After the first Republican debate back in August, I wrote a piece over at healthinsurance.org titled "Has FOX News surrendered on Obamacare?" in which I noted that the ACA, which had been a near obsession on the part of the GOP for over 5 years, was barely mentioned:
In short, from what I can gather, the Affordable Care Act …
… the law which has consumed 99 percent of the Republican Party’s attention for the past 6 years or so …
… the law which has survived over 50 repeal attempts …
… the law which recovered from an unprecedented epic technical meltdown …
… the law which survived a federal government shutdown designed specifically to destroy it …
… the law which survived hundreds of millions of dollars worth of Koch Brothers attack ads …
… the law which survived two major Supreme Court decisions …
… proved to be worth perhaps three minutes of total airtime and discussion out of nearly four hours of Republican Party Presidential debate.
With the 2016 Open Enrollment Period quickly approaching, here's the most important advice I can give:
#1: SHOP AROUND. SHOP AROUND. SHOP AROUND.
Earlier today, the HHS Dept. released an in-depth analysis of the coverage decisions made for by the 4.8 million people who were still enrolled in HealthCare.Gov policies at the end of 2014 who went on to either renew their policies or switch to a different one for 2015 (note that the analysis only covers the 35 states run via HC.gov in both years. Oregon and Nevada ran their own ill-fated exchanges in 2014 and Idaho moved onto their own exchange in 2015, so these 3 states aren't included. Hawaii is moving to HC.gov for 2016 but was on it's own for both 2014 and 2015).
The report itself is quite detailed about how many people actively shopped around, how many of those kept their current plans, how many switched to a different carrier and/or a different metal level, but the bottom line is this:
The thought just occurred to me: Given that 9 of the ACA CO-OPs have closed up shop over the past few months...including no fewer than 6 in just the past 2 weeks (Kentucky, Tennessee, Colorado, Oregon, South Carolina and, just yesterday, Utah), along with at least two private insurers (WINhealth of Wyoming and, to a lesser extent, Coventry of Kansas) due specifically to wha
The HHS Dept's official exchange enrollment projection for the end of 2015 has always been that they expect roughly 9.1 million people to still be enrolled as of December (of which perhaps 8 million will renew their coverage for next year). If accurate, this would represent an 8.5% drop from the 9.95 million enrolled at the end of June.
As regular readers know, for the past couple of weeks I've been piecing together a theory, based on limited data, that ACA exchange QHP enrollment may have actually increased since June...or, at worst, only dropped slightly. Hard numbers from 8 states show a net increase of 2.7% from June through September; removing Massachusetts from the mix (special case) brings this down to a nominal 0.1% net drop:
After not one, not two, not three, but ten of the CO-OP organizations created by the ACA (and crippled from the get-go by being underfunded, not being allowed to advertise, not being allowed to arrange for additional funding and then having their sole lifeline cut off in the middle of the Open Enrollment period) melting down, you just knew that this was coming:
House Energy and Commerce Committee sets November hearing on ACA health co-op program
The House Committee on Energy and Commerce will hold a hearing on the Affordable Care Act's health co-op program in the wake of a string of collapses of consumer operated and oriented plans around the country, two sources familiar with the matter told SNL on Oct. 27.
Watch and learn. KFF does an excellent job of boiling down all of the insanity into just over 5 minutes (not that this reduces how stupid the system is, even under the ACA, but it at least explains it).
NOTE: The Open Enrollment dates listed at the end are obviously wrong because this video is from last year. For 2016, Open Enrollment runs from November 1st, 2015 through January 31st, 2016.
Thanks to Esteban B in the comments for the reminder.
This morning I noted a New York Times article regarding a whole bunch of ACA exchange enrollees who either forgot to/didn't realize they had to file a federal tax return in order to keep receiving their Advance Premium Tax Credits or who did file their taxes but forgot to include the subsidy reconciliation form when doing so.
At the time, I was so astonished at the idea that people who are receiving federal tax credits would not only not realize that they had to file a return, but would actually get angry when informed that they had to do so, that I completely missed out on the larger implications.
28,524 additional people were enrolled in July 2015 as compared to June 2015 in the 51 states that reported comparable July and June 2015 data.
Yes, that's right: The net total number of Medicaid/CHIP enrollees went up fewer than 30,000 people in July.
It's worth noting that the improving economy may be a significant part of this. Remember that this is the net number of enrollees; for all I know, 300,000 new people joined the program but 270,000 who were already on it left. Baseline churn is tricky to keep track of.
However, the more likely cause is far simpler: ACA Medicaid expansion has simply finally maxed out in most of the states allowing it, and most of the "woodworker" crowd has presumably finally figured out that they're eligible as well.
The next Open Enrollment period for the Health Insurance Marketplace begins on November 1, 2015 for coverage starting on January 1, 2016. According to an HHS analysis, about 8 out of 10 returning consumers will be able to buy a plan with premiums less than $100 dollars a month after tax credits; and about 7 out of 10 will have a plan available for less than $75 a month. Highlights of the 2016 Marketplace Affordability Snapshot include:
