Charles Gaba's blog

Well, Oregon's website may still be a complete disaster, but their manual enrollment process seems to be chugging along fairly well. Private QHPs are up 3,500 from 38,806 a week earlier, while Medicaid enrollments are up another 7,100 from 84,991.

Note that they've finally stopped including the "Fast Track" Medicaid numbers, presumably because they've already enrolled everyone they could find via that route:

March 7, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Total: 134,412 
Private insurance: 42,325
Oregon Health Plan: 92,087

Update: Something else very interesting about Oregon's situation. Take a look at their QHP enrollment history:

  • 12/28: 18,337
  • 02/01: 33,808 (15,471 in 35 days, or 442 per day)
  • 02/28: 38,806 (4,998 in 27 days, or just 185 per day...a 58% drop per day, ouch!)

However, today they announced the number, as of (I presume) yesterday, the 6th, as:

Back in January, I found my first solid data on off-exchange enrollments via a Co-Op operating in Iowa and Nebraska called CoOportunity. They helpfully provided their data through January 24, which totalled 10,166 off-exchange enrollments in Iowa and antoher 17,779 in Nebraska.

Last week, they provided an update to these figures. When you add off-exchange individual/family policies to small & large group policies (which are "off-exchange" by definition, since the HC.gov SHOP system isn't operational yet...you get redirected to the individual companies/co-ops), Iowa is up to 12,293 and Nebraska is up to 19,959, as of February 24.

Last month there was news out of Massachusetts of some sort of extension being granted to "bring the state’s health care system in line" with ACA regulations. At the time I didn't pay much attention to it, thinking that it only related to administrative procedures or somesuch.

However, it turns out that there's actually 154,000 people who are currently enrolled in a sort of healthcare batter's box, being placed on hold until MA's screwed-up exchange is able to absorb them into the system via proper ACA-compliant QHPs (or Medicaid/CHIP...not sure about that yet):

Unable to immediately enroll applicants in new, private plans under the Affordable Care Act, state officials extended existing state coverage for about 124,000 individuals, and granted temporary state coverage to about 30,000 new applicants. Those individuals were supposed to move onto new plans by March. 31; the federal waiver gives officials another three months to do that.

So why am I bringing this up today, 3 weeks after that story broke? Because a contributor called my attention to this story out of Oregon:

Maryland's private QHPs went up 2,434 in the last week of February. More noteworthy, Maryland's exchange seems to be getting a lot of pressure to explain their "paid/unpaid" data; this is the most extensive explanation I've seen from any state about the subject (except for one Vermont report last month). They're up to 38,070 total, of which 20,439 are paid up.

Medicaid numbers are the same, since they're still through 2/25.

Through March 1, 38,070 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

On the one hand, it's nice to see Minnesota post 3 enrollment updates in a single week. On the other hand, for some reason they didn't include the exact number or the QHP/Medicaid breakdown this time. Not sure why...it's already known that their private QHPs have been making up around 30% of the total until now, and the exact tally through 3/1 will be out next week sometime anyway; no point in trying to mask low numbers. Strange.

Anyway, I'm still assuming a 30/70 split, which would be another 300 QHPs and 700 Medicaid/CHIP on the pile, for a total of 34,000 / 79,001.

ST. PAUL, Minn. —  Today, MNsure announced more than 113,000 Minnesotans have enrolled in comprehensive, affordable health insurance coverage through the state’s new health insurance marketplace.

Hawaii's private QHP exchange may still be a mess, but there's great news out of the Medicaid side: Over 48,000 new enrollees since October 1st. The article specifies that these are a combination of "strict expansion" and "woodworkers", though it doesn't break the total out between those two, which would have been nice to have, but so be it. Based on existing data, I'll assume roughly 25% woodworkers to 75% strict expansion for now, or 12K / 36K.

Hawaii has seen a spike in Medicaid enrollment since eligibility was expanded under the federal Affordable Care Act, with more than 48,000 new enrollees since October.

“The expansion (to 138 percent of the federal poverty level) meant Hawaii was expecting about 48,000 additional beneficiaries because of the mandate that you have to have insurance,” said Kayla Rosenfeld, spokeswoman for the Hawaii Department of Human Services, who noted that enrollment has exceeded that benchmark to date. Increasing enrollment is also due to greater awareness rallying Medicaid-eligible individuals “out of the woodwork.”

The good news is that North Dakota's Medicaid tally has gone up from 1,700 as of early January to over 4,000 at the beginning of February. The bad news is that due to an oversight on my part, this is actually a drop from what I had entered in that field (a confusingly-worded article in January led me to confuse enrollees with the potential pool, which was considerably higher). Anyway, ND Medicaid stood at 4,071 as of a month ago.

As of Feb. 1, 4,057 people in North Dakota had selected an insurance plan through the marketplace. That’s up from 2,624 who chose a plan in the final three months of 2013. Another 4,071 here have been determined to be eligible for Medicaid or the Children’s Health Insurance Program.

Another non-exact update; in a press release issued today, MNsure gives the combined total of QHPs & Medicaid enrollees as "more than 112,000", up around 3,000 from a few days back. As I did then, assuming the same 30/70 split that MN has had up until now, this means an increase of around 900 QHPs and 2,100 Medicaid enrollees. 

As always, these figures will be adjusted as necessary when the formal data is released by MNsure.

To date, more than 112,000 Minnesotans have selected health insurance plans on the MNsure online marketplace. Under the Affordable Care Act, consumers must enroll in health insurance coverage by April 1, 2014, or face a penalty. 

Back in January, the McKinsey Center for U.S. Health Care Reform gave a lot of anti-ACA forces ammunition when they released a study which claimed that only 11% of the total exchange-based enrollees through the end of December had been previously uninsured.

This sounded awfully low to me, especially since New York was reporting that fully half of their enrollees were previously uninsured, but no one else seemed to be tracking this data point at the time, so it was all we had to go on.

Iowa's Medicaid total just got a nice shot in the arm. It seems that 55,034 Iowans who were previously enrolled in IowaCare have been bulk-transferred over ot Medicaid proper, on top of over 13,000 additional new enrollees. All of these people are specifically listed as being due to ACA Medicaid expansion, they are not woodworkers.

While the total above is 67,893, another article from the next day lists the exchange-based enrollments as "more than 13,000", so I've bumped it up by another 142.

More than 50,000 former IowaCare members automatically were enrolled in the new system, giving them access to more services and a choice in who provides their health care, including – in many cases – local options, McCoy said.

Including those who have signed up since, the Iowa Health and Wellness Plan through mid-February boasted a total enrollment of 67,893 – 55,034 in the wellness plan and 12,859 via the marketplace choice, according to McCoy.

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