Charles Gaba's blog

As I noted in my #OE3 projection methodology breakdown the other day, among the 32.3 million uninsured individuals in the country, around 4.9 million of them aren't legally allowed to receive federal financial assistance (tax credits/CSR) to enroll via the ACA exchanges because they already have a standing offer of ACA-compliant health insurance from their employers, but have (so far) refused to sign up for said coverage. The New York Times explains why many of them haven't done so:

But 10 months after the first phase of the mandate took effect, covering companies with 100 or more workers, many business owners say they are finding very few employees willing to buy the health insurance that they are now compelled to offer. The trend is especially pronounced among smaller and midsize businesses in fields filled with low-wage hourly workers, like restaurants, retailing and hospitality.

Two big ACA-related stories in the New York Times this morning; each is worthy of a full entry, but I don't have time today so I'm lumping them together:

First up: The Times' editorial board has blasted the GOP over the CO-OP failure debacle. They give a concise summary of how the CO-OPs were created and why they're facing so many problems now:

• A New Attack on Health Care Reform

[GOP critics] neglect to mention that the nonprofit plans, known as health insurance cooperatives, were created as a weak, underfunded alternative to a much stronger option that the Republicans blocked from passage.

...Their problems have been attributed to wrong estimates for how many people might enroll and to setting premiums too low to cover the cost of care, as well as severe reductions in the amount of money available to the co-ops from federal loans and for risk adjustment payments, both the result of Republican opposition to supporting the plans.

Just 3 days ago, Colorado HealthOP was stunned by the announcement by the state insurance division that they were pulling the plug on the ACA-established CO-OP:

Dear Member,

It is with a heavy heart that I write to you today. This morning, the Colorado Division of Insurance (DOI)announced Colorado HealthOP will not be selling plans through the Connect for Health Colorado marketplace.

Please be assured that, as a Colorado HealthOP member, your coverage will remain in effect through December 31, 2015, so long as you continue to pay premiums. In two weeks, on November 1, 2015, the Connect for Health Colorado marketplace will open and you will have the opportunity to find another health insurance provider that will begin coverage for you on January 1, 2016.

Needless to say, we are astonished and disappointed by the DOI’s decision. We believe it is both irresponsible and premature.

I've already laid out, in exhaustive detail, my rationale for projecting that 14.7 million people will select qualified health plans (QHPs) via the various ACA exchanges during the 2016 Open Enrollment Period (11/1/15 - 1/31/16...possibly with another week tacked on in an "overtime" period).

As always, I could very well be dead wrong about this. For all I know, the HHS Dept's far more conservative target range (11.0 - 14.1 million) could prove to be correct, or it could surprise the hell out of everyone and come in closer to the Congressional Budget Office's estimate of 20 million (although that number actually reflects their projection of the average number of people enrolled year-wide, which would require more like 25 million to select a plan by the end of January.

As I noted back in April, the New York Affordable Care Act exchange (NY State of Health) will become the second state (besides Minnesota) to offer a "Basic Health Plan" under a fairly little-reported on provision of the ACA:

The BHP will offer qualified individuals and families a choice of plans from high-quality, private health insurers through NY State of Heath (NYSOH), the state’s official health plan Marketplace. New York State health insurers were invited to offer plans through the BHP when the NYSOH plan invitation was issued today to New York State licensed health insurance companies. The invitation includes requirements for insurer certification and recertification for Qualified Health Plans and Stand-Alone Dental Plans, and for the new Basic Health Program which will start on January 1, 2016. 

When I compared my 2016 Open Enrollment projection (14.7M) against the HHS Department (11.0 - 14.1M), I was operating under the assumption that the Congressional Budget Office was still projecting a whopping 21 million average exchange QHP enrollees per month for 2016 (which would actually require, in practice, more like 25 million people to actually select plans during open enrollment).

Here's what the CBO report from March looked like:

HOWEVER, it turns out that the CBO has revised their projections since then after all...you just have to look carefully for it.

In a New York Times article about the HHS Dept's projection from Friday, Robert Pear states:

I've already stuck my neck out pretty far by projecting that 2016 Open Enrollment ACA Exchange Qualified Health Plan (QHP) Selections will reach 14.7 Million, which is about 4% higher than the HHS Dept's high-bar estimate (and 33% higher than their low-bar estimate).

While I'm at it, I might as well try and project the rate of enrollments. Again, remember that this is not about how many people actually have their enrollment policy effectuated, nor is it about how many are still enrolled at the end of 2016; this is purely about how many select private policies via the ACA exchanges, which is the heart & soul of this website (after all, it's called "ACASignups", not "ACA Effectuated Enrollments at the End of the Calendar Year").

Hey, remember this from March 20, 2014?

Gaba In, Gaba Out: WaPo Hails 'Nonpolitical' Blogger Spouting Rosy Obamacare Numbers

GIGO: Garbage In, Garbage Out.

In computer science, GIGO means that a faulty input will result in a faulty output. Perhaps GIGO in the specific area of Obamacare enrollment projects should be Gaba In, Gaba Out since many leftwing sites are currently singing the praises of one Charles Gaba, a blogger who is projecting incredibly high Obamacare numbers. And now the Washington Post's Wonkblog writer, Jason Millman, is the latest person to be enthralled by the very convenient Obamacare numbers served up by Gaba. Here is Millman singing his Gaba paean:

The Obama administration on Monday announced that 5 million people had signed up for Obamacare exchange plans. Hours earlier, a self-employed Web developer from Michigan had already predicted the milestone would be hit on Monday.

UPDATE: 1/13/15: I've modified my final #OE3 projection; I'm now projecting a range of anywhere between 13.8 - 14.2 million (but I'll still be judging myself based on how close I came to the 14.7M figure, however.)

And the hits keep on coming:

That's 2 in one day, the 8th to fold to date and the 4th one which can be specifically connected the Risk Corridor Disaster:

Health Republic Insurance Not Offering Plans in 2016

Lake Oswego, Ore. (Oct. 16, 2015) –Health Republic Insurance, a non-profit health insurance carrier, announced today that it will not offer small group or individual plans on or off exchange in 2016. All current Health Republic individual and small group policies remain in full effect through the end of 2015. Members can continue to see plan providers and claims will be paid under plan terms.

The federal government recently announced it would pay insurance companies only 12.6% of their risk corridor receivable for the 2014 plan year and has created industry-wide concern about when, or if the 2015 risk corridor would be paid.