Charles Gaba's blog

As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.

My standard methodology applies:

Assuming 37,000 people enroll in private exchange policies by the end of January, I estimate around 25,500 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 169,000 enrolled in the ACA Medicaid expansion program, for a total of over 195,000 West Virginians kicked to the curb.

As for the individual market, my standard methodology applies:

OK, with this morning's CMS/ASPE "mid-season report" being released, I figured this would be a good time to take a look at where things stand on both a state-by-state and national level. All of the state enrollment numbers should be accurate with the possible exception of California; there's a potential discrepancy of around 93,000 enrollees which I'm still trying to clarify. The tables/graph below all assume that those disputed 93K are supposed to be included.

Here's my original projections for each state, sorted in order based on what percent of my personal target each state has reached. As you can see, Minnesota, Hawaii, Massachusetts and South Dakota have already broken 100%, with Utah, Vermont, Oklahoma, Wyoming, Colorado, Oregon and (possibly) California all over the 90% mark. Any state over 90% at this point should hit my targets by the end of January.

For the past couple of weeks I've been compiling the county-level data across various states for just how many people are at risk of losing healthcare coverage if the Republican Party actually does follow through with repealing the Affordable Care Act. The main numbers are the subsidized QHP enrollees and the Medicaid Expansion enrollees.

What people really want, though, given the politics of the situation, are these numbers by Congressional District. Unfortunately, I can't provide that, which is why I'm going with County level data for now.

HOWEVER, this morning, CMS provided a major tool for getting these numbers at the CD level: ZIP CODE breakout of the number of QHP selections through 12/24 for the 39 states on the federal exchange.

There's some major caveats here, of course:

Along with today's HHS report which confirms more than 11.5 million 2017 QHP selections as of Christmas Eve, CMS has released an additional report which breaks the numbers out by state...and unlike HC.gov's "snapshot" reports (which only cover 39 states), the CMS/ASPE report also confirms the enrollment numbers for all 50 states (PDF).

As I've noted before, until today, there was one state which I had no OE4 data for whatsoever: Vermont (which is ironic given their historic support of healthcare reform, including Sen. Bernie Sanders). This blank has been filled in by today's supplemental CMS/ASPE report: 29,021 QHP selections as of 12/24, which is actually quite a bit higher than I expected for the state (my target for VT is only 30,000 total through 1/31).

As regular readers know, I've always made sure to report the number of people who enroll in the ACA's Basic Health Plan (BHP) programs in Minnesota (since 2014) and New York (since 2016). The HHS Dept. didn't really highlight BHP numbers in 2014 or 2015 because they weren't even a rounding error nationally (they had 43,000 enrolled in BHPs via MNsure in April 2014, for instance). In addition, the BHP program in Minnesota was really just a retooling/expansion of an existing program anyway. As a result, it was treated as more of a footnote in the national reports. Interestingly, the number of MN residents enrolling in BHPs through MNsure this year is quite a bit lower (20,000), although state-wide the number is much higher (around 62,000 as of this week). Basically, 1/3 of MinnesotaCare enrollees are doing so via the ACA exchange, the rest via traditional state agencies/processes.

Don't get excited yet. This isn't remotely settled yet, and even if the GOP backs off now, there's no reason to think they won't be back in full force a few months down the road.

Having said that, this evening does have some positive news on the GOP repeal front:

GOP Senators Propose Delay On O'Care Repeal To Work Out Replacement

After publicly airing some of their grievances with the GOP's current strategy of repealing Obamacare without a replacement plan, a handful of Republican senators put their concerns in legislative writing. Five senators on Monday evening introduced a measure that would delay the next steps on repealing the Affordable Care Act by more than a month. The senators, in their statements accompanying the provision, said the delay would buy Congress more time to work out of the the details of a replacement.

Assuming 265,000 people enroll in exchange policies by the end of January, I estimate around 175,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 692,000 enrolled in the ACA Medicaid expansion program, for a total of over 865,000 Ohioans kicked to the curb.

As for the individual market, my standard methodology applies:

Whoops! I think I owe the folks at MNsure a bit of an apology. A week or so ago I stated:

Minnesota is a different story. They started out Open Enrollment with a bang, racking up enrollees at up to 12x last year's pace...but that was mainly due to their unique "enrollment cap" policy this year. Once the caps were filled and current enrollees were all squared away, new enrollments appear to have dropped off dramatically. They're now dead last percent-of-target wise (again, I can't include NY or VT here since neither has enough data available).

It feels a little odd to be alternating estimates about how many people could lose their coverage in each state with the number signing up for it at the same time, but that's where we are: Remember, there's still 6 more days for people to enroll for 2017 coverage starting in February, and 16 days after that to sign up for coverage starting in March.

My last enrollment update for Colorado ran through December 18th; at the time the tally was 139,509 Medical QHPs via Connect for Health CO.

Today they issued another update:

Connect for Health Colorado Reports Increase in Healthcare Plan Selections for 2017 Coverage

DENVER —  More than 158,000 Coloradans selected healthcare coverage for 2017 through the state health insurance Marketplace through Sunday, January 8, a rate 18 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®.

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