Christmas and New Year's), things should have heated up again this past week as yesterday's February coverage deadline approached.
The first week after the January deadline, HC.gov saw a mere 96K QHP selections due to Christmas Eve/Day, and the following week wasn't much better at 103K. As expected, they picked up somewhat last week with 163K QHPs.
Presented without comment, because this story is so awesome there's not much I could say to make it any better:
Community Health pulls plans after meeting ACA goals
Community Health Alliance has pulled its health insurance plans off the federal marketplace because it hit its enrollment goals.
Knoxville-based Community Health Alliance, a nonprofit consumer operated and oriented insurance provider, or co-op, hit its enrollment goals in the first two months of open enrollment. It stopped offering plans on the exchange Jan. 15.
I have no idea whether there's a healthcare-specific awards ceremony or anything, but this seems to be the closest thing to it, so I'll take it: Dan Diamond of The Advisory Board Company has posted his "Best of 2014" list when it comes to healthcare journalism (is it one word or two?), and I'm honored to be mentioned among field luminaries such as Sarah Kliff, Alex Wayne, Nicholas Bagley, Margot Sanger-Katz and many others.
I've had a couple of days to shake off the funk I was in after CoveredCA director Peter Lee stated that they would not be releasing any 2014 renewal data until as late as February. I'm still pretty grumpy about that.
Through January 12: 228,766 New Individuals Selected a Qualified Health Plan for 2015
Big deal, right? It updates the new enrollment figure a bit, but that's about it. But wait a minute...what was the CA QHP total just 1 day earlier (through January 11th)?
TODAY, January 15th, is the deadline for anyone who wants to enroll in a private insurance policy for coverage starting on February 1st in most states (or to switch to a different policy if you have one but want to make a change starting in February).
After that, of course, we'll have the big February 15th deadline (for March 1st coverage), which will also be a big deal because it'll be the last chance many (not all) uninsured people have to get coverage before the door slams closed until next fall.
Remember, the penalty in 2016 for not having health insurance in 2015 is considerably higher than it was for 2014: Instead of 1% of your taxable income (or $95/person in your household, whichever is higher), the fee this year is 2% of your income or $325 per person.
No official press release yet, but all of the numbers are here and are (thankfully) properly presented:
Following a flurry of activity leading up to a New Year’s Eve enrollment deadline for coverage on Jan. 1 — and also through the first 10 days of this month — 80 percent of first-year customers have signed up for a plan for this year, according to figures to be released on Thursday. Of those, 67 percent have followed through and paid their first monthly premium.
...Total enrollments for individuals now stands at 27,690, up from 25,288 just before the start of open enrollment in mid-November.
...“We were preparing for that with a very robust consumer outreach plan,” said spokeswoman Maria Tocco, adding, “I’m not sure we knew what to expect.”
...HealthSource RI reports that, as of Wednesday, 6,918 people who were not previously customers had been signed up for coverage. Wallack called that figure “great.”
...The new subscribers joined 20,772 returning individuals. Together, the two groups combined for an increase of 2,402 covered individuals, up slightly less than 1 percent from just before enrollment began.
The Access Health CT board of directors is holding a meeting this morning and promises to liveblog the latest developments, including updated enrollment numbers.
Connecticut hasn't updated their numbers since 12/15, when they announced 66K renewals and 19.4K new enrollees, so this should be somewhat interesting.
Remember that today (Jan. 15th) is the deadline for February 1st coverage
ENROLLMENT:
As of last Friday, "around" 90,000 customers (20% higher than last year)
1,500 - 2,000/day...on track to hit/exceed (combined)
last year: 100 - 120K total (includes Medicaid)
midnight tonight: should have over 500K in system (includes Medicaid)
dental: 1K any day now
OPERATIONS:
IRS form 1095 (tax credit form)
education/outreach/etc. programs already in gear
some people already asking questions, etc. re taxes
Earlier, I noted that now that the HHS Dept. has broken out the 6.75 million confirmed QHP selections by state, combined with the state-based exchange data that I also have, I'm finally able to get a real sense of how each individual state is doing so far. I noted that 18 states have already reached 100% of their respective 2015 QHP goal based on the official national HHS projection of 10.4 million QHP selections by February 15, and many others are close to that.
Of course, I shouldn't be too geeked about that, since the HHS projection was almost certainly lowballed somewhat to begin with. Therefore, I've also come up with my own projection of where I think things will stand by 2/15: Around 12.5 million QHPs total. None of the states/DC have reached my state-level targets yet, although 4 small states (Alaska, Delaware, DC and North Dakota) are over 90% of the way there.
Aside from the Mystery of the Missing Renewal Data® from California & New York, the biggest unknown between now and the end of 2015 Open Enrollment on February 15th is this: How big of a "final deadline surge" will there be?
