Charles Gaba's blog

Even after yesterday's Big 7.3 Million Currently Enrolled News (or perhaps because of it), there's still tremendous confusion about what that number actually means. In addition, there's been some ongoing confusion about some other numbers relating to the ACA exchange qualified healthcare policies (QHPs), so here's a rundown, in descending order, based partially on existing data and partially on my projections through November 15th (that's when the 2nd Open Enrollment period starts for coverage beginning on January 1st, 2015, making the current enrollment numbers partially moot).

As you can see, depending on what question you're trying to answerwhat you feel should "count" and what your political spin is, there are up to 12 different numbers (!!!) which you could conceivably "use" for your answer.

As I've stated many, many times before: In spite of their $300 million disaster of a website failing to enroll a single person, Oregon has still managed to rack up one of the most impressive enrollment tallies in the entire country relative to their population, with a grand total of over 481,000 people added between QHPs, Medicaid and CHIP (in addition to the 353,000 noted at the link, OR added another 128K to Medicaid via their "fast track" program which they don't list here for whatever reasons).

For a state with only 3.9 million people, that's bound to have an impressive impact on the uninsured rate...and sure enough...

Thanks to Jesse Lee for saving me the trouble of compiling these:

Report: 1/3 of #ObamaCare "enrollees" haven't paid premiums. How does not paying the premium constitute enrollment?

— Reince Priebus (@Reince) May 1, 2014

Uh oh: House committee claims only two-thirds of federal ObamaCare enrollees paid first…

— memeorandum (@memeorandum) May 1, 2014

New report confirms just 67% of ObamaCare ‘enrollees’ have actually paid their first month’s premium.

— NRCC (@NRCC) May 1, 2014

Another Big Number story today on top of the national and Illinois ones. My most recent numbers for California Medicaid expansion had it pegged at around 1.4 million "strict expansion" and around 600K "woodworkers" as of late June. However, that was just an estimate.

This article about a class action lawsuit being filed over the massive Medi-Cal backlog (down to 350K from a whopping 900K back in May) is mostly negative for obvious reasons. However, there's an interesting data point in the middle of it:

According to state officials, 2.2 million new Medi-Cal members were added as a result of the Obamacare healthcare expansion, bringing the total number of participants in the program to about 11 million.

State Department of Health Care Services spokesman Norman Williams said that as of Sept. 1, 350,000 applications remained backed up in the enrollment system. That system has been plagued by computer troubles that have stymied county government efforts to verify patients' Medi-Cal eligibility. 

The backlog was as large as 900,000 earlier in the summer.

Holy smokes! This may seem a bit anticlimactic after this morning's surprise announcement by CMS Administrator Marilyn Tavenner, but it's still just as important in other ways:

@JeffYoung @philgalewitz I can tell you there are now roughly 450,000 newly eligibles who enrolled so far in Medicaid in Illinois.

— Peter Frost (@peterfrost) September 18, 2014

When I inquired, he explained:

@charles_gaba @JeffYoung @philgalewitz Sure. Those are the figures from @CoveredIllinois. They say total is now 670,000 (mktplc + Medicaid)

— Peter Frost (@peterfrost) September 18, 2014

When I asked for a link for confirmation, Jonathan Ingram helpfully chimed in:

Apparently it took Congressional testimony to get it out of them, but here it is:

Another couple of key points...

7.3 million people were signed up for Obamacare as of Aug 15 and paid their premiums, HHS says

— igorvolsky (@igorvolsky) September 18, 2014

Now, before anyone claims that I'm "wrong" about the paid number being 7.3 million instead of 8.07 million, read the tweet carefully: I says that 7.3 million were enrolled as of August 15th. In other words, that's the net number after subtracting those who've dropped their coverage after 1, 2, 3 or more months.

This is FANTASTIC news.

It means that either...

In a new 60-second ad, Kentucky Senate candidate Alison Lundegran Grimes finally goes after opponent Mitch McConnell regarding his repeated attempts to damage/weaken Medicare. It isn't really connected to the Kynect = Obamacare = ACA issue, but it's in the ballpark, anyway:

The ad seems to have gotten under the skin of the McConnell campaign; they're actually attacking her grandfather for having a stroke:

.@Team_Mitch "Any1 who would use their grandfather's stroke" 2 reintroduce false ads "has run out of justification 4 their candidacy" #KYSen

— Phillip M. Bailey (@phillipmbailey) September 18, 2014

A ton of great ACA news coming out of Connecticut this morning, courtesy of Arielle Levin Becker (posted in reverse-chronological order, newest at the top):

Arielle Levin Becker provides some updated numbers out of Connecticut, which is great...but I'll have to do some calculations to parse the data out for my purposes:

Current Access Health membership: 76,094 in private insurance, 207,020 in Medicaid (total Medicaid enrollment is much higher)

— Arielle Levin Becker (@ariellelb) September 18, 2014

OK, so those are the current enrollment numbers. 76,094 QHPs is 4% net attrition from the 4/19 total of 79,192, or less than 0.8% per month, which is fantastic.

However, since that 76K figure combines both additions and subtractions (ie, it's the net total, not gross), I can't really tell what the cumulative total is, which is what I use for my off-season projection chart.

I've posted several times about the appalling shamelessness of Republican candidates trying to take credit for the Affordable Care Act's Medicaid expansion provision (which was only possible thanks to Democrats) while continuing to badmouth the law itself.

Then there's the ones who try to take credit for Medicaid expansion finally being put into effect even though it was their own ineptness which dragged the process the case of Michigan, needlessly putting hundreds of thousands of people through 3 months of unnecessary anxiety and medical risk while costing the state hundreds of millions of dollars in federal funds in the process: