With the GOP Congress still obsessed with repealing the ACA and Donald Trump doing everything in his power to sabotage the law whether it gets repealed or not, the final 5 days of the 2017 Open Enrollment Period, which would normally see a spike in enrollments regardless, is going into a bit of a panic mode. Trump and his Republican cohorts are doing whatever he can to discourage people from enrolling before the deadline, while the insurance carriers, healthcare advocates and everyone else is doing whatever they can to encourage it.
New York State of Health, the NY ACA exchange, just announced that with the 1/31 final deadline rapidly approaching next Tuesday, they're extending their customer service hours on Saturday and Sunday.
The Trump administration has pulled the plug on all Obamacare outreach and advertising in the crucial final days of the 2017 enrollment season, according to sources at Health and Human Services and on Capitol Hill.
Even ads that had already been placed and paid for have been pulled, the sources told POLITICO.
...Individuals may still sign up for Obamacare plans until the Jan. 31 deadline — but the Trump administration isn't advertising that fact any longer.
It is also halting all media outreach designed to spur signups in the days leading up to the deadline. Emails are no longer being sent out to individuals who visited HealthCare.gov, the enrollment website, to encourage them to finish signing up. Those emails had proven highly successful in getting stragglers to complete enrollment before the deadline.
A few weeks ago, frustrated with the disturbingly large number of Trump supporters (and, let's face it, plenty of non-voters and even a few Hillary supporters) who still seemed to be unaware that "Obamacare" and "The Affordable Care Act" are the exact same thing, I whipped up a snarky and admittedly sarcastic infographic trying to clue them in.
A few days later, after calming down a bit, I reworked the infographic into a nonjudgmental, more informative version:
SEN. TOOMEY: “Now, one way to force it is to force insurance companies to provide health insurance coverage for someone as soon as they show up, regardless of what condition they have, which is kind of like asking the property casualty company to rebuild the house after it’s already burnt down.”
Now, aside from the obvious callousness of this statement, there's a couple of important problems with his comparison:
Politically, the big unknown is whether or not Paul Ryan and Mitch McConnell will get away with trying to pin the blame for this on the Democrats/the law itself. That's why they've been pushing the "Obamacare is already in a death spiral!" claim hard for the past few weeks, even though it quite simply isn't.
...So, if this does end up in a worst-case scenario, Trump's "stop enforcing the mandate altogether!" order here could end up causing that death spiral even if the GOP doesn't technically end up repealing anything legislatively. The carriers would start announcing that they're bailing next year as soon as this spring (remember, the first paperwork for 2018 exchange participation has to be filed in April or May), and McConnell/Ryan would simply say, "See?? We told you it was collapsing all by itself! We didn't touch nuthin'!!"
As has been obvious for some time now, the early projections by the Congressional Budget Office back in the pre-exchange days of 2010 - 2013, which foresaw ACA exchange enrollment heading into the 20-million-plus range by this point, obviously not only never came to pass, but are unlikely to do so anytime in the near future under the current legal/healthcare policy structure. There are several reasons for this ranging from legitimate problems with the structure of the ACA itself to Republican obstruction, but the two most obvious errors the CBO made in their projections were:
The last time Covered California released enrollment data, they gave a hard number for new enrollees (258,158) but left the number of people renewing their policies a bit vague ("approximately 1.3 million"). I later learned that the actual number of renewals had been rounded up, so I'm assuming it's actually around 1.27 million; this gives a total of 1.53 million QHP selections as of January 3rd.
Today, CoveredCA issued another update, touting a new enrollee survey which concludes that in California, at least, people don't seem to be shying away from enrolling in spite of the ugly ACA repeal rhetoric coming out of Washington, DC:
Covered California Enrollment Continues at Strong Pace; New Research Suggests ACA News Coverage Is Not Deterring Consumers
In Arkansas, 70,404 people enroll in private exchange policies as of the end of January. I estimate around 50,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 331,000 enrolled in Arkansas' "Private Option" ACA Medicaid expansion program for a total of 380,000 residents kicked to the curb.
As for the individual market, my standard methodology applies:
Plug in the 2/01/16 QHP selections by county (hard numbers via CMS)
Adjust for 1/31/17 QHP selections based on hard CMS data.
Knock 10% off those numbers to account for those who never end up paying their premiums
Multiply the projected effectuated enrollees as of March by the percent expected to receive APTC subsidies
Then knock another 10% off of that number to account for those only receiving nominal subsidies
Whatever's left after that are the number of people in each county who wouldn't be able to afford their policy without tax credits.
The Medicaid expansion data comes directly from state data.
Back on December 15th, I posted an entry entitled "I cannot guarantee accurate federal data after 1/20/17", in which I warned that given Trump's never-ending stream of bullshit and the fascistic overtones of the impending Trump Administration, the odds were pretty high that once they took over, all data from the federal government would likely become highly suspect. Cooking the books, doctoring the data, flat-out purging vast quantities of information...all of this was possible.
Federal Workers Told To Halt External Communication In First Week Under Trump Staff have been told to stop talking to Congress and the press.
WASHINGTON ― Multiple federal agencies have told their employees to cease communications with members of Congress and the press, sources have told The Huffington Post.