My 12.5 million projection is based on the assumption that there's a mini-surge happening this week (the deadline for Feb. 1st coverage is tomorrow in most states), followed by another 3 week "quiet period" from around January 20th until around February 10th. During that 3 week period, I QHP enrollments should average roughly 40K per day (up from the 30K/day that should have been the average over the first "quiet period" we just came out of). That would bring the grand total to around 10.5 million around February 10th.
Now, the actual tally might be a bit higher or lower than that until that point, but I'm pretty confident it'll be in the neighborhood of 10.5M. The bigger question is what happens in the final 5 days of the Open Enrollment period, from 2/11 - 2/15 (which also happens to be Valentine's Day week, for whatever that's worth).
Yesterday, Peter Lee of Covered California held a phone press conference in which he gave out updated data for new QHP enrollments (bringing the total up to over 217K), but refused to give out any numbers whatsoever when it comes to renewals / re-enrollments of 2014 enrollees...whether these were done actively by the enrollee or automatically by the system.
Just now, I've learned that the other major state exchange missing data--New York State of Health--has apparently stated that not only are they not giving out their renewal/re-enrollment data either, they aren't even going to give out any new updates until February 1st:
With today's confirmation of 6.75 million QHPs via HC.gov (thru 1/09) and the almost-certain-to-be-close 90K figure from Massachusetts (through yesterday), the confirmed (or virtually confirmed) QHP total nationally is now up to over 7.82 million. However, my estimate is now up to 9.34 million, or around 1.52 million higher.
I've done this before, but this seems like a good point to again review where the gap between the numbers is:
OK. The latest weekly snapshot released by the HHS Dept. an hour or so ago was about 25,000 enrollees higher than I figured, which is nice. However, the real news was that they included a state-level breakout of all 37 states, which is awesome!
I've plugged all 37 states into the spreadsheet, broken into 2 numbers: Total active renewals (ie, those who actively renewed or switched plans by the 12/15 deadline) and total autorenewals + new enrollments (unfortunately, I can't really break these out; I tried, but there are overlaps between the 12/15 ASPE report and the 12/19 weekly snapshot). In addition, the autorenewals are a "lump sum" instead of being broken out by state; I attempted to estimate based on the percent-of-total but came up with some states having negative figures, so obviously there are too many variables. That is, just because a particular state has, say, 2% of the active renewals doesn't mean they had 2% of the auto renewals, and so on.
Anyway, after plugging everything into the spreadsheet--along with the state-based exchange data--I can now see just where the HC.gov QHPs are...and the results are impressive and interesting in several ways:
At least 18 states (well, 17 + DC) have achieved 100% or more of the HHS's (admittedly lowballed) target (or in some cases, the state administration's publicly-stated target) for 2015 already. Note that this generally assumes 30% higher than last year's open enrollment total (ie, 10.4M nationally = 30% more than 8M):
Alabama, Alaska, Arizona, Delaware, DC, Florida, Indiana, Kansas, Maine, Maryland, Nebraska, North Dakota, Oklahoma, South Carolina, South Dakota, Virginia, West Virginia and Wyoming
I say "at least" 18 because we still have zero renewal/re-enrollment data from California, New York or Hawaii, and even the new enrollee data is still as much as a month out of date in a few states.
Massachusetts, as always, is a special case. 30% higher than last spring would only be around 42,000; they're up well over 2x that already. However, a more realistic goal for them would be 175K or more given the unique nature of their situation.
Another likely 1,100 QHPs yesterday (out of 2,540 QHP eligibility determinations) means that Massachusett's QHP selection total should be up to around 90,700 by now. Medicaid has broken the 175K mark:
The HHS Dept. just released the Week 8 "snapshot" report which has the actual total coming in slightly higher, at 6,756,438, about 0.4% higher.
The real news this week is that HHS has provided an updated STATE BY STATE BREAKDOWN for all 37 states operating off of the Federal ACA exchange!
This is a completely unexpected bonus, and kudos to the HHS Dept. for providing this!
I'm working right now on breaking the state-level numbers out by renewals and new enrollment using the table above + the monthly ASPE report from a couple of weeks ago, but that'll take a bit of time. Stay tuned...
As you may recall, a week or so ago I ran into a weird discrepancy with the numbers out of a few states. In the case of Vermont, it turned out that the enrollment data they were releasing included both QHPs and Medicaid without distinguishing between the two.
The following numbers are up-to-date as of 11:59pm Monday, January 12, 2015.
New Vermont Health Connect Customers
8,709 individuals have checked out a 2015 health plan. This includes 3,506 individuals in Qualified Health Plans (private health insurance) and 5,203 individuals in Medicaid or Dr. Dynasaur plans.
BOISE, Idaho – In the first two months of open enrollment, Your Health Idaho processed 83,383 customers, which includes consumers renewing coverage for 2015 and new applicants.
“Having health insurance gives Idahoans peace of mind that if something horrible should happen they are covered” said Your Health Idaho executive director, Pat Kelly. “We are happy so many Idahoans have been able to find a health insurance plan that meets their needs, however, we know many more people still need to find coverage and we will continue to reach out to them until open enrollment ends on February 15.”
