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I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
The typical agreement a QHP issuer enters into if selling on the FFM requires them to keep the policy in force for the entire calendar year. [This exit clause] gives them option to term the policy abruptly if the Courts rule, or a Trump administration decides, that it won't pay CSR offset payments to carriers. Because this won't hit the Supreme Court until late 17 or early 18, I think this is as much about assuaging carriers fears of a Trump admin trying to destroy the marketplaces as anything else.
Illinois is pretty straightforward. Assuming 400,000 people enroll in exchange policies by the end of January (a modest 3% increase over last year), I estimate around 275,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus the 643,000 enrolled in Medicaid expansion as of June 2016, for a total of just over 918,000 Illinoisians kicked to the curb.
As for the individual market, my standard methodology applies:
OK, it's really important to note that a) this is a very simplified rendering of the true situation and b) this only applies to two populations: The individual market (around 20 million people) and the medicaid expansion population (around 14 million, plus another 2.6 million being denied thanks to 19 states refusing to expand it). In other words, it has nothing to do with the large group market, small group market, Medicare, the VA/TriCare, federal/state/local public employees and so on. This chart only applies to around 37 million people in the U.S. Got it?
Having said that, what I've tried to do is to provide a visual representation of, among that population, who the ACA is working well for, who it isn't working so well for, and who can legitimately complain about feeling screwed by it:
Oops. Last week I reported that Access Health CT appeared to state that they had a total of 114,421 QHP selections during the current open enrollment period. The wording was slightly squirrelly ("currently active for 2016 and/or 2017"), especially since I also knew there were around 12,000 existing enrollees who still hadn't chosen a new policy...but an earlier update had given the number as "around 113,000" in a seemingly less-confusing way, so I assumed that all 114,421 applied to 2017.
22 Percent Increase Over Last Year • New Yorkers Show Demand for Quality, Affordable Healthcare
ALBANY, N.Y. (January 6, 2017) – NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.4 million people have enrolled in health insurance through December 24, 2016.
With almost a month to go until the end of the 2017 Open Enrollment period, participation in the NY State of Health Marketplace has already increased more than 22 percent since the last Open Enrollment period ended, January 31, 2016. Enrollment has increased in all 62 counties of the state. The overall share of New Yorkers now enrolled through the NY State of Health has reached nearly 18 percent of the state’s population.
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.
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:
Plug in the 2/01/16 QHP selections by county (hard numbers via CMS)
Project QHP selections as of 1/31/17 based on statewide signup estimates
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.
In the case of Georgia, assuming 567,000 people enroll in exchange policies by the end of January, I estimate around 396,000 of them would be forced off of their policy upon an immediate-effect full ACA repeal.
