I had read something about this a week or so ago but I didn't really think about the implications at the time.

Now that I've read it...I can't for the life of me figure out why it hasn't gotten more press. Perhaps because it hasn't actually become a law yet?

Calif. Senate bill to give health coverage to undocumented passes committee

SAN MATEO, California— A landmark bill to extend subsidized health care to some 1.25 million undocumented immigrants in California — more than one third of whom are Asians and Pacific Islanders, passed the California Senate’s Health Committee on April 15.

Senate Bill 4, also known as the 2015 Health for All Act, sponsored by Sen. Ricardo Lara (Dem-Bell Gardens) passed 7-0, according to reports by the Orange County Register.

Capital Public Radio’s KXJZ News said the bill was supported unanimously by the committee’s Democratic members, Republican members of the same committee, however, abstained from the vote.

Earlier today I posted updated exchange enrollment numbers out of Washington State; as of 4/17, ACA exchange QHPs were up to 170,000 currently enrolled out of about 177K paid enrollments and perhaps 200K total selections.

This evening, another piece of the puzzle is filled in : OFF-exchange QHPs in WA:

The office of the state insurance commissioner estimated 170,000 people bought private insurance outside the state marketplace during the open enrollment period. That’s about the same as last year.

Well, now. After all my dead ends, that was remarkably...simple and to the point.

Three weeks ago I posted an entry called "Greg Sargent: GOP claims 3-legged stool won't collapse if you take away 2 of them", about the corner that the Republican Party has painted themselves into when it comes to the King v. Burwell case.

As I noted at the time, the Affordable Care Act is primarily based on a "3-legged stool" approach (as outlined by the now-infamous Jonathan Gruber back in 2010):

At the health law’s core is a “three-legged stool” approach to reforming these markets: new rules that prevent insurers from denying coverage or raising premiums based on preexisting conditions, requirements that everyone buy insurance, and subsidies to make that insurance affordable.

This Just In...

Washington Healthplanfinder Enrolls 170,000 in Qualified Health Plans; 16,000 Enroll through Spring Special Enrollment Period
Enrollment Continues for Residents with Qualifying Life Events

FOR IMMEDIATE RELEASE: April 22, 2015

OLYMPIA, Wash. – Washington Healthplanfinder today announced that 170,101 Washingtonians have currently signed up for a Qualified Health Plan or renewed their health coverage through www.wahealthplanfinder.org. Of the total number of Qualified Health Plan enrollees, more than 16,000 enrolled during the spring special enrollment period.

The spring special enrollment period, which ran from Feb. 17 to April 17, was previously available to Washingtonians who recently became aware of the tax penalty for not having health insurance or were unable to complete their applications due to technical issues by the Feb. 15 deadline.

In a story about the continuing struggles of the ACA's Small Business Health Options Program (aka SHOP, though it should really be SBHOP, which admittedly sounds rather stupid), reporter Allison Bell cites my SHOP enrollment estimates and also states that:

Christopher Koller, president of the Milbank Memorial Fund, recently provided a SHOP exchange enrollment summary in written testimony submitted for a state legislature hearing in Hawaii.

Out of curiosity, I took a look at his presentation, hoping to find some updated numbers out of Hawaii (I don't have anything for the Aloha State since 2/21). Instead, on 3 different slides, I found...ACASignups.net listed as a data source.

Yup, I've now been repeatedly cited in an official presentation to a Joint Committee Meeting of the Hawaii State Legislature.

Huh.

OK, this was an unexpected update:

Here's which health insurers lost or gained market share in Oregon this year

The numbers are in: It appears that Oregon consumers were fairly price sensitive when it came to choosing health plans this year.

LifeWise had the lowest rates, at $222 a month for a 40-year-old Portlander on a silver plan. Probably not coincidentally, it more than doubled its individual membership in plans that comply with Affordable Care Act guidelines.

As of March 31, LifeWise has nearly 37,000 members in ACA-compliant plans, up from 4,735 last year, according to the Oregon Insurance Division.

The article goes on to tally every single one of Oregon's individual policy QHP enrollees. The bad news is that they don't break them out by exchange vs. off-exchange. The good news is that they specifically clarify that these are all ACA compliant policies (ie, no "grandfathered" or "transitional" numbers included):

Last year, after a bunch of different piecemeal data points and surveys came in, I estimated off-exchange (that is, directly via the insurance companies) private insurance policy enrollments were likely around 8 million or so, of whom perhaps 7 million paid at least their first premium, plus another 4-5 million or so "grandfathered" or "transitional" enrollments. Add these to the 7 million (paid) exchange-based enrollees and you had perhaps 18-19 million people on the private individual market for 2014.

This year, I actually have less hard off-exchange data to work with so far (only a handful of states), but since early February I've been operating on a rough estimate of around 80%. That is, whatever the exchange-based QHP figure is at any given time, I'm pretty sure that the off-exchange QHP tally is somewhere around 80% of that number.

If you look at The Graph lately, you'll notice that in addition to extending the projections out for the full calendar year, I've also recently added the Effectuated Enrollment line, which hovers around the 10.0 - 10.1 million enrollee mark for most of the year.

I've explained this several times before, but with the recent confirmations from states like Idaho and Massachusetts that the 2015 payment rate is likely higher than the 88% "rule of thumb" that I've been using for nearly a year now, yesterday's data showing that the #ACATaxTime enrollments appear to be roughly 3,000/day nationally (I overestimated by a lot), and today's confirmation out of California that my estimate of at least 7,000 additional QHP selections per day during the "normal" off-season is likely underestimating things a bit, it seems like a good time to modify things.

With that in mind, here's 2 tables which lay out how I expect the rest of 2015 ACA exchange enrollments and attrition to play out. The first table assumes that 88% of enrollees pay their 1st premium; the second table assumes 90%. Other than that, both are identical and assume:

Sally Pipes, according to her byline in Forbes, is the President of the Pacific Research Institute (another one of those "free market think tanks" along the lines of the American Enterprise Institute, Heritage Foundation, bla bla bla).

Today over at Forbes.com she posted an entry singing the praises of private insurance exchanges, as opposed to the eeeeeevil Obamacare exchanges.

I want to be clear about this up front: I have no problem with private insurance exchanges (at least no moreso than I have a problem with private, for-profit health insurance in general). Companies such as eHealth Insurance and it's brethren are perfectly fine, and I wish them well.

Having said that, Ms. Pipes has written an unbelievably disingenuous essay. Let's take a look, shall we?

The federal government is desperate for Americans to enroll in Obamacare’s exchanges. But most people have refused.

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