ID had 74,689 enrollees as of December 14th (including autorenewals). They bumped out their January deadline a bit, but that's still a pretty good baseline for the post-deadline numbers: 8,694 between 12/15 - 12/31, or 511 per day.
They also include some demographic data for the 83.4K QHPs:
Massachusetts continues to set the example (are you paying attention, CoveredCA??), releasing near-daily enrollment reports and regular weekly reports with hard numbers on QHP enrollments every week (including payment data, I should note):
Again, assuming 45% QHP selections out of the 2,652 determined eligible for private policies, MA should have tacked on another 1,200 or so yesterday, bringing their QHP total up to around 89,600 to date.
In addition, they've enrolled another 3,709 into MassHealth (Medicaid).
Ouch. I was expecting CoveredCA to announce somewhere in the neighborhood of 314K new QHPs for 2015 through Sunday night (the 144K already announced, plus another 170K since 12/15). Instead, the total turned out to be just 217,146. I was way off on this figure, and I'm willing to accept that. In fact, in retrospect, I must've miscalculated something, since the odds of enrolling more new people in the 28 days following the January coverage deadline (which also included the "dead zones" of Christmas Eve, Christmas Day, New Year's Eve and New Year's Day) than the 31 days before that deadline were almost nil.
As I noted the other day, CoveredCA will be releasing (hopefully) completely updated ACA enrollment data, right up through Sunday night (1/11) in about a half an hour. So far they've only said that 144K new QHP enrollees have been added, and even that only includes 11/15 - 12/15. They haven't released any data on renewals of the 1.12 million 2014 enrollees yet, nor have they issued any further updates on new additions since Dec. 15th, 4 full weeks ago.
I've noted several times that I'm expecting them to announce roughly 960K renewals (active + automatic) from California, or around 85% of current enrollees to be renewed/re-enrolled. If that proves accurate, that would bring their 12/15 total up to around 1.1 million. That just leaves the new enrollments since 12/15.
Obviously the real unknown here is the renewal/autorenewal number. If it's fairly close to 85%, I should be pretty close on my total.
On the surface, this is just another (admittedly good) enrollment update from Maryland:
As of Jan. 11, 169,462 Marylanders have enrolled in quality, affordable health coverage for calendar year 2015, since the 90-day open enrollment period began Nov. 15. That includes 91,137 people enrolled in private Qualified Health Plans and 78,325 people enrolled in Medicaid.
Marylanders can enroll by Jan. 18 for coverage effective Feb. 1 and, if eligible, for an Advanced Premium Tax Credit (APTC) to immediately lower their monthly insurance bills. Marylanders who were enrolled for 2014 should re-enroll by Jan. 18 for an Advanced Premium Tax Credit that begins Feb. 1. They will receive any tax credit owed for January 2015 when they file their federal income tax return in 2016.
Yes, that's right: We're quickly approaching the next big deadline: Private policy enrollment in time for coverage starting on February 1st.
Of the 3 monthly deadlines (January 1st start, February 1st start, March 1st start), this is the one getting the lowest amount of hype, for obvious reasons. The December 15th (or December 18, 23 or later, depending on the state) deadline was a huge deal because millions of people had to be renewed (either actively or automatically) in order to avoid any sort of a coverage gap, while a few million more people new to the exchanges jumped on board in time to start 2015 running. By my estimate, there should have been roughly 8.6 million people whose 2015 policies started on Jan. 1st.
My email in box has gotten so crammed full that I'm not even going to include any teaser descriptions this time around. Some of these are weeks or even a month or more old by now; I meant to write up a full entry on some of these but simply didn't have the time, so...
As I noted Saturday, CoveredCA is supposedly going to finally release their full, updated ACA enrollment data between now and Wednesday. So far they've only said that 144K new QHP enrollees have been added, and even that only includes 11/15 - 12/15. They haven't released any data on renewals of the 1.12 million 2014 enrollees yet, nor have they issued any further updates on new additions since Dec. 15th, 4 full weeks ago.
I've noted several times that I'm expecting them to announce roughly 960K renewals (active + automatic) from California, or around 85% of current enrollees to be renewed/re-enrolled. If that proves accurate, that would bring their 12/15 total up to around 1.1 million.
Over the past year, I've stumbled through the rules (some written, some unwritten) regarding confidential sources in journalism--you know: "Off the Record", "On Background", "Embargoed until XX date" and so forth. For the most part, I've figured these rules out, and common sense dictates my approach the rest of the time.
However, please keep in mind that a) I'm not perfect; misunderstandings do happen; b) I'm still naive about some of this stuff and c) even now, this website still isn't my day job; I don't have an editorial or legal department who I can "run things by" other than myself and, on occasion, my wife.
Please keep all of that in mind before you contact me with information which you don't want posted publicly or, alternately if you want the info posted but don't want me to cite you as a source.
