Charles Gaba's blog

OK, it turns out I have found an early enrollment update for a third state. Connect for Health Colorado held their monthly board meeting today, and along with a full report on October 2015 enrollments, they also posted a Business/Technology presentation for 2016 Open Enrollment, which includes this slightly cryptic bullet point:

  • Enrollment Results 2016 = 6,718 (as of 11/8/15)

That seems pretty cut & dry. I've confirmed with the exchange that this number represents QHPs only; it doesn't include SHOP (small business) or standalone Dental plans.

Last year Colorado ended up with 140,327 QHP selections during open enrollment out of 11,688,074 total...or about 1.2% of the national total.

Over at the Washington Post, Amy Goldstein has a pretty good story about the Real People who are benefitting from the ACA in Kentucky...and those among them who voted for Republican Matt Bevin anyway:

Dennis Blackburn has this splintered self-interest. The 56-year-old mechanic hasn’t worked since he lost his job 18 months ago at a tire company that supplies a diminishing number of local coal mines. “The old guy had to go home,” Blackburn says of his layoff.

He has a hereditary liver disorder, numbness in his hands and legs, back pain from folding his 6-foot-1-inch frame into 29-inch mine shafts as a young man, plus an extra heartbeat — the likely vestige of having been struck by lightning 15 years ago in his tin-roofed farmhouse.

When it comes to how many people are currently enrolled in effectuated Qualified Health Plans (QHPs) via the assorted ACA exchanges, I'm continuing to get completely different numbers from the actual exchanges as I am from the major insurance companies. To recap:

  • According to 8 of the state-based exchanges (CO, CT, DC, ID, MD, MA, MN & WA), effectuated enrollments as of the end of September were up 2.7% from the end of June (or down just 0.1% if you disregard Massachusetts, which has some special circumstances).
  • However, the quarterly financial reports from 8 major insurance carriers claim that private exchange enrollments in September were down around 7.9% since the end of June.

This discrepancy continues with the release of the Colorado exchange's October enrollment report. As you can see, when you add up the effectuated tax credit enrollees (APTC/CSR) (78,670) and the full-price enrollees (64,485) as of October 31st, they total 143,155 people.

...which is 1,304 more than the 141,851 effectuated enrollees reported as of the end of September.

Things have been changing rapidly in the ongoing Health Republic of New York saga, and as recently as last night each development seemed to make the situation worse...but a few hours ago, Politco New York reporter Dan Goldberg posted a new story which indicates that the powers that be finally have some positive news:

In an effort to head off a potential health insurance disaster, state officials on Sunday announced a series of steps to protect roughly 200,000 customers who are set to lose their health coverage, and promised to investigate the company behind the crisis.

...And those were just the customers who were aware of the change. No one could say for certain how many were unaware they were about to lose their coverage, and other insurers operating on the exchange expressed concern that the customers most likely to pick a new plan were the ones most likely to be sick, a scenario of adverse selection that few companies were prepared to handle.

Last year, to my everlasting joy, the HHS Dept. finally started issuing not just big, bulky monthly ACA exchange enrollment reports but also began issuing simple weekly enrollment "Snapshot" reports, giving just the "top line" number of people who had selected Qualified Health Plans (QHPs) in the preceding week. The first few weeks they only gave out the national total, but a few weeks in they started breaking it out by state (and, eventually, even by major metropolitan areas).

The irony here is that if they had started doing exactly this in the first place back in 2013 (just the QHP tally per state on a weekly basis, nothing more than that) I almost certainly never would have bothered tracking ACA enrollments myself, and thus this website/project never would have started at all.

In March 2014, as the first ACA open enrollment period deadline was approaching, President Obama made an appearance on Zach Galifianakis' "Between Two Ferns" to try and ramp up enrollments among the uninsured. In February 2015, as the second OE deadline approached, he teamed up with BuzzFeed to shoot a different type of promotional video, featuring the first Presidential Selfie Stick (and a nice milk-and-cookies "Thanks Obama" riff).

