Charles Gaba's blog

OK, today saw two major 2018 Open Enrollment Period data updates out of HealthCare.Gov and Covered California, plus a minor one out of Maryland.

As I reported this morning, the HC.gov Week 5 Snapshot report came in much lower than I expected this week, at just 823K vs. the 1.2 million I was anticipating; as a result, the HC.gov section of The Graph (in green below) has finally reverted back to my original projection line with a total of 3.6 million as of December 2nd. If it follows my trendline this week, HC.gov should tack on another 1.2 million for a total of 4.8 million by Saturday night, December 9th, ahead of what should be the Big Final Week Surge.

Then, about half an hour ago, Covered California issued THEIR big enrollment press release: Around 1.2 million renewals (active + passive combined), plus 102,000 new enrollees, as of November 30th.

Covered California has released another 2018 Open Enrollment Update report...and thankfully, they finally included their renewal numbers as well as the new additions:

Covered California’s Open Enrollment Continues at a Brisk Pace with New Data Showing Most Consumers Who Renewed and Enrolled in November will Pay Less in 2018

More than 102,000 new consumers selected a plan during the first month of open enrollment, a 28 percent increase over the same time period last year.

This just in from the California Insurance Dept...

Thank you for signing up to receive email alerts when new health insurance rate filings are submitted to the California Department of Insurance.

This message is to inform you that we have posted new rate filing submissions to our health rate filing website. Please select the link below to review and/or comment on newly added rate filing submissions. The Department of Insurance does not respond to questions about rate review filings submitted through the rate website, but we do consider comments during our review process.

http://interactive.web.insurance.ca.gov/apex/f?p=102:4:0::NO:5,RIR:IRGT_...

Oh? What's up?

After being way off in my initial HC.gov projections the first and second weeks of the 2018 Open Enrollment Period, I recalibrated and was dead on target for Weeks 3 and 4: As of November 25th, just shy of 2.8 million people had selected Qualified Health Plans (QHPs) through the federal exchange.

As I had predicted, there were a bunch of eye-roll-inducing headlines about how enrollments had dropped off a cliff, etc etc, which completely ignored the fact that it was Thanksgiving week, and that a 35%+ drop-off is typical for the holiday weekend. Whatever.

For the post-Thanksgiving week, however, ACA enrollments typically roar back to life, and this year was no exception...although not by nearly as much as I was hoping:

I've written a LOT about Silver Loading, the Silver Switcharoo and the bizzare policy pricing many people will find on the ACA exchanges this year due to two actions:

• First, Donald Trump officially pulling the plug on CSR reimbursement payments to insurance carriers, and...
• Second, the response to the CSR cut-off by some very clever state insurance departments, ACA exchange boards and individual market insurance carriers.

The gist of Silver Loading/Silver Switcharoo is that across roughly 40 states, subsidized enrolles may find themselves eligible for dirt-cheap (or even zero-premium) Bronze plans...as well as bargain-priced Gold plans which may cost the same or even less than Silver plans.

The last update out of Maryland had 2018 QHP selections breaking 130K total, with new enrollments up 10% and overall enrollments up 3% year over year through Nov. 17th.

Just now, the MD Health Connection posted an update through this week:

Incoming exec director Michele Eberle of @MarylandConnect urges Marylanders to enroll in health coverage with 10 days left. New enrollments up 14% this year. Mobile app visitors up 140% Overall enrollment up 4% Keep it going! pic.twitter.com/75g2qu5PbC

— MD Health Connection (@MarylandConnect) December 5, 2017

I'm assuming these stats are as of December 4th. Last year MD's official QHP selection tally as of December 3rd was around 129,000; if they're 4% ahead of that as of the same date, that means they should have a little over 134,000 to date this year.

Yesterday:

So @SenatorCollins sold out for bills which won’t help much and aren’t gonna happen anyway.@jeffflake sold out for a promise to attend a meeting which won’t happen.@lisamurkowski sold out for destroying her own environment.@SenJohnMcCain sold out for...nothing at all. Huh.

— Charles GetCoveredBa (@charles_gaba) December 3, 2017

Today:

Last week I noted that Maine Republican Senator Susan Collins' proposal to "solve" the problems created by repealing the ACA's individual mandate (passing the Alexander-Murray CSR bill and her own Collins-Nelson reinsurance bill) would only mitigate a small portion of the damage caused by such a mandate repeal.

As I had previously noted, the Alexander-Murray bill would simply restore CSR funding into place which was already assumed to be there when the CBO made their "13 million losing coverage/10% rate hike" projection earlier, making passing it kind of a non-factor when it comes to the impact of repealing the mandate. That just left the reinsurance bill. Collins original proposal was a mere $2.25 billion/year (and only for two years at that)...which I estimated would fall short by a factor of anywhere from 3x to 7x, depending on which back-of-the-envelope math you use:

So one of the Big Deals on Twitter this morning was this tweet by Republican (correction: Former Republican) MSNBC talking head Joe Scarborough:

.@SenOrrinHatch talking about children's health care: “I have a rough time wanting to spend billions and billions and trillions of dollars to help people who won’t help themselves – won’t lift a finger – and expect the federal government to do everything.”

— Joe Scarborough (@JoeNBC) December 3, 2017

...which caused an immediate and understandable backlash uproar, including my own tweet (since deleted),

Holy crap. They're CHILDREN. Plus...didn't he used to brag about helping CREATE the CHIP program in the first place?

I hadn't actually seen the full clip at the time. My own tweet went semi-viral, with several hundred RTs and a bunch of Likes within a couple of hours.

However, shortly after that, Bloomberg reporter Steven Dennis correctly noted that...