As expected, things have quieted down considerably over the weekend. The confirmed QHP selection tally is 85,981 through January 7th. I'm walking back my "% of QHP determinations" a bit from 50% to 45%, which means that out of 5,390 determinations from the 8th - 11th, they should be a minimum of 2,400 more actual QHP selections by now.
That should mean the total up to around 88,400 as of last night, plus 168,130 people confirmed to have been added to Medicaid (MassHealth).
Last night, "60 Minutes" had a segment about Steven Brill's new book, "Bitter Pill", which is an attempt to tell the comprehensive story of how the Affordable Care Act (aka Obamacare) was created.
I don't know much about Brill other than that he did write a compelling account of the technical problems at HealthCare.gov (along with the successful "Apollo 13-style" effort to repair the site) for Time Magazine last fall. Obviously he's a talented writer and he's done a bunch of research. This post isn't about his book itself, which may or may not be brilliant & dead-on target...I haven't read it, so I'm in no position to judge.
This article pretty mostly is a more in-depth explanation of the Medicaid/Medi-Cal situation in California that I wrote about the other day. However, the final line in the article also addresses my other post from a couple of days ago, asking when the heck CA and NY are going to release updated enrollment data (including renewals from 2014, which should account for around 960K in CA alone):
...New enrollment numbers from Covered California for the rest of December will be released next week, exchange officials said, before the exchange board meets Jan. 15.
Woo-hoo! Today is the 10th, tomorrow is Sunday, so they should be coming out with fully-updated (I hope) data from the largest state in the country sometime between Monday & Wednesday.
Not much to say here. The past 2 weeks were both dampened by Christmas (96K for the week) and New Year's (103K for the week). With the holidays out of the way, things should be ramping up again; the only question is by how much? I'm gonna be cautious and go with about a 35% bump over last week, to around 140,000 on the federal exchange, bringing total plan selections to around 6.73 million QHP selections for Healthcare.Gov through tonight (January 9th). As always, I'll be happy to have underestimated a bit.
Hmmm...ok, it looks like I'll have to drop my "QHPs selected as a percent of determinations" rule of thumb back a bit. I figured that MA would be up to around 88K by today; instead they're just below 86,000. Still impressive, though...and the 160K Medicaid enrollments are equally so.
In addition, the payment rate is now up to 72% of the total, up from around 65% a couple of weeks ago. Again, remember that many of these 86K are for February start dates, so the payment rate is a bit misleading (for instance, it's possible that 60K out of 67K January enrollees have paid so far (90%) while only 2K out of 19K February enrollees have paid (11%), or something along those lines).
Again, it's also worth noting that in addition to the 86K QHPs selected, there's another 5,511 waiting for checkout and another 76K people who have filled out all their info and been approved for QHP coverage, but who haven't actually selected a policy yet. Some of these may be duplicates or abandoned accounts, of course, but assuming, say, 80% of them eventually do complete the process, that would bring Massachusetts up to a minimum of 151K QHPs by Feb. 15th. If 90% do so, that's a minimum of 159K...and that doesn't include the additional people who start/complete the process over the 40 days remaining in the enrollment period.
My most recent data for PA's "Healthy PA" program (their implementation of the ACA's Medicaid expansion provision) was 118K, so I wasn't going to post on this today, but a subsequent update says that the actual number is higher still, at 134,000:
State officials estimate that as of January 1, 2015 about 600,000 Pennsylvanians became eligible for Medicaid through its newly expanded Healthy Pennsylvaniaoption.
Enrollment began last month, and as of Monday, a spokesperson reported the state had received at least 114,000 household applications (it's unclear how many came from people who were previously uninsured).
.@sangerkatz just got another update - # of household applications for #HealthyPAwent up to 134K (unclear how many previously uninsured).
The Lancet is a weekly peer-reviewed general medical journal. It is among the world's oldest, most prestigious, and best known general medical journals.
The Lancet was founded in 1823 by Thomas Wakley, an English surgeon who named it after the surgical instrument called a lancet, as well as after the architectural term "lancet arch", a window with a sharp pointed arch, to indicate the "light of wisdom" or "to let in light".
The Lancet publishes original research articles, review articles ("seminars" and "reviews"), editorials, book reviews, correspondence, as well as news features and case reports. The Lancet has been owned by Elsevier since 1991. As of 2015, the editor-in-chief is Richard Horton. The journal has editorial offices in London, New York, and Beijing.
LA Times reporter Chris Megerian has posted an important story about California's looming healthcare budget crisis. It mostly deals with the headaches facing the state budget as it tackles major increases in both Medi-Cal (CA's name for Medicaid) and the cost of caring for public employee retirees, and is a good read for healthcare/budget wonks.
What caught my eye, however, was this line about halfway through:
Over the next year, total Medi-Cal enrollment is expected to reach 12.2 million, he said — about one-third of the state's population. It was less than 8 million in 2013.
