Last week I attempted to figure out just how many Trump voters would lose their healthcare coverage if/when the ACA is repealed by the Republican Party. Paul Krugman took a "big picture" approach and came up with numbers in the 4-6 million range. My own back-of-the-envelope math came in higher, at perhaps 9 million. I concluded that the actual number is likely somewhere in the middle (4-9 million).
I mention this because this morning the Urban Institute issued their own detailed analysis of just how many people would lose coverage after a partial repeal of the Affordable Care Act shortly after my own projection of lost coverage from a full repeal. Ironically, a partial repeal would be even worse (29.8 million losing coverage) than the already-devastating numbers from a full repeal (23.1 million losing coverage).
The nation’s hospital industry warned President-elect Donald Trump and congressional leaders on Tuesday that repealing the Affordable Care Act could cost hospitals $165 billion by the middle of the next decade and trigger “an unprecedented public health crisis.”
The two main trade groups for U.S. hospitals dispatched a letter to the incoming president and Capitol Hill’s top four leaders, saying that the government should help hospitals avoid massive financial losses if the law is rescinded in a way that causes a surge of uninsured patients.
“The idea that you can repeal the Affordable Care Act with a two- or three-year transition period and not create market chaos is a total fantasy,” said Sabrina Corlette, a professor at the Health Policy Institute of Georgetown University. “Insurers need to know the rules of the road in order to develop plans and set premiums.”
As anyone who's visited the site the past few days knows, I've spent countless hours digging up data to find out exactly how many people are enrolled in Medicaid/CHIP specifically due to the ACA's expansion provision. This is much more difficult than you'd think for a variety of reasons. For one thing, each state seems to have different methodology for how they track and report Medicaid enrollees (some weekly, some monthly, some quarterly, etc). For another, there's a wide variety of eligibility thresholds under pre-ACA Medicaid for different groups of residents in each state (pregnant women, infants, children, parents, etc), and since the funding mechanism varies depending on whether the enrollee qualifies for "normal" Medicaid or "ACA expansion" Medicaid, categorization can be tricky. Finally, due to the churn factor (people moving up and down the income scale as well as gaining or losing job-based or other forms of coverage), the numbers can jump around from month to month or even week to week.
Earlier today I posted fully broken-down estimates of just how many people would be directly impacted by a full & repeal of the Affordable Care Act this spring, assuming that the repeal took immediate effect and there was no replacement plan in place for the various provisions of the law.
The largest single category of enrollees in my estimates are those enrolled in Medicaid/CHIP due specifically to the ACA's Medicaid expansion provision. I estimated this to be roughly 11.3 million people nationally.
01/12/17: PLEASE NOTE: I know there's a whole bunch of updates/revisions below; this is because I'm constantly updating both the Medicaid expansion and exchange policy numbers daily, in real time as I'm able to compile the most recent enrollment numbers. In most cases the numbers are quietly increasing, although in a few cases I've revised them downward.
I operate this site by myself and I do have a day job, family, etc, so if I haven't updated your state, be assured I'll get to it as soon as possible.
Now that we're past Thanksgiving weekend and the big December 15th deadline (for January coverage) is coming up fast, OE4 enrollments should have started ramping up significantly, on the order of 250,000 per day or more nationally (around 190K via HC.gov).
The Connecticut ACA exchange, AccessHealthCT, issued a press release today reminding Connecticut residents in general of the December 15th deadline for January 1st coverage. They also stressed, however, that while most current enrollees will be automatically renewed into either their existing policy, there are about 26,000 current enrollees who can't be auto-renewed because their carrier is leaving the exchange in 2017:
On December 1st, AHCT’s automatic renewal process began. The AHCT eligibility system will automatically enroll into 2017 coverage customers who have selected auto-renew and whose plans are still available. “But, there are 26,000 people who currently have coverage through AHCT who cannot auto-renew and must take action to renew their 2017 plans,” Wadleigh noted. Wadleigh reminds all customers “they should shop around and compare your options for 2017– that’s the purpose of the marketplace.”
DENVER — More than 37,000 Coloradans selected healthcare coverage for 2017 through the state health insurance Marketplace in November, a rate 23 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®.
“The pace of sign-ups during the first month of this Open Enrollment has been very heartening,” said Connect for Health Colorado CEO Kevin Patterson. “We know that there is a lot of discussion now about the future direction of healthcare, but what remains constant and true is the importance of protecting the health and financial future of all Coloradans. I encourage everyone who needs health insurance to check to see if they qualify for financial assistance, review the available plans, and complete an enrollment before the last-minute rush.”
In the first month of the annual Open Enrollment period, Coloradans selected 37,948 medical and dental insurance plans. That compares to 30,777 such plan selections in November 2015.
