Charles Gaba's blog

My latest piece for healthinsurance.org is the second part of my explanation of why people shouldn't freak out about my estimate from a week ago that the current ACA QHP enrollment appearing to have dropped down to below the 7 million mark.

Of course, as it turns out, the actual QHP enrollment as of mid-October turned out to be around 7.1 million anyway, making some of my points moot, but they're food for thought since 7.1M is still less than 7.3M (which in turn, of course, is less than the 8.0M from April).

Anyway, check it out.

In the meantime, here's a video of a cat wearing a shark costume while riding a Roomba.

UPDATE: More specifically, Friday morning, probably between 8 - 9am.

Last week, I posted a major entry in which I painstakingly pieced together the current QHP enrollment data from 16 states in an attempt to extrapolate what the current national enrollment figure stood at as of October. Since last spring, the only data point that HHS had given out was that 7.3 million were enrolled as of August 15th; I was trying to calculate how many were still enrolled 2 months later, after adding "special life event" enrollments and subtracting people who dropped their policies for other assorted reasons.

In addition, there was the question how much the "3 month grace period", "citizenship/immigration data" and the "income data discrepancy" issues would contribute to the attrition rate, as people were dropped due to failure to continue payments or for not being legally eligible for the policies.

Yup, that's another 16,000 Michiganders who are royally hosed if the Republican Party gets their way and repeals the ACA. The total is now up to around 662,000 people state-wide if you combine Medicaid expansion and those receiving QHP tax credits:

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 449,949
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of November 10, 2014 

And the MNsure train keeps on rolling along...

Latest Enrollment Numbers

November 9, 2014

Health Coverage Type Cumulative Enrollments
Medical Assistance 234,698
MinnesotaCare 80,391
Qualified Health Plan (QHP) 55,879
TOTAL 370,968

That's another 66 QHPs and 1,784 Medicaid/MinnesotaCare enrollees from just November 5th through 10th.

Even with #OE2 staring them in the face, Minnesota continues to see more people trickle into private policies for December alone.

OK, with the HHS Dept. issuing this press release a couple of hours ago, I can now make one, final update to The Graph before the 2015 Open Enrollment Period (#OE2) kicks off.

As you can see, there are only cosmetic changes at this point. A week or so ago, I had estimated that the number of current QHP enrollees had likely dropped from 7.3 million as of 8/15/14 down to somewhere between 6.8 - 7.0 million. However, according to the HHS press release, the actual number "as of October" stood at 7.1 million. I don't know if that means the beginning, middle or end of October, but let's assume it's somewhere in the middle, or October 15th. [Update: HHS confirmed that this number does indeed run through 10/15].

I'm dealing with several day-job crises at the moment, so a detailed analysis will have to wait a bit, but this was just released from the HHS Dept:

The main points:

  • GOOD NEWS: A week or so ago I calculated that the current number of QHP enrollees, which was stated as being 7.3 million as of mid-August, might have dipped down to somewhere between 6.8 - 7.0 million people. I'm happy to report that according to HHS, that number was still 7.1 million as of October. This means that there was a bit of a drop, but not nearly as significant one as the limited state-level data was indicating (especially Florida...still not sure what's going on there).
  • While the CBO was still projecting a total of 13 million people enrolling (or re-enrolling) through the ACA exchanges by the end of 2015, the HHS Dept. is issuing a much more cautious range of 9.0 - 9.9 million. They're basically saying that the CBO's 13M was based on the assumption that it would take about 3 years to ramp up to the eventual 25M total, but they now feel it will take either 4 or 5 years to ramp up, meaning 2015 should see either 11.5M (assuming 4 year ramp-up) or 9M (assuming 5 year ramp-up).
  • Whether you see this new projection as good or bad news really depends on your POV. On the one hand, if it does prove to be accurate, they'll catch a lot of flack for "walking back lofty earlier projection", bla bla bla, and the GOP will use this as yet another opportunity to attack the ACA as "failing" etc (ignoring the 9-10 million people who will be on the exchanges, the millions more on Medicaid thanks to the ACA, the protections in place for everyone else, and so on and so forth).
  • On the other hand, if the 2015 enrollment does end up meeting or beating the CBO's original projection of around 13 million (or even coming close), the administration will be able to crow from the rooftops about kicking butt even more than they did this year (when the final number ended up beating the original 7M figure even after all the start-up technical problems and even after subtracting out those who didn't pay their premiums).

Connect for Health Colorado has just released their final ACA exchange report prior to the 2015 open enrollment period starting up (it runs through October 31st). The top of the line numbers aren't surprising: 2,206 more people enrolled in private QHPs last month, while the SHOP (small business policy) enrollment total went up a mere 4 people (from 2,517 to 2,521).

The QHP rate was 71 per day in October, down from 126 per day from May through September and from 627 per day during the 2014 open enrollment period. This is hardly surprising; a lot of people are likely to decide to "stick it out" for the final 1-2 months of the year and wait until Nov. 15th to enroll in a policy that kicks in on January 1st instead of going through the trouble of enrolling in a policy that will have to be renewed or changed a month or so later anyway.

UPDATE: Someone pointed out that the more likely reason is that ValuePenguin/HealthSherpa are still listing the 2014 pricing only for most states.

Basically, ignore everything below. I would just delete the entire post but it is important to call attention to the fact that both of these 3rd-party sites are still listing 2014 pricing. ValuePenguin has a "2015 Preview" checkmark next to 11 states (you can choose between 2014 and 2015 when you go to a zip code in those states), but HealthSherpa.com doesn't seem to make it clear at all which year you're looking at pricing for.

I've already contacted both sites and strongly suggested that they make it crystal-clear on the actual rate pages whether the pricing is for 2014 or 2015.

UPDATE x2: To their credit, ValuePenguin.com has added "2014 Plans" prominently to the top of each state listing to make it more obvious. HealthSherpa.com, however, still doesn't really indicate which year their policies are for anywhere that I can see.

UPDATE x3: HealthSherpa.com has also now added a note at the top of the site clarifying which year the plans shown are for.

Ask and ye shall receive:

https://www.healthcare.gov/see-plans/

UPDATE: It took me awhile to find this link from the home page of HC.gov, but it turns out it's the very first one ("Get Coverage") in the top left corner. You have to enter your state first because they want people from states using their own exchange such as California, Colorado, Kentucky etc. to be directed to the correct website.

UPDATE x2: OK, they've actually already changed the home page to also include a big "See Plans & Prices" button in the middle of the page as well:

 

A few key things to note right off the bat:

  • From a technical/design POV, the new site is indeed like night and day from where it was a year ago. The new site is fully mobile-responsive, loads very quickly, extremely streamlined data entry, the ability to edit any/all info on the fly, and you can choose from multiple filtering criteria via Amazon-style "filtering" instead of just one at a time. That is, last year you could compare metal levels, companies, premium ranges, PPOs vs. HMOs and so on...but only one of these sets of criteria at a time. Now, you can "drill down" to the specific types of policies that you're interested in, or remove certain filters to check them out another way. Very nice.

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