Charles Gaba's blog

I haven't checked in on the Medicaid/CHIP enrollment situation in awhile, but with last week's revelation that California's Medicaid enrollment is a whopping 500,000 higher than previously thought, I probably should have done so earlier.

Between the corrected CA data and some other oddball Medicaid/CHIP data which has come in from other states, I'm fairly sure that the total ACA-enabled increase in Medicaid/CHIP enrollment nationally has crossed the 13 million line, broken out roughly as follows:

  • 8.42 million via "strict" ACA expansion
  • 1.07 million via bulk transfers from existing state-run programs
  • 3.51 million "Woodworkers" (already eligible for traditional Medicaid but never enrolled previously)

Well this one was unexpected: It's not a formal press release, but this story from the Hawaii Reporter--which actually has a pretty negative slant to it--is chock full of actual, current enrollment data points for Hawaii...and they're pretty good, relatively speaking.

None of the numbers are precise--they're all rounded off...but it's still a breath of fresh air from the Aloha state, and brings the number of states which haven't provided renewal data down from 3 to two (of course, the other two are California and New York, but still...)

Anyway...

...The Connector had about 1,000 people enrolled at this time last year. As of Thursday, that number had grown to 16,000.

...More than 365 small businesses, with 2,400 enrollees, have joined the Connector through the Small Business Health Options Program, or SHOP, in part because of tax deductions available to them, Kissel said.

Hmmm...kynect (Kentucky's ACA exchange) reported 88,289 QHP enrollees (renewals + new) as of January 6th. Just now they tweeted...

In the last week alone, #kynect has newly enrolled 3,141 individuals in one of the qualified health plans offered through the KY exchange.

— kynectky (@kynectky) January 16, 2015

So, that brings their total up to 91,430 as of...um...well, "the last week alone" suggests 7 days, which would mean either 1/07 - 1/13 or 1/09 - 1/15 (which would leave a 2-day gap). Fortunately, they then followed up with this:

Two months of open enrollment down & more than 125,000 Kentuckians have newly enrolled 4 health coverage or renewed their plans thru #kynect

— kynectky (@kynectky) January 16, 2015

Over the past month or so, the "Healthy Michigan" program (our name for ACA Medicaid expansion) has been bouncing around between 490K - 505K...a bit higher one week, a bit lower the next as people move on and off of it.

This week it reached an all-time high of 509,435 enrollees.

However, given that the estimated maximum number of Michiganders eligible for the program is somewhere between 477K - 500K depending on your source, it's unlikely to go much higher than that. I'll keep a close eye on it for the next few weeks, but assuming it continues to jostle above/below the 500K mark, I'll consider Michigan to be effectively "tapped out" and will likely stop reporting it every week.

Last week, with autorenewals added into the mix, MNsure was sitting at 41,704 QHPs as of January 5th. They just posted another update running through last night (the date of the numbers is actually as of the night before, as made clear from the corresponding press releases):

Latest Enrollment Numbers: January 16, 2015

MNsure will release 2015 enrollment metrics weekly, and will present a more robust metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. During weeks that MNsure is closed on Friday, the enrollment metrics update will be released earlier in the week.

Health Coverage Type Cumulative Enrollments
Medical Assistance 38,405
MinnesotaCare 16,056
Qualified Health Plan (QHP) 43,461

TOTAL 97,922

I was burned a couple of weeks in a row by overestimating the actual private policy (QHP) selections to date in Massachusetts by around 5% or so. Last week I downshifted a bit (from 50% of eligibility determinations to 45%), resulting in an estimate of around 90,700 QHPs as of Tuesday.

Today the MA exchange released their weekly dashboard, with official QHP selections, and sure enough, I'm back on target: 93,262 QHP selections as of Wednesday the 14th, in addition to 178,912 Medicaid (MassHealth) enrollees.

As for the payment rate, on the surface it appears to be just 72% (67,265 out of  93,262). However, remember that the 93K figure includes 19,000 people who are enrolling for coverage starting in February. We know this because of this update from December 30th:

Of the 74,203 people who selected plans by the Tuesday deadline, 51,888 paid their first month’s premium by Friday.

I've updated The Graph again, bringing things up to the end of the day today (Friday, January 16). After a 3-week "quiet period" (made even quieter due to both Christmas and New Year's), things should have heated up again this past week as yesterday's February coverage deadline approached.

The first week after the January deadline, HC.gov saw a mere 96K QHP selections due to Christmas Eve/Day, and the following week wasn't much better at 103K. As expected, they picked up somewhat last week with 163K QHPs.

Presented without comment, because this story is so awesome there's not much I could say to make it any better:

Community Health pulls plans after meeting ACA goals

Community Health Alliance has pulled its health insurance plans off the federal marketplace because it hit its enrollment goals.

Knoxville-based Community Health Alliance, a nonprofit consumer operated and oriented insurance provider, or co-op, hit its enrollment goals in the first two months of open enrollment. It stopped offering plans on the exchange Jan. 15.

I have no idea whether there's a healthcare-specific awards ceremony or anything, but this seems to be the closest thing to it, so I'll take it: Dan Diamond of The Advisory Board Company has posted his "Best of 2014" list when it comes to healthcare journalism (is it one word or two?), and I'm honored to be mentioned among field luminaries such as Sarah Kliff, Alex Wayne, Nicholas Bagley, Margot Sanger-Katz and many others.

In my case, it wasn't any specific story that I wrote which earned the nod, it was the overall site itself:

I've had a couple of days to shake off the funk I was in after CoveredCA director Peter Lee stated that they would not be releasing any 2014 renewal data until as late as February. I'm still pretty grumpy about that.

Still, today brings some cheerier news: The CoveredCA BoD had a meeting, including this slideshow which includes a bunch of data stuff. No, it doesn't have any renewal data...but take a look at page 4:

2015 OPEN ENROLLMENT

Through January 12: 228,766 New Individuals Selected a Qualified Health Plan for 2015

Big deal, right? It updates the new enrollment figure a bit, but that's about it. But wait a minute...what was the CA QHP total just 1 day earlier (through January 11th)?

217,146 NEW QHPs total

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