Hmmm...that sounds a bit high to me, so I ran the numbers against my own current estimates and came up with the following:
Updating Oregon's QHP total does nothing to change the overall tally this year because they're operating on HC.gov now. It is useful to keep a running total on the state, however. In addition, Oregon is the only state (so far) providing hard numbers for off-exchange QHP enrollments.
Members enrolled, Nov. 15-Jan. 4
On Healthcare.gov 81,037
Outside of Healthcare.gov 62,678
Total 143,715
About the data: Enrolled means a person has selected a plan. Consumers must pay the first month's premium for their coverage to become effective. These numbers do not identify whether the first month's premium has been paid. These numbers do not include Oregonians enrolled in the Oregon Health Plan (Medicaid).
Cornyn predicted the King v. Burwell case that will be argued before the Supreme Court in March will end up going a long way towards undoing the law.
The court will decide whether the law allows people participating in the federally run health care exchange to get subsidies. A decision denying the subsidies would significantly undermine the law.
“What I expect is that the Supreme Court is going to render a body blow to Obamacare from which I don’t think it will ever recover,” Cornyn said.
The 980K confirmed by the 14 assorted state-run exchanges,
The unreported renewals (both active and automatic) from California & New York, and
Another roughly 150,000 scattered amongst all 50 states & DC since the date of their most recent updates until today (which varies from as little as 1 day to as much as 25 days in the case of Idaho).
If you do the math, you'll see that the biggest missing piece here is the 3rd item above: Covered California and New York State of Health have, to date, still refused to give out any re-enrollment/renewal data for 2014 QHP enrollees. Not just autorenewal numbers, but active renewals as well.
At long last (well, by my standards anyway), the Washington State exchange has released updated enrollment numbers, and the results are...well, kind of all over the place.
First up, of course, is the private QHP enrollment figure:
OLYMPIA, Wash. – Washington Healthplanfinder today announced that more than 107,000 residents have signed up or renewed their Qualified Health Plan through wahealthplanfinder.org for coverage that started on Jan. 1. Approximately 26 percent of current Qualified Health Plan enrollees have signed up through Washington Healthplanfinder for the first time.
In addition, 471,602 new adults have accessed coverage through Washington Apple Health (Medicaid). The total number of residents who are currently enrolled under Medicaid expansion and in Qualified Health Plans totals nearly 580,000.
...Currently, 60 percent of customers who were enrolled in 2014 coverage have taken action to renew their coverage for 2015. Any remaining customers must return to their online account or contact the toll-free Customer Support Center to reconfirm their eligibility for financial help, select a health plan and submit their payment.
That's another 2,489 QHP determinations. Again, assume 50% of them followed through and selected a plan and that's at least 1,200 more added, bringing the likely total up to around 87,600 QHP selections to date, plus 160,824 confirmed Medicaid enrollees.
Last week I noted that if the Supreme Court rules in favor of the plaintiffs in the King v. Burwell case (challenging the IRS tax credits given to over 85% of enrollees via the Federal exchange, Healthcare.Gov), around 7 million people would have their tax credits yanked away.
Of these, I figured that perhaps 5-6 million are receiving substantial credits--that is, a family making $90,000/year would be among those 7M, but they'd only be getting perhaps $5 - $10/month in credits, so losing a couple hundred dollars a year would be annoying, but not devastating.
However, I also noted that in addition to the 5-6M who would be directly impacted, there would also likely be a major ripple/domino effect which would seriously impact others in those states as well, even those who aren't receiving the credits themselves:
Statements by Secretary Lew and Secretary Burwell on preparing for the upcoming tax season
In preparation for the 2015 tax filing season, the U.S. Department of Health and Human Services and the Treasury Department are putting in place resources to provide tax filers with the information and resources they need to get their questions answered.
Millions of Americans who get their health insurance through work are benefitting from the Affordable Care Act, and millions of others have signed up for the Health Insurance Marketplaces and received financial assistance to lower their monthly premiums.
Starting this year, consumers will see some changes to their tax returns. While the vast majority of tax filers – over three quarters – will just need to check a box on their tax return indicating they had health coverage in 2014, people who have coverage through the Marketplaces, or decided not to enroll in coverage, should be aware of some additional steps that will be a part of the tax filing process starting this year.
A few days ago, Rhode Island issued their latest numbers through 12/27. However, like Vermont, Minnesota and Hawaii, they bumped their January-start deadline out to New Year's Eve, making it tricky to get a bead on their "post deadline" enrollment pattern, which is where things are for every state now.
PROVIDENCE – HealthSource RI (HSRI) has released enrollment data, certain demographic data and certain volume metrics through Saturday, January 3, 2015, for Open Enrollment.
Individual Enrollment data (November 7, 2014 through January 3, 2015) As of January 3, 2015, 78% of Year One customers have renewed (selected a plan) for 2015 (59% of renewing customers paid their first month’s premium).
