Earlier today, contributor Esther Ferington brought an old New York Times article from last October to my attention. The article is actually about off-exchange enrollments as an option to using the exchanges, but the opening line of the story includes an interesting snippet:
WITH so much attention being paid to the troubled debut of the Obama administration’s health insurance exchanges, another alternative has largely gone unnoticed: unless you live in Washington, D.C., or Vermont, you can also buy insurance outside the exchanges — by going directly to insurance brokers, agents or company Web sites.
(Sigh) Don't get me wrong, I'm glad Minnesota is staying on the ball with their updates but really, this is like 8 in the past 9 days or something...anyway, this one includes specific numbers for both categories, no messing with private/public ratios: 33,722 QHPs, 86,932 Medicaid.
Today, MNsure announced more than 120,000 Minnesotans have enrolled in comprehensive, affordable health insurance coverage through the state’s health insurance marketplace. With an original goal of enrolling 135,000 Minnesotans, MNsure is on pace to meet or exceed that goal when open enrollment ends on March 31.
“We are averaging about 1,000 new enrollees every day,” said interim CEO Scott Leitz. “We anticipate we will continue, or improve this pace, keeping us on track to meet our original goal of enrolling 135,000 Minnesotans during this open enrollment period.”
The goal of enrolling 135,000 Minnesotans during the 2014 open enrollment period was discussed at the MNsure Board of Directors meeting on October 16, 2013.
Their last update had them at 57,090 QHPs and 223,378 Medicaid/CHIP, 280,468 total, so this is an increase of at least 19,532.
KY has recently shifted towards roughly a 17.5% QHPs / 82.5% Medicaid split. I'll assume a 15/85 with the newest batch for now, which brings the totals to 2,932 QHP / 16,600 Medicaid, for totals of over 60,000 and 240,000 respectively.
In addition, California's NEW Medicaid enrollee numbers continue to skyrocket, up from 877K (exchange) / 652K (bulk transfers/other) at the end of January to a whopping 1.136 Million + 968,500 = 2,104,500 total (!)
The wording of the 1.136M Medicaid number specifies that this is a combination of NEW enrollees as well as "ongoing caseload activity", which sounds to me like people who enrolled a few months earlier but are still having paperwork issues. Either way, it sounds clear to me that these are not "renewals (aka rederminations)".
A beautiful find by new contributor Uncle Toby: Highmark Inc., a major insurer which serves Pennsylvania, West Virginia and Delaware, just did exactly what I've been wanting every insurer to do: They officially announced not just their off-exchange enrollments, but specified the exact date that these run through and the fact that they're all 100% ACA compliant.
As a bonus, they've included specific state-by-state breakdowns as well as a comparison against their on-exchange enrollments. 32% of PA's, 27% of WV's and 29% of Delaware's QHP enrollees to date have been off-exchange. This proves exactly what I've been saying: There are absolutely several million (at a minimum) direct QHPs out there which simply haven't been documented publicly yet.
A couple of days ago, Avalere Health, with whom I've alternately butted heads with and agreed with on all things Medicaid-related, has issued their QHP projection: They're calling for around 5.4 million total. In order to hit that number, the March average would be around 38,600/day.
Avalere is basing their projection primarily on the Medicare Part D enrollment pattern back in 2006. They could very well be correct, but there's also some key differences between that situation and this one (the most obvious one: Medicare enrollments were presumably mainly limited to those over 65, whereas it's the "Young Invincibles" that are the primary target at the moment). However, I'm not going to pooh-pooh their projection either, as there are many similarities between the two as well: Both were/are large, national government healthcare enrollment programs, with a 6-month limited enrollment period, a financial penalty for not enrolling by the deadline and so on.
After a couple of weeks where the paid QHPs seemed to only be drawing from the existing unpaid enrollments (a sign of new additions drying up), WA seems to be back in gear with 2,740 more paid QHPs, 4,019 more unpaid QHPs and 16,247 new Medicaid/CHIP additions, all since February 27th.
Qualified Health Plans: 109,021
Medicaid Newly Eligible Adults: 222,607
Medicaid Previously Eligible but not Enrolled: 115,159
Qualified Health Plan Applicants – Need to Pay: 82,060
*Note: These numbers reflect enrollments and applications through March 6.
Looks like the 30/70 QHP/Medicaid split that I've been assuming for Minnesota has shifted somewhat; as a result, I actually have to lower the QHP number by a bit compared with the 3-4 mini updates from last week. MN QHPs now stand at 33,362; new Medicaid/CHIP enrollees are at 85,267 as of March 11.
In addition, SHOP (Sm. Biz) enrollees are up a bit from 1,042 to (660 employees x1.8 per household) = 1,188 total individuals covered.
DC itself has an unusual situation: Due to the quirky ACA rule that has Congressional Staffers (some 10,000 of them) enroll via the Small Business SHOP exchange instead of the individual exchange (or that of their home state), DC's SHOP exchange actually has twice as many enrollees as individual QHPs. Anyway, QHPs have gone up 267 in the first week or so of March, while SHOP enrollees have gone up 104. Meanwhile, new Medicaid enrollees are up 506.
As of March 9, 2014, 30,642 people have enrolled through DC Health Link in private health plans or Medicaid:
6,516 people enrolled in private health plans through the DC Health Link individual and family marketplace; 11,383 people gained Medicaid coverage through DC Health Link; and 12,743 people enrolled through the DC Health Link small business marketplace.