Charles Gaba's blog

As I noted yesterday, it appears that contrary to my concerns, the devastating election results aren't discouraging anyone from signing up for 2017 coverage after all. If anything they appear to have "inspired" people to scramble and sign up ASAP before the door presumably slams shut.

As a result, until I hear otherwise, I'm going to assume that the enrollment rate is tracking my original, pre-election projections...in which case this is where things should stand as of an hour ago:

I've only actually confirmed about 132,000 QHP selections so far, so obviously I could be off on either or both of the above, but I'm feeling pretty confident that if they didn't hit those numbers last night, they will have done so by this evening.

Just yesterday I noted that Minnesota's ACA exchange is full bore ahead, especially due to their unique first-come, first-serve enrollment cap cut-off for 4 of the 5 individual market carriers. They're still moving at a breakneck pace:

From MNsure today:

ST. PAUL, Minn.—More Minnesotans have shopped early and enrolled in comprehensive health care coverage though MNsure than ever before. In just the first nine days, more than 20,000 Minnesotans enrolled through the state's health care exchange. It took about six weeks to achieve this milestone last year.

The results of this week's elections do not change MNsure's focus on providing high quality customer service to Minnesotans shopping for health care coverage and encouraging Minnesotans to take advantage of the financial assistance available only through MNsure.

As I've been noting for a few months now, Connect for Health Colorado's monthly enrollment reports are chock full of data and confusing as hell at the same time.

As a result, I've started simply presenting them without much commentary. Here's the October report (remember, this is for currently enrolled 2016 policies, not 2017 Open Enrollment policies:

In addition to releasing their 2017 enrollment data for the first 8 days of November, the Massachusetts Health Connector has posted their latest monthly enrollment report (through the end of October), and the news is good. As I note every month:

Unlike most states, the Massachusetts Health Connector has not only seen no net attrition since the end of Open Enrollment, but has actually seen a net increase in enrollment...mainly due to their unique "ConnectorCare" policies, which are fully Qualified Health Plans (QHPs) but have additional financial assistance for those who qualify and which are available year-round instead of being limited to the open enrollment period.

The amount of the increase depends on which "official" number you start with; the MA exchange claimed 196,554 people as of 1/31/16...while the ASPE report gives it as 213,883 as of the next day....yet their March report claims 208,000 effectuated enrollees as of February.

So, for about 24 hours or so I was feeling nearly suicidal, and this morning I expressed my own tiny bit of symbolic gloom by swapping out the normal header graphic for this one:

I was planning on leaving it like that for a day or so, then swapping it back again tomorrow...but since then I've received several emails/messages/comments from people along the lines of this one:

We are all devastated about the outcome of this election and that the ACA is on the line. Like so many others I wanted to crawl into a hole yesterday. I myself will lose my insurance as will so many of my family, friends and so many people that I assisted and encouraged in their own enrollment over the years.

This is why we can't/won't give up!

From MNsure:

More than 15,000 Minnesotans have Enrolled in Health Coverage in Six Days

November 7, 2016

ST. PAUL, Minn.— MNsure is providing an update on the 2017 open enrollment period. Within six days, more than 15,000 Minnesotans have enrolled in health coverage. This milestone took about six weeks to achieve during last year's open enrollment period.

Since the start of open enrollment, we have seen:

The most recent hard current exchange QHP enrollment number I have for Massachusetts is 230,412 people as of September 1st. Due to MA's unique "ConnectorCare" program, they've actually seen a gradual increase in exchange enrollment during the off-season instead of net attrition like almost every other state.

Today I was informed that as of November 8th, they had a grand total of 2,942 new QHP selections via the state exchange...of which 510 are fully enrolled (i.e., they've paid their January premiums already). This does not, however, include any renewals / re-enrollments by current enrollees, which could be substantially higher.

UPDATE: OK, I have the total enrollment numbers now: 10,251 (7,309 renewals + 2,942 new additions). That's 1,281 per day, or about 4.8% of their total enrollment last season.

Minnesota and Massachusetts are the only state exchanges I have data for so far, and MN is a special case, so here's a simple extrapolation of MA's numbers:

Over the past day or so, in response to the shocking and horrifying news that a racist, misogynistic, xenophobic con-artist sexual predator moron has been elected our next President and who has also stated point-blank that he intends to help the now-100%-Republican-controlled Congress eliminate the Affordable Care Act, I noted that this would likely cause 2017 enrollments to plummet as a result.

I figured that a lot of people who were planning on enrolling for 2017 policies might decide not to bother anymore, reasoning that if the ACA is about to be repealed, why should they go through the hassle and bother of signing up for a policy which is likely to be scrapped within a couple of months of it taking effect anyway?

I even whipped up a crude modified version of The Enrollment Graph:

In fact, I was feeling so despondent that earlier today I even swapped out the header logo with this:

OK, so Mitch McConnell has now confirmed that yes, repealing the Affordable Care Act is indeed Priority 1 for the incoming 100% GOP-controlled Congress now that they know they'll have President Trump (good God, I'll never get used to writing that) ready to sign it with his big Sharpie.

The only saving grace I keep seeing being thrown around today is the assumption that the Senate will in all likelihood simply dust off the repeal bill they passed in 2015 (the one which President Obama vetoed), cross out the date and pass that one...which included keeping the existing APTC subsidies in place through the end of 2017.

This would still suck royally, but at least it would buy everyone one more year to figure out what the hell they're gonna do for a healthcare policy starting in 2018, right?

Well...perhaps. But there's a catch, which Amy Lotven of Inside Health Policy wrote about back in September and which I discussed with Prof. Nicholas Bagley from the University of Michigan:

Don't worry, I'm not gonna rehash the whole thing, but some of you may recall that way back in January (a lifetime ago, this morning), I caused a bit of a brouhaha (or a "bro-ha-ha") when I noted that Bernie Sanders' Single Payer Healthcare Plan (aka "Medicare for All"), while sounding awesome in theory, was not only absurdly lacking in detail even for a general campaign outline, but that there were simply too many logistical problems for it to go into effect within such a short timeframe (which I assumed would be perhaps the same 5-year timeline as the ACA, since Sen. Sanders didn't specify any sort of timeline himself).

The response from Bernie's supporters was, to put it mildly, negative.

While I knew that a national single payer system was a non-starter, I thought that perhaps it might be feasible to get one through at the state level (assuming the funding mechanism could be adequately resolved, which was the Achilles' heel of Vermont's failed attempt a few years earlier).

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