Total New Customers: 6,067
Total Renewed Customers: 20,313
Total HealthSource RI enrollments for 2015 coverage (including those who have not yet paid): 26,380
As always, this is just an estimate; it could be slightly higher or lower. However, my best estimate is that 2015 private QHP selections via the various ACA exchanges (HC.gov plus the 14 state-based versions) will cross the 9 million milestone sometime today if it hasn't already done so.
In addition to the 6.59 million enrollees via the federal exchange which were just confirmed within the past hour or so, today has also seen updates from Minnesota, Kentucky and Massachusetts. Plug all of those into the Spreadsheet and the confirmed, official total has now reached 7.56 million nationally.
Tack on an estimated 960K renewals (active & automatic) from California, around 330K from New York, along with another 150K or so from the past week or two across various states (remember, some state exchanges such as Idaho haven't updated their numbers for as long as 24 days), and I'm quite confident that the 9 million mark has been reached. As always, see The Graph (also posted below) for a visual representation of where things stand and where they should be headed.
MNsure will release 2015 enrollment metrics weekly, and will present a more robust metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. During weeks that MNsure is closed on Friday, the enrollment metrics update will be released earlier in the week.
Health Coverage Type Cumulative Enrollments Medical Assistance 29,936
MinnesotaCare 12,225
Qualified Health Plan (QHP) 41,704
TOTAL 83,865
The major change here isn't so much new QHPs (just 1,844 of the increase) as the autorenewals (or "passive renewals" as MNsure calls them) which made up 8,701 of the total:
Updated @MNsure enrollments: 83,865 total. 41,704 in QHP (8,701 of which are passive renewal), 12,225 in MinnesotaCare and 29,936 in MA
In the post-deadline, post-holiday period, Massachusetts seems to be settling into a pattern: Around 6,000 total eligibility determinations per day during the week, around 2,000/day on weekends. Of those, around 60% of them tend to be Medicaid enrollments, the other 40% for private policies (QHPs, which also include "ConnectorCare" in this case).
Yesterday there were another 6,508 added; 3,760 were immediately enrolled in MassHealth (Medicaid). The other 2,748 were for QHP applicants. As always, assuming at least 50% of those also selected a plan, that should tack another 1,400 to the total, bringing it to around 86,400 or so, while total Medicaid enrollments are now up to over 157K.
...The plaintiffs’ premise in King is that Obamacare was never intended to offer credits to people in states with federally-run exchanges. Indeed, by reading one passage of the Affordable Care Act out of context, they claim that the law unambiguously states that only state-run exchanges are allowed to provide tax credits.
But that’s not the conclusion Walker reached after spending a couple of years considering the question. Rather, in his interview with theWall Street Journal, Walker explains that there is no practical difference whatsoever between state-run and federally-run exchanges:
Ahead of the latest weekly report from HC.gov, Gallup reports that:
WASHINGTON, D.C. -- The uninsured rate among U.S. adults for the fourth quarter of 2014 averaged 12.9%. This is down slightly from 13.4% in the third quarter of 2014 and down significantly from 17.1% a year ago. The uninsured rate has dropped 4.2 percentage points since the Affordable Care Act's requirement for Americans to have health insurance went into effect one year ago.
The uninsured rate declined sharply in the first and second quarters last year as more Americans signed up for health insurance through federal and state exchanges. After the open enrollment period closed in mid-April, the rate leveled off at around 13%. The 12.9% who lacked health insurance in the fourth quarter is the lowest Gallup and Healthways have recorded since beginning to track the measure daily in 2008. The 2015 open enrollment period began in the fourth quarter on Nov. 15 and will close on Feb. 15.
A Roseburg-based nonprofit recently made news when it announced it can't afford to offer health care insurance for its employees and is preparing to pay a federal fine under the Affordable Care Act that's likely to reach six figures.
Adapt provides drug and addiction treatment in three Southern Oregon counties and employs 183 people. However, rising costs have made group health insurance so expensive that the organization has decided to budget for fines of up to $2,000 per employee, according to Susan Jeremiah, the agency's human resources director.
As of Jan. 1, 2015, all employers with more than 100 full-time equivalent employees are required to offer affordable health care insurance or face penalties.
In view of broad reader interest in the story, we asked Portland attorney Iris K. Tilley, a partner with Barran Liebman who advises employers on employee benefits, to answer a few questions about the Roseburg case and the ACA in general.
Taking a look at the QHP Spreadsheet, here's where things stand as of today (or at least as of the latest data provided by the exchanges to date).
It's impossible to know how close most of the HC.gov states (along with California, New York & Hawaii) are to their targets because the renewal/autorenewal data either hasn't been provided yet (CA, NY, HI) or has been provided but hasn't been broken out by state yet (35 of the states on HC.gov).
In most cases, the official government target is based on 30% above last spring's 8 million figure (10.4 million = 30% higher), but in some cases the state exchange itself has set the bar.
