As everyone who's been following the ACA over the past few years knows, the October 2013 launch of HealthCare.Gov and 16 state-based marketplace websites was not one of the prouder moments in the Obama administration's history. The federal exchange (which covered 35 states at the time) was a disaster out of the gate, as well about half of the state-based websites.
Over the past three Open Enrollment Periods, of course, most of the technical headaches have been worked out of most of the sites. HealthCare.Gov operates like a dream now (update: well, relatively speaking, anyway) and major improvements have been made in most of the state exchanges as well. In 5 cases, the solution was to either scrap the original platform and start over (Maryland and Massachusetts) or to say "to hell with it", drop their own platform completely and move home to the Mothership (Oregon and Nevada in 2015; Hawaii starting this year). Washington State kept their own platform but gave up trying to handle billing for their enrollees, joining just about every other state in letting the carriers handle payments directly.
Tracking ACA Enrollments: Figuring Out How Many Grandfathered/Grandmothered Plan Are Still Around
In this week’s entry, Charles Gaba of ACASignups.net gives us a breakdown of a tally of Grandfathered and Grandmothered plans in the individual market. He did, in his own words, a “back of the envelope” calculation and, with input from Louise Norris of healthinsurance.org, came up with an estimate of those old plans still hanging around. Charles says, “My Conclusion? There should be roughly 1 million people still enrolled in Grandfathered policies and perhaps 1.5 million in Transitional/Grandmothered plans today.”
The go-to journalist in Connecticut for all things Obamacare-related is Arielle Levin Becker. Judging from her feed this AM, it sounds like she's livetweeting the monthly AccessHealthCT board meeting. Here's her key points:
CT exchange enrollment down about 9.2 percent from end of open enrollment. Also about 2% shift from subsidized to unsubsidized.
During the official Open Enrollment Period, MNsure enrolled 85,390 Minnesotans in Qualified Health Plans. Unlike most of the state exchanges (and HC.gov itself), MNsure has been dutifully continuing to update their data every month or so during the off season, providing an interesting glimpse into how the Special Enrollment Period (SEP) is going:
3/07/16 - 4/17/16: 90,696 QHPs Cumulative since 11/01/15 (+3,840, or 91/day); 55,357 MNcare; 156,983 Medicaid
Didja notice that? While the private QHP enrollment rate obviously dropped off tremendously after open enrollment closed (duh!), the SEP enrollment rate has dramatically increased since then, from 21/day in early February, to 55/day in late Feb/early March, to 91 per day over the past month. While it's still just 10% of the Open Enrollment rate, over 4x as many people are signing up for QHPs via MNsure now as were at the start of the off season.
UnitedHealthcare is operating on the ACA exchanges in 34 states this year. I assumed that they'd announce which states they were staying in or dropping out of all at once during yesterday's quarterly earnings conference call, but apparently not. Instead, the status of each state has been dribbling out one by one over the past week or two.
I haven't posted anything about Louisiana's ACA Medicaid expansion since back in January, just before newly-elected Democratic Governor John Bel Edwards took office. At the time, it looked like the program wouldn't actually kick off until July, and would enroll perhaps 300,000 people.
La. Governor Announces Medicaid Expansion Will Begin June 1, Save State $677M Over 5 Years
About 375,000 people in Louisiana are expected to enroll in the program for low-income residents. At the same time, officials in Arkansas continue wrestling with the governor's plan to end the political impasse over expansion.
However, it's also worth keeping in mind that in many of these states, United has a pretty small presence to begin with. Case in point: Connecticut:
LT. GOVERNOR WYMAN, ACCESS HEALTH CT CEO WADLEIGH STATEMENTS ON UNITED HEALTHCARE ANNOUNCEMENT
(HARTFORD, CT) – Lieutenant Governor Nancy Wyman, Chair of the Access Health CT (AHCT) Board, and AHCT CEO Jim Wadleigh today issued the following statements on the announcement that in 2017, United Healthcare is pulling out of most state healthcare marketplaces:
For nearly 7 years now (starting well before the Affordable Care Act was even voted on, much less passed or signed into law), the Republican Party has been promising their own comprehensive plan to replace it.
One of the best running jokes in American politics is the one about Republicans releasing their own alternative to the Affordable Care Act. Any day now, GOP leaders have been saying for many years, they’re going to have a plan that rivals “Obamacare,” and it’s going to be awesome.
As I've stated many times in the past, I'm in favor of ultimately phasing out most of the private, for-profit insurance industry. My timeline and specifics differ greatly from, say, Bernie Sanders's proposed single payer plan, and I think there's room for the private market for supplemental insurance, but I'm no fan of keeping things as they are. While not every carrier is guilty of doing so, the health insurance industry as a whole has repeatedly proven itself to have a hell of a lot of bad corporate citizens over the years, to put it mildly.
Having said that, there are some criticisms which aren't always warranted, and one of these just came up today in light of UnitedHealthcare's decision to pull out of the ACA exchanges in most of the 34 states they're currently operating in...or more specifically (since United wasn't even participating the first year), the losses sustained by many other carriers during the first 2 Open Enrollment Periods for 2014 and 2015.
UPDATE: Zachery Tracer of Bloomberg News and Phil Galetitz of Kaiser Health News have confirmed that UnitedHealthcare will stay in Virginia and Nevada next year, but they won't stay around in Connecticut. More details as they come in....
Update 4:10pm: According to Zachery Tracer, UnitedHealthcare to pull out of Texas, Pennsylvania, North Carolina, Tennessee and Missouri as well.
