Between the impending election on Tuesday, the upcoming 2nd Open Enrollment Period (henceforth to be designated "OE2" or hashtag #OE2) and a serious technical crisis with my day job which I've had to spend the past few days cleaning up, I have upwards of 150 ACA/Obamacare-related emails clogging up my In Box.
Most of them are worth a mention, but there's no possible way I can do a full entry / commentary / analysis on most of them, so I'm just doing roundup-style summary mentions:
Supreme Court justices have their first chance this week to decide whether they have the appetite for another major fight over President Barack Obama’s health care law.
...The appeal has arrived at the Supreme Court at a curious time; there is no conflicting appeals court ruling that the justices often say is a virtual requirement for them to take on an issue.
NOTE: In light of some serious discussion with IBD's Jed Graham and a lot of thought afterwards, I've decided to run the "attrition" numbers two ways: "Current vs. April Paid" and "Current vs. April Total", for reasons I'll explain soon.
The main thrust of this article is general hand-wringing over how the state of Rhode Island plans on funding their ACA exchange after this year, although it's a bit confusing since it sounds like the problem has nothing to do with having the funding and everything to do with having permission to use it:
Enrollment starts on Nov. 15.
Not long after, the state will have to make its own big decision: how to finance the exchange.
Of the $23.4 million in federal funds budgeted for HealthSource RI this year, only $1,353,570 has been spent so far. The state anticipates — but does not yet have — federal permission to spend any of the remaining dollars after Dec. 31.
However, there's one data point that pops up smack in the middle of my current "mini-project", trying to lock down the current QHP enrollments in each state:
The numbers ranged from as poor as Florida losing 12% of their enrollments in just 2 months to as well as Maryland and Oregon seeing a 30%+ net increase in enrollees over the past 6 months.
Today I can add Kentucky to the latter list. She couldn't provide an exact current count, but according to the woman I spoke with at the kynect exchange (that's "Obamacare", Mitch!), the number of Kentuckians currently enrolled in private policies via kynect is "right around the same number it was at last spring, between 80-85 thousand".
Why has the law been such a flop in a state that had so much to gain from it? When I traveled across Mississippi this summer, from Delta towns to the Tennessee border to the Piney Woods to the Gulf Coast, what I found was a series of cascading problems: bumbling errors and misinformation; ignorance and disorganization; a haunting racial divide; and, above all, the unyielding ideological imperative of conservative politics. This, I found, was a story about the Tea Party and its influence over a state Republican Party in transition, where a public feud between Governor Phil Bryant and the elected insurance commissioner forced the state to shut down its own insurance marketplace, even as the Obama administration in Washington refused to step into the fray. By the time the federal government offered the required coverage on its balky HealthCare.gov website, 70 percent of Mississippians confessed they knew almost nothing about it. “We would talk to people who say, ‘I don’t want anything about Obamacare. I want the Affordable Care Act,’” remembered Tineciaa Harris, one of the so-called navigators trained to help Mississippians sign up for health care. “And we’d have to explain to them that it’s the same thing.”
OK, this is gonna be difficult for people to see, since the Medicaid spreadsheet is so wide (the link goes directly to the spreadsheet itself, which should help somewhat). First, scroll all the way to the right. Then scroll to the bottom. In the lower-right corner, you'll see the following:
Last week I crunched the numbers and pointed out that if the Republican Party ever successfully completes repealing the Affordable Care Act, tearing it out "root & branch" as Mitch McConnell is so fond of putting it, that 638,000 Michiganders would lose their healthcare coverage in one shot.
Beneficiaries with Healthy Michigan Plan Coverage: 433,469
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)
*Statistics as of October 27, 2014
*Updated every Monday at 3 p.m.
Yup. We're up to over 646,000 Michigan residents who'd be pretty much screwed if the GOP gets its way.
In spite of their ugly technical problems, Cover Oregon was surprisingly consistent and reliable with their off-season enrollment updates, issuing them about once a week throughout the entire spring and summer. This came to a halt on September 29th, however; they didn't issue any updates at all throughout all of October. I assumed that this was because they were too busy shutting down the state exchange and moving everything over to Healthcare.Gov for the 2nd Open Enrollment period, and I'm sure they are. However, tonight I was pleasantly surprised to see that they have issued one more update after all, taking things all the way through...today:
October 28, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon
Medical enrollments through Cover Oregon: 416,056 Total private medical insurance enrollments through Cover Oregon: 105,055
Oregon Health Plan enrollments through Cover Oregon: 311,001
When HHS Secretary Sylvia Burwell finally revealed that 7.3 million people were enrolled in policies as of August 15th, most of my assumptions were confirmed...except that the attrition rate, which I had been assuming was around 3% per month, now seemed to be even lower, at 2%. However, I wasn't sure about this until now.
Today I added a whole slew of updated state-level current enrollment numbers, and now I have these for 10 states, comprising nearly 3.2 million of the original 8.02 million enrollees through 4/19/14, or almost 40% of the total. This strikes me as being a pretty good base to extrapolate the other 40 states (+DC) from.
I addressed Nevada's apparent attrition rate about a month and a half ago. At the time, it appeared to be a fairly ugly 7.7% per month...relative to the "high water mark" of paid enrollments they had achieved in July of around 38,000.
However, since then I've realized that given the high amount of churn during the off-season as people enter and leave the marketplace, a far more accurate measure is the number of current enrollees relative to the April tally, since that was the "8.02 Million Total / 7.06 Million Paid" figure that everyone was focusing on anyway. Doing it this way is also far more consistent, since there's a hard 4/19 number to compare against for every state instead of it being all over the map.
In the case of Nevada, I've just received word that the current number of people enrolled in exchange QHPs is exactly 32,460 as of mid-October.
