About 316,000 households that got tax credits paid to them in advance but did not file any return at all last year. Before the healthcare law, many low-income people were not required to file taxes. Now they must do so if they got a subsidy. But if taxpayers don't realize it, that can create mix-ups.
Some 976,000 households that got tax credits and filed 2014 returns, but omitted a new form that is the key to accounting for their subsidies. Called Form 8962, it was introduced for the 2015 tax filing season.
About 147,000 households that had requested extensions to file their 2014 taxes, but never followed through.
For the past few weeks, I've been pointing out some of the reasons why a wholesale replacement of the entire U.S. healthcare system with a universal, comprehensive, single payer system in one shot (or even a short-term series of shots) would be absurdly improbable to happen even if Bernie Sanders not only won the Presidency (which, unlike some people, I do think could happen), but also somehow managed to along solidly progressive majorities in both the House and Senate (which, I'm sorry, I just don't). I then took a closer look at the ideas which Hillary Clinton has proposed so far, and found them to be important but mostly minor improvements.
Hmmm...OK, I guess "as of today" means I need to make the "thru date" 2/04/16 instead of 1/31 or 2/01, but whatever; the point is that this is Kentucky's final official total.
Kynect's total was 81,121 as of 12/26, so they only added about 12,500 more since Christmas. 93,687 is only around 75% of the 125K I was expecting, and is over 12,600 fewer private enrollees than they had last year, making them one of only 8 states to drop their open enrollment total.
So...what went wrong? Well, from the HHS Dept's POV, nothing...or at least nothing that they didn't already project last October. They had already openly stated that they didn't expect any dramatic exchange enrollment increases this year, giving a wide open enrollment range of 11.0 - 14.1 million QHP selections...which has a mid-range of 12.6 million.
The better question is how I managed to be off by so much, overestimating (originally) by a whopping 2 million people, Obviously I can't be expected to nail every number, but that would be the least-accurate projection I've had to date (overshooting by 15.7%).
There's still a handful of enrollees left to be added to the state-level numbers (perhaps 60K or so collectively), but it's time to look at the major reasons for the shortfall.
Some of these are well-documented criticisms: Premiums and/or deductibles are simply too damned high for many policies/regions in general. This post is not about price/affordability issues, however; this is about more specific factors.
First, let's take a look at the state-by-state enrollment table, sorted highest to lowest in terms of how well each did vs. my personal projections:
The final numbers (through either 1/31, 2/01 or 2/02 depending on the state) are now in for 44 states plus DC. There are still 6 states which are missing some enrollment data:
Your Health Idaho informs me that their official final OE3 total won't be announced until after February 15th, but here's a quick mini-update:
More than 97,000 Idahoans Select Insurance through Idaho Exchange
Lawmakers Get Update on Your Health Idaho’s Progress
BOISE, Idaho – Your Health Idaho executive director Pat Kelly went before lawmakers on Tuesday to give them an update on the second year of operations for Idaho’s state-based health insurance exchange. Kelly said Idahoans have benefitted from state lawmakers’ choice to keep the federal government out of Idaho’s health insurance decisions.
Currently, more than 97,000 Idahoans have selected a health insurance plan through the exchange. In 2015, Idaho ranked fourth in the nation per-capita for enrollments and had the highest enrollment numbers of any state-based health insurance exchange.
YHI also makes a strong case for keeping full state exchanges as opposed to moving to HealthCare.Gov (Matt Bevin of Kentucky might want to take notice...):
This Just In...the DC exchange has issued their official enrollment report as well (note: remember that this includes the first 2 days of February as well):
DC Health Link Individual Marketplace Data for Third Open Enrollment Period
61% of New Customers are 34 years old and Younger
Washington, DC – Today, the DC Health Benefit Exchange Authority (HBX) released preliminary individual marketplace data for the third open enrollment period for DCHealthLink.com, the District’s online health insurance marketplace for individuals, families and small businesses.
The third open enrollment period for individuals and families ended January 31, 2016. District residents had two extra days to enroll due to the historic snow storm that hit the DC region. Data includes people enrolling from November 1, 2015 to February 2, 2016.
There are 22,912 customers with 2016 health insurance coverage through DC Health Link’s individual marketplace:
OK. As expected, HHS released the "top line" number for the 2016 Open Enrollment Period: 12.7 million Qualified Health Plan enrollments nationally.
On the one hand, yes, I blew it this year: This is almost exactly 2.0 million fewer than the 14.7 million I originally projected for this year.
HOWEVER, as I've noted many times before, this isn't an apples to apples comparison, because that 12.7 million is after subtracting a minimum of 300,000 cancelled plans (pre-purging). The first two years, any plan cancellations during open enrollment weren't subtracted until after the dust settled; this year, due to improved backend software, CMS was able to purge/remove most cancelled plans from HC.gov on the fly.
In other words, an apples to apples comparison of the actual grand total of QHP selections vs. the same figure last year is at least 13.0 million (actually somewhat higher, since CMS hasn't released the total number of "pre-purges").
SACRAMENTO, Calif. — With three days left for consumers to finish their applications for affordable, quality health care coverage through the Patient Protection and Affordable Care Act, Covered California announced that more than 425,000 consumers had made plan selections during its third open-enrollment period.
UPDATE 4:00pm: OK, the HHS call is over now (see notes below), but now I'm on the Covered California call...and my kid gets off the school bus in 10 minutes, so it'll be a bit before I can post a fuller analysis of anything.
OK, everyone, here we go...a press call with the heads of HHS/CMS/HC.gov:
Secretary Sylvia M. Burwell, U.S. Department of Health and Human Services
Andy Slavitt, Acting Administrator, Centers for Medicare and Medicaid Services
Kevin Counihan, CEO, Health Insurance Marketplace
Remember, last years' total exchange enrollment was around 11.7 million nationally (8.8 million via HC.gov). HHS's official projection for 2016 was only around 10% higher (officially between 11.0 - 14.1 million, with a midrange around 12.6 million or so), while mine was more ambitious (around 25% higher overall, or 14.7 million).
