So, a couple of hours ago, CMS Administrator Seema Verma tweeted out the following:

.@coveredca blames subpar enrollment on no federal mandate penalty, but NJ kept penalty and saw much, much bigger drop. Forcing Americans to buy insurance they can’t afford isn’t the answer.

— Administrator Seema Verma (@SeemaCMS) January 31, 2019

Last fall, I reported that thanks to the one-two punch of a) reinstating the ACA's individual mandate penalty at the state level and b) using the revenue generated from the mandate penalty to help fund a robust reinsurance program, the state of New Jersey had successfully lowered average unsubsidized premiums for 2019 individual market policies by a net swing of nearly 22 percentage points.

With Covered California releasing their final, official 2019 Open Enrollment Period data, and the latest updates from New York (which still has 2 days to go) and Massachusetts (which wrapped up last week), I now nearly all 2019 OEP data on hand.

I say nearly all because there are still three numbers missing:

  • Vermont has yet to release any 2019 enrollment data. This is the 3rd year in a row that they've been radio silent. Assuming they're close to last year (28,763 QHP selections), they should add around 28,000 to the national total.
  • New York still has 2 days left for people to #GetCovered. I'm going to assume they'll tack on perhaps 5,000 more people today and tomorrow.
  • The District of Columbia hasn't posted any updates since December 11th, which means not only do they still have 2 days for people to sign up, they're actually missing a whopping 51 days worth of enrollment data. Again, assuming they wrap up close to last year, that should mean another 1,400 or so from DC.

Between the three, I'd expect another ~34,000 QHP selections to be tacked onto the totals below.

This Just In from Covered California...

Covered California Plan Selections Remain Steady at 1.5 Million, but a Significant Drop in New Consumers Signals Need to Restore Penalty

  • Covered California finishes open enrollment with 1.5 million plan selections, which is virtually identical to 2018’s total, despite federal changes.
  • A key reason for the steady enrollment is that more people entered the renewal process for 2019 coverage after a strong enrollment period for 2018.
  • The federal removal of the individual mandate penalty appears to have had a substantial impact, leading to a decrease of 23.7 percent in new enrollment.

SACRAMENTO, Calif. — Covered California announced that more than 1.5 million consumers selected a health plan for 2019 coverage during the most recent open-enrollment period, a figure in line with last year’s total. There was a 7.5 percent increase in the number of existing consumers renewing their coverage and a 23.7 percent drop in the number of new consumers signing up for 2019.

With just two days left to go for New Yorkers to #GetCovered, Politico healthcare reporter Dan Goldberg has the latest numbers:

@charles_gaba NY latest numbers 265,209 in QHP 784,202 in EP. Enrollment deadline is tomorrow

— Dan Goldberg (@DanCGoldberg) January 30, 2019

These are solidly impressive numbers. Last year's final tally (including the last two days of Open Enrollment) was:

Last year I briefly attempted to keep track off the dozens of various state-based "ACA 2.0" protection/improvement bills flying around various state legislatures. I eventually abandoned this project since it became too difficult to keep up with, but I'm still reporting case studies as they come to my attention...and Louise Norris has just alerted me to some pretty big changes going into effect in Colorado this April.

First up: Short-term plans are being heavily neutered. In addition to being limited to 6 months per year (which is still longer than the Obama Administration's 3-month cut-off)...

Short-term plans will have to charge older adults no more than three times as much as they charge younger adults. Short-term plans are generally not available after a person is 64, but a quick check of plans currently available in Colorado show that some insurers are charging a 64-year-old up to seven times as much as a 21-year-old. That will have to stop as of April.

Last April, Maryland was one of several states which took action to counteract portions of the Trump Administration's attempts to sabotage the Affordable Care Act. In particular, Maryland (which has a Democratically-controlled state legislature but a moderate (by today's standards) Republican Governor) passed and signed into two important bills:

The combined effect of these changes was dramatic: Maryland's individual market insurance carriers, which had been planning on jacking up their average premiums by a whopping 30%, instead ended up lowering their 2019 premiums by over 13%. This is a net swing of around $3,200 per enrollee for the year (around $266 per month). In other words, instead of seeing unsubsidized 2019 premiums go up by $2,200 apiece, they dropped around $1,000.

Believe it or not, the 2019 ACA Open Enrollment Period officially ended last night...but only in 43 states. In the remaining seven (+DC), Open Enrollment hasn't ended yet2019 ACA Open Enrollment is still ongoing for over 23 million people!

In the District of Columbia (population 694,000) and New York (population 19.85 million), open enrollment runs through Jan. 31st for coverage starting March 1st.

BUT ALSO...

This is a very quick post as I’m in the middle of the Families USA healthcare conference, but it’s a significant one: The Massachusetts Health Connector, which wrapped up their 2019 ACA Open Enrollment Period last night, just reported the following:

Here is an update as of today, with Open Enrollment having ended last night.

Note: These numbers below should be considered something of a high-water mark. There will be fluctuations as plan-selecteds lose their window, members terminate, but also some applicants end up enrolling in March coverage.

Total enrollments (Including all January, February and March enrollments to date): 292,006

Plan selected/unenrolled: 8,079

2019 enrollment as defined by CMS: 300,085

Our new enrollment (people who did not have Health Connector coverage as of Nov. 1) is 60,361. This is a 23 percent increase from last year’s 49,034 at the same point in time.

Our retention rate is currently 89.7 percent, up about 2.6 percent from last year.

Holy smokes.

I know I was out of town for a couple of weeks recently, but I'll be on the job this time, really!

I'm flying out to DC Wednesday for the annual Families USA Health Action conference:

Working together, we are stronger. That’s why Families USA brings together community leaders from across the nation each year to improve the lives of America’s families. In 2019 we will meet for the 24th annual Health Action Conference on January 24-26, in Washington, D.C. at the Hyatt Regency Washington on Capitol Hill.

No other national grassroots health care conference brings together the swath of consumer activists and policymakers to inform, engage and inspire America’s health care agenda. We will be rolling up our sleeves to greet a new Congress and state legislatures in 2019.

via DC Health Link (the District of Columbia ACA exchange):

DC Health Link Pulling Out All the Stops for African-American “Week of Action”
Friday, January 18, 2019

Marching in MLK, Jr. Day Parade, barber shop outreach, and visiting churches highlight opportunities to boost African-American health insurance enrollment

WHAT/WHO:

With less than two weeks left to the January 31 deadline to sign up for 2019 coverage, DC Health Link is ramping up outreach efforts to the African-American community, where the uninsured rate remains high. DC Health Link, in partnership with various community organizations, is encouraging uninsured African-Americans to enroll in quality, affordable health insurance during DC Health Link’s “African-American Week of Action.”

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