A proposal to expand a federal health insurance program for needy people could be off the table following the results of Tuesday's election.
The victory of Republican Donald Trump, who has called for a repeal of Obamacare, along with the increasingly conservative Republican make-up of the South Dakota state Legislature could thwart Gov. Dennis Daugaard's efforts to expand Medicaid in the state.
Daugaard for more than a year has worked with the Obama administration and the Indian Health Service to strike a deal, which stemmed the approval of a federal policy that allows the state to spend less on Medicaid-eligible Native Americans. And part of that bargain has been staked on South Dakota using the savings to cover an additional 50,000 South Dakotans under Medicaid.
Trump hasn't set a clear policy position on Medicaid expansion but has said he'd repeal the Affordable Care Act, though two of his closest allies, New Jersey Gov. Chris Christie and Indiana Gov. Mike Pence, have accepted Medicaid expansion.
Burwell's Tweet doesn't give the cumulative total to date, but her "best day yet" clarifier certainly helps. My pre-election model was projecting the following:
11/01: 68K
11/02: 92K (160K total)
11/03: 92K (252K total)
11/04: 92K (344K total)
11/05: 75K (419K total)
11/06: 51K (470K total)
11/07: 92K (562K total)
11/08: 92K (654K total)
11/09: 85K (739K total)
I then went on to note that the actual tally for 11/09 specifically (the day after the election) turned out to be "over 100,000"...later clarified as 105,000 people, which is 24% higher than my own one-day projection.
My projections for the next few days were around 85,000 per day, for a cumulative total of 993,300 QHP selections via HealthCare.Gov as of November 12th.
Today CMS issued their first bi-weekly "snapshot" report. Lo and behold:
Biweekly Enrollment Snapshot • WEEKS 1 AND 2, NOV 1 - 12, 2016
But actually, he thought as he re-adjusted the Ministry of Plenty’s figures, it was not even forgery. It was merely the substitution of one piece of nonsense for another. Most of the material that you were dealing with had no connexion with anything in the real world, not even the kind of connexion that is contained in a direct lie. Statistics were just as much a fantasy in their original version as in their rectified version. A great deal of the time you were expected to make them up out of your head.
I don't write a whole lot about Medicare, since just about all U.S. citizens over 65 are covered by it and therefore don't enroll via the ACA exchanges anyway. However, it does come up on this site from time to time, and a good 55 million or so are enrolled in the program, so this little story might be of some relevance:
"Possibly because of my love affair with ships and boats, the Titanic story has always fascinated and still grips me, but one scene in particular always gets to me: the sight of the ship's band, there on the decks as the ship was sinking, not panicking, not running for their life, but doing their duty by sitting there and playing and giving strength and comfort to those who were about to die with them and the lucky few in the boats."
As you may recall, there was a day or two last week where I was as despondent over the election results as anyone, and I was deeply concerned that Trump being elected—combined with his promise to join the GOP in wiping out the ACA—would cause people to abandon the currently ongoing 2017 Open Enrollment Period...thus making my pre-election projection utterly meaningless.
Instead, the exact opposite appears to be happening...or, at the very least, the election results don’t seem to be keeping anyone from signing up. Some people may be abandoning their plans to enroll via the exchange out of fear that it’s gonna get yanked away from them a few months into the new year, forcing them to scramble later...but many others seem to be realizing that the law, including the federal tax credits and CSR assistance, is still on the books and will continue to be through Jan. 20th at the very soonest...and, depending on how much squabbling and legal steps the GOP has to go through, could potentially stick around mostly as is for up to 2 more years. In any event, many have concluded that it’d be better to go ahead and sign up now so they’re covered for as long as possible.
I noted last week that contrary to my concern that OE4 might get off to a slow start due to people holding off until after the election, the early enrollment numbers appear to be right on pace with my official projections after all. In fact, the single day's worth of data provided for HealthCare.Gov ("over 100,000"* enrollments on 11/09 specifically) is 17% higher than what I was expecting it to be, although obviously that could vary widely day to day. The numbers from Minnesota are also extremely impressive, running over 6x higher than the same period last year, that's mostly due to their unique enrollment cap situation, so that's not much of an indicator of any other state.
*(Update 11:55am: This Washington Post article gives HC.gov's 11/09 tally as 105K instead of simply "over 100K").
UPDATE 1/15/17: Reposting this given this evening's "news" that Donald Trump is "promising" to allegedly replace Obamacare (the ACA) with "insurance for everybody" in some mysterious fashion which wouldn't involve being "single payer" (assuming he even has a clue what that actually means):
Ever since Trump's stunning electoral college victory on Tuesday, there's been a lot of hand-wringing (including by myself) about the Republican Party finally getting to actually make good on their obsessive desire to kill off the Affordable Care Act.
At the same time, there's been a similar number of articles written about why doing so might be trickier than they think. Many of those articles focus on the actual legalities involved (which parts can be killed via reconciliation, which parts can't, what the timeline would be and so on), while others go into the political and economic impact of actually repealing the law and what their replacement might look like. This is what I'm writing about in this entry.
As I keep noting, the DC exchange insists on presenting their enrollment numbers as cumulative since October2013.
As a result, I have to subtract the prior numbers from the current ones to find out the net increase in QHP selections, Medicaid enrollments and SHOP enrollments.