For the third time around, I'm guessing the President has something similar in store for the final lap in mid-January (remember, the deadline is 1/31/16 this year), but to kick things off, he's annouced an interesting new promotional effort:

White House launches Obamacare sign-up competition

As open enrollment season on HealthCare.gov begins, President Obama is introducing a contest meant to motivate Americans to sign up for health insurance coverage through federal and state exchanges.

IMPORTANT DISCLAIMER: I COULD BE COMPLETELY WRONG ABOUT THIS OPTION.

Just this morning I posted some significant updates in the ongoing, increasingly messy saga of Health Republic of New York, one of the ACA-created Co-Ops which is being shut down due to severe financial issues (partly due to the Risk Corridor Massacre debacle, but other reasons as well).

Once again, the short version is:

  • Most of the Co-Ops which are being shut down are at least able to cover their policies through the end of December, giving their current enrollees plenty of time to shop around and switch to a different insurance carrier. This was supposed to be the case for Health Republic of NY as well.
  • However, on October 30th, there was a surprise announcement by the NY Dept. of Financial Services (which includes insurance regulation) that instead of December 31st, the HRoNY policies are being yanked effective November 30th. Furthermore, current enrollees have only until November 15th to find a replacement to tide them over for December.
  • While one month may not sound like a big deal, it's a huge problem for at least some of the 200,000-odd people currently enrolled via HRoNY (note: I thought this number was down to 166K, but may be mistaken about the figure).
  • It's a major problem for some enrollees who are undergoing chemotherapy, for instance, or have other recurring medical services/treatments (many of which are expensive) which can't be "paused" for 31 days.

I wrote a couple of posts last week about the ongoing Health Republic of New York Co-Op meltdown, which has quickly gone from being just-another-Co-Op-closure to a complete disaster for up to 166,000 New York residents, primarily because unlike the other Co-Ops which are at least covering their existing enrollees through the end of December, Health Republic is now having the plug pulled out at the end of November, which gives current enrollees just 8 days to scramble to find new coverage for the last month of 2015.

This was made worse by the fact that the November 30 cut-off wasn't even announced until October 30, and even then, the powers that be in the NY Dept. of Insurance, NY State of Health exchange and Health Republic itself didn't appear to treat this development with any particular sense of urgency. I mean yes, they posted notices about it and supposedly sent out letters to all 166,000 people, but an awful lot of those people didn't appear to have received those notices as of a few days ago. Hell, until a day or two ago the NY State of Health website didn't even have anything posted about the 11/30 cut-off at all.

Well, I've been screaming bloody murder about the situation, as have others, and it seems to be getting some butts moving...but I'm not sure how helpful any of it will be.

First up: Dan Goldberg, a very good reporter for Politico New York, posted a big story about the mess on Thursday which no doubt forced some action:

Unlike the federal exchange (HealthCare.gov) and many of the state-based exchanges which have experienced massive technical problems to some degree or another over the past two years (Oregon, Nevada and Hawaii have gone kaput; Massachusetts & Maryland had to be completely rebuilt; Vermonts is still iffy),  the Kentucky ACA exchange website, aka "kynect" (lower-case intentional), has been chugging along smoothly since Day One on October 1, 2013. It's fully self-sufficient, well known and trusted by Kentuckians, and has been an amazingly successful venture in general.

So naturally...

Speaking in his first public comments since he was elected governor of Kentucky on Tuesday, Matt Bevin repeated his pledge to dismantle kynect, the state’s health insurance exchange that has been hailed as a national model.

“My intent is to have it wound down by the end of next year,” Bevin said of the online service people use to shop for health coverage or determine whether they are eligible for Medicaid under the Affordable Care Act.

NOTE: I am very much aware that simply "mashing up" 2 different surveys and splitting the difference is not a statistically professional way to do this, but it's the best I can do for the moment.

Back in July, after Gallup released their quarterly survey finding the U.S. uninsured rate to have dropped to 11.4% for adults 18 and older, I posted a more detailed graph which also separated out people caught in the Medicaid Gap as well as uninsured Undocumented Immigrants (who aren't eligible for either the ACA exchanges or Medicaid/CHIP, except for children in California...and I presume the new CA law doesn't start until January). Here's what the chart looked like at the time:

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