In my case, I'm generally assuming around 56% higher than last year, except for Massachusetts which is a special case (see below):
UPDATE 01/07/15: A few more states have updated their numbers so I've updated the table as well:
As always, assuming a minimum of 50% plan selections out of the QHP eligibility determinations, Massachusetts should have tacked on another 1,600 QHPs yesterday, bringing their total up to around 85,000 to date.
Immediate Medicaid enrollments have crossed 153,000.
For the past month or so I've repeatedly noted that Michigan's ACA Medicaid Expansion program (Healthy Michigan) enrollment has exceeded the estimates given as to how many Michiganders are actually eligible for the program (between 477K - 500K depending on the source).
Beneficiaries with Healthy Michigan Plan Coverage: 496,870
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)
*Statistics as of January 5, 2015
*Updated every Monday at 3 p.m.
DENVER, CO – Between Nov. 15 and Dec. 31, more than 151,000 Coloradans enrolled in healthcare coverage for 2015, either in Medicaid, Child Health Plan Plus (CHP+) or in private health insurance purchased through the state health insurance Marketplace, according to new data released today by Connect for Health Colorado® and the Colorado Department of Health Care Policy and Financing.
...The initial six weeks of open enrollment saw a total of 113,864 enrollments in private coverage through Connect for Health Colorado (20,790 people new to the Marketplace and 93,074 re-enrollments from 2014); 35,981 in Medicaid; and 1,517 in CHP+. Connect for Health Colorado also enrolled 19,068 individuals in dental plans.
As I've noted before, updating Oregon's QHP total does nothing to change the overall tally this year because they're operating on HC.gov now. It is useful to keep a running total on the state, however, given the mess from last year that they're comparing against. In addition, Oregon is the only state (so far) providing hard numbers for off-exchange QHP enrollments.
As I also noted a week or so ago, however, there's an odd discrepancy between the OR state website (which claimed just 67.4K QHPs through 11/21) and the HHS Dept. report (which claimed QHP selections were alredy at over 73K 6 days earlier, on the 15th). With that in mind, use tonight's update with caution:
Open enrollment weekly updates
The Insurance Division will collect enrollment information from carriers each week throughout 2015 open enrollment. Updated numbers will be posted each week on this web page.
Members enrolled, Nov. 15-Dec. 28
On Healthcare.gov 75,740
Outside of Healthcare.gov 40,731
Total 116,471
The total numbers aren't much higher than the last update, but that's understandable; this official report only includes 3 more days, including a quiet holiday weekend:
As of Jan. 4, 156,305 Marylanders have enrolled in quality, affordable health coverage for calendar year 2015, since the 90-day open enrollment period began Nov. 15. That includes 87,348 people enrolled in private Qualified Health Plans and 68,957 people enrolled in Medicaid.
Marylanders can enroll by Jan. 18 for coverage effective Feb. 1 and, if eligible, for an Advanced Premium Tax Credit (APTC) to immediately lower their monthly insurance bills. Marylanders who were enrolled for 2014 should re-enroll by Jan. 18 for an Advanced Premium Tax Credit that begins Feb. 1. They will receive any tax credit owed for January 2015 when they file their federal income tax return in 2016.
Open enrollment for 2015 for Maryland Health Connection ends Feb. 15.
As I noted last week, Minnesota had around 41,000 people enrolled in 2014 exchange QHPs as of October, and due to PreferredOne dropping off the exchange (with around 60% of the market), along with a state law which requires insurance companies to continue providing the same policy as long as a current enrollee wants to keep it (and keeps paying premiums), that meant that MN's renewal/re-enrollment situation was especially unusual compared to most states.
MNsure will release 2015 enrollment metrics weekly, and will present a more robust metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. During weeks that MNsure is closed on Friday, the enrollment metrics update will be released earlier in the week.
Health Coverage Type Cumulative Enrollments
Medical Assistance 26,540
MinnesotaCare 11,152 Qualified Health Plan (QHP) 31,159
TOTAL 68,851
Vermont: I don't have a 12/15 report from the VT state exchange, but they did release one from 4 days earlier. It claimed 25,867 total QHP selections for 2015. The HHS report says it was 21,709...as of 4 days later. Again, a 4,100 difference.
Today I received my answer: It turns out that until now, the official state exchange enrollment reports were including both QHPs and Medicaid in both the "renewed" and "new" enrollment numbers. Medicaid/CHIP enrollments make up around 7,000 of the total (around 2,800 renewals and 4,300 new).
The broken-out numbers for Vermont, as of last night, directly from my contact at Vermont Health Connect, are as follows:
Chalk up another (likely) 2,000 QHPs for Massachusetts over the weekend: There were 4,116 QHP determinations from the 2nd - 4th (plus just a handful on New Year's Eve and Day for obvious reasons). Assuming at least 50% of them followed through and selected a plan (which has been pretty reliable so far), that should bring the grand total of QHP selections up to around 83.4K to date.
Meanwhile, Medicaid enrollments are closing in on 150K.
