Charles Gaba's blog

OK, this may seem like a minor thing, but you just know there's that one family in Juneau which waits until the last minute...

Midnight Monday, Pacific time, is the deadline for new customers to pick a health plan that will take effect Jan. 1, and for current enrollees to make changes that could reduce premium increases ahead of the new year.

HealthCare.gov and state insurance websites are preparing for heavy online traffic before the deadline, which gives consumers in the East three hours into Tuesday to enroll.

Thanks to contributor farmbellpsu for the heads' up.

Also, 21 year olds (in all states, not just Alaska) should pay special attention:

Doing nothing appears to be a particularly bad idea for people who turned 21 this year, according to the Center on Budget and Policy Priorities, a Washington group that advocates for low-income people.

As the article notes, just because someone applies for Medicaid doesn't mean that they'll be approved (or some in the household might while others aren't). Still, assuming that, say, 95% are approved and enrolled, and assuming 1.8x people per household on average (the Census Bureau says it's more like 2.5x), that should still be a good 125K Pennsylvania residents added to the tally in the first 2 weeks...or over 20% of the total eligible in the state:

Two weeks after enrollment began, the state has received tens of thousands of applications for health care coverage by way of the “Healthy PA” program, which offers subsidized, Medicaid-like insurance through private carriers to low-income Pennsylvanians.

As of the end of the day Wednesday, the state had received applications from nearly 44,000 households, according to the Department of Human Services. It also has received an additional 30,000 household applications referrals through the federal health care marketplace.

That doesn’t necessarily mean all those applicants will be eligible to receive coverage, though likely many of them will be, said Kait Gillis, a DHS spokeswoman.

Anyone who follows this site and The Graph regularly knows that I'm expecting a massive spike in enrollments this weekend and tomorrow (Monday)...possibly as many as an incredible 1.4 million nationally in just a 3 day period (370K yesterday, 380K today and potentially as many as an astonishing 650,000 tomorrow alone.

HOWEVER, even assuming that that many people try to log in and renew their current policy or switch to a different one (which I strongly advise), there's one snag: Sheer server capacity.

To the best of my knowledge, the highest load ever placed on HealthCare.Gov was on March 31st last spring, when upwards of 250,000 or so enrollments were processed in a single 24-hour period (for the record, the next 4 busiest dates at HC.gov included March 25 - 30th, April 1st, and December 23rd and 24th, which all make perfect sense).

Assuming around 75% of enrollments on any given day are added via the federal exchange, 650K total would mean around 480K via HC.gov...or nearly twice as many as the busiest day the site has ever experienced.

Marco Rubio

OK, Sherman, let's fire up the Wayback Machine and revisit August 29th, 2014, shall we?

TALLAHASSEE — Last year, legislators allocated $900,000 to help Floridians find affordable health care through a new state-backed website.

At the same time, they refused to expand Medicaid or work with the federal government to offer subsidized insurance plans.

Six months after the launch of the state's effort, called Florida Health Choices (floridahealthchoices.net), just 30 people have signed up. Another seven plans were canceled either because consumers changed their minds or didn't pay for services.

As I noted at the time:

OK, this is a bit...um...confusing.

Back on October 1st, Your Health Idaho posted the following blog entry launching their "window shopping" tool for 2015 private policies, which also included very specific deadlines for both selecting a plan as well as paying the first premium for January 1st coverage:

BOISE, Idaho – As the December 23 deadline for health coverage to begin on January 1 is days away, Your Health Idaho and insurance companies selling plans on Your Health Idaho are taking several steps to provide consumers with a smooth transition to coverage.

Yup, my wife and I went ahead and manually renewed our own private healthcare policy via HC.gov this morning here in the Wolverine State. We had already used the window shopping/browsing feature ("See Plans & Prices") and determined that in our case, sticking with the same plan through the same company made the most sense for us.

Now, here's where things get interesting: For 2014 we qualified for a small tax credit. For 2015, while our projected taxable income is expected to be pretty much identical to what we had projected a year earlier, our tax credit went up by $61 per month.

The policy itself also did go up by $93/month, but due to our tax credit also increasing, our net cost ends up being just $32/month more. Don't get me wrong, I'm not thrilled about having to pay $384/year more on top of what's already a pretty steep rate, but the point is that for some people, their tax credits are increasing next year (ie, meaning a lower net premium increase than the official rate increase would indicate).

Special thanks to Nick Budnick for providing a direct link to Oregon's ACA exchange enrollment update page, which, as a bonus, also tracks off-exchange QHPs as well (which I really wish every state would include as a separate line item):

​The Insurance Division will collect enrollment information from carriers each week throughout 2015 open enrollment. Updated numbers will be posted each week on this web page.

Members enrolled, Nov. 15-Dec. 7
On Healthcare.gov 26,933
Outside of Healthcare.gov 17,923
Total 44,856

About the data: Enrolled means a person has selected a plan. Consumers must pay the first month's premium for their coverage to become effective. These numbers do not identify whether the first month's premium has been paid. These numbers do not include Oregonians enrolled in the Oregon Health Plan (Medicaid).

These preliminary numbers are subject to change week to week based on people changing or canceling plans or having a change in status such as a new job or marriage.

Updated: Dec. 12, 2014

Yeah, yeah, I know; the HHS Dept. issued a list of proposals for the 2016 Open Enrollment Period like 3 weeks ago, but I've been a wee bit busy with this year, y'know?

Anyway, let's take a look at them (there's 35 in all, I'm not gonna get into all of them but will provide commentary on selected proposals):

Things weren't looking great eight months ago for Dr. Peter Beilenson and Evergreen Health Co-op, the insurance company he created from scratch.

The brand-new insurance company had been counting on Maryland's health exchange to bring in its first members. But the online marketplace was a nightmare for people trying to sign up. With higher prices and less name recognition than competitors like CareFirst BlueCross BlueShield, Evergreen ended the exchange's open enrollment period with just 400 members.

...Fast-forward to today and business is looking up for Evergreen. The companyshifted focus to small business groupsonce it realized it couldn't rely on the exchange alone. Evergreen lowered its premium prices for 2015 individual plans and is locking in the rates on both its individual and small group plans for two years. About 800 people have signed up for Evergreen health plans through the exchange since it opened in mid-November.

I've posted a few times before about the ACA Medicaid expansion situation in some deep red states; Tennessee, Utah and Wyoming among them:

Two of the most heavily Republican states, Utah and Wyoming, appear to be moving closer to an expansion of Medicaid under the Affordable Care Act. Other GOP-dominated states, like Indiana and Tennessee, are also looking more closely at it, despite the hostility of their party’s leaders toward Obamacare.

...Gov. Matt Mead of Wyoming, where Republicans hold 78 of 90 seats in the legislature, acknowledged his opposition to Obamacare but said the statehad to be realistic by embracing Medicaid expansion in one form or another. “I don’t think we can say to those people in Wyoming who are working [and] who cannot get insurance that we’re not going to do anything,” he said.

...While the odds for expansion in Wyoming remain uncertain, Utah seems likely to move in the coming months. There, Gov. Gary Herbert made the case on moral grounds — as a duty to help people he described as “our neighbors, our friends and our family members.”

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