Earlier this evening I received the following email. I'm not including the sender's identifying information for obvious reasons:
Someone from this website contacted me to help with enrolling in health insurance. They created an account on healthcare.gov with an id of XXXXXXXX@acasignup.net instead of my email address and did not give me the password. I am trying to make some changes to my healthcare coverage and update my information.
I am very concerned with the safety of my information. I thought they were from the health insurance marketplace.
If you could change my id to my email and give me the password I would very much appreciate it.
If not I will assume you are an identity thief and contact the FBI.
New York state regulators say more than 225,000 people have newly enrolled in Affordable Care Act health insurance coverage heading into 2015.
That is important because more people with health insurance equals jobs,according to some investment advisers, who say hospitals and health care companies spend more money on construction and other related growth as the uninsured rate drops.
With the Affordable Care Act seemingly off to a good start in its first year, increasing access to insurance coverage for adults, attention is likely to turn to an older program for children that will come to an end in 2015 if it is not reauthorized: the Children’s Health Insurance Program, or CHIP.
OK, this is kind of strange...the WA exchange has not posted any press releases since the 23rd, and specifically told me that they don't have any updated numbers since then, but this brief story at KLEW TV is pretty clear about it...and the numbers are about right, since they only include 1 more day of data (the press release went through the 22nd, and the 23rd was the deadline for January coverage in WA):
LEWISTON, ID - We start off with news about healthcare. 101,000 people in Washington State have bought health insurance through the Washington Exchange so far during this open enrollment period.
About 76,000 renewed their policies by the Tuesday deadline for January first coverage. About 25,000 are new to the exchange and will have insurance on the first day of the new year.
The article also gives a solid number for how many current enrollees didn't make the deadline and what their options are:
Lost in the shuffle of the first monthly HHS report (which only ran through 12/15 and was missing gobs of data) was their weekly snapshot report, which was released the same day. It runs through 12/26, but isn't broken out by state, of course, and most importantly only includes QHP selections for the 37 states run through HC.gov.
I was expecting the number to drop substantially last week, of course, since the January coverage deadine has passed and the vast bulk of renewals (active + automatic) were already baked into the prior week's report. I figured that we'd be looking at roughly 30K/day on HC.gov until around January 10th, when it should start to spike again...or around 210K for the week.
Instead, I was surprised at how much it dropped last week--only 96,000 more QHPs added.
The Massachusetts exchange has released their weekly dashboard report, which includes actual QHP selections and payments, although that data only runs through 12/29.
Add them up and you get 79,842 total QHP selections, of which 55,260 have paid their first premium and are fully enrolled. This may sound like only a 69% payment rate, but remember that many of the remaining 24,582 aren't scheduled to have their current coverage dropped until the end of January and thus aren't even expecting their new policy to kick in until February 1st anyway. As always, the payments are a rolling average, and will ebb & flow until around mid-March (after which they should stabilize at around 88% at any given time).
For example, on Wednesday the 31st, the MA exchange issued a press release which stated that the total number who have paid in time for January 1st coverage is "over 50,000":
There hasn't been a lot of news about the upcoming King v. Burwell case lately, other than the fact that it's been scheduled to be heard by the Supreme Court on March 4th (with a final ruling likely to come out sometime in June).
One thing to watch as we approach the SCOTUS hearings on King v. Burwell this spring is how many people are newly qualifying for subsidies in those states as this year’s enrollment period continues.
The Department of Health and Human Services has released a new reporton enrollment data that suggests that number could be very large — which could (theoretically, at least) make it harder for SCOTUS to gut the law.
Remember, Rhode Island bumped out their January coverage deadline all the way through New Year's Eve, so even this data is still presumably missing a small surge on the final day:
HEALTHSOURCE RI RELEASES ENROLLMENT, DEMOGRAPHIC AND VOLUME DATA THROUGH DECEMBER 27, 2014
Posted on January 2, 2015 | By HealthSource RI
PROVIDENCE – HealthSource RI (HSRI) has released enrollment data, certain demographic data and certain volume metrics through Saturday, December 27, 2014, for Open Enrollment.
Enrollment data (November 7, 2014 through December 27, 2014)
As of December 27, 2014, 71% of Year One customers have renewed plans for 2015.*
Total New Customers: 4,969
Total Renewed Customers: 17,941
Total HealthSource RI enrollments for 2015 coverage
(including those who have not yet paid): 22,910
*As of December 30, 74% of Year One customers have renewed plans for 2015.
SHOP (cumulative as of December 27, 2014)
Small employer applications completed: 532
Small employer accounts created: 1,904 Small employer enrollment: 437 (representing 3,157 covered lives, based on their submitted census)
Small employers enrolling in Full Choice Model: 76%
On it's surface, this sounds like a decent but not amazing update: Up 2,600 since 12/28. However, consider this: 86,347 QHP selections is up 6,360 since MD's January coverage deadline of 12/18. That means they're still enrolling new people at 454 per day for coverage starting in February...as opposed to the 339/day that they averaged duing the entire first open enrollment period. That's a rate over 33% faster.
