I nailed the total QHP enrollment figures during the off-season almost precisely (99% accurate on the total number, 96% accurate on the daily average)
The gross attrition rate has been only 1.6% per month, and the net attrition rate since April is an astonishingly low 1.8% over 6 months, or just 0.3% per month, which is far better than anyone (including myself) had imagined. Basically, people being added are almost entirely cancelling out people dropping coverage.
The list of technical improvements, new features, beefed-up staffing and ramped-up outreach efforts for the 2nd open enrollment period included in the press conference was extremely impressive (see the lower half of this entry from earlier today).
HOWEVER, there was one key data point which was quite surprising and disappointing to me: The initial payment rate.
I still have to sort through a bunch of data, but the main takeaway is this:
I projected the total California QHP enrollment figure to be around 1.68 million. The actual number is 1,414,668 (as of 4/15...see update at bottom of this page)plus 200,000 off-season enrollments from 6/1 - 9/30 plus an unknown number from the 46 days between 4/16 - 5/31.
I have no idea why they left those 46 days out of the press conference. Very odd.
There were 200,000 people who enrolled from June 1st - September 30th (122 days), or 1,639 people per day.
Assuming the missing 46 days saw a similar rate to the rest of the off-season period, that would be 1,639 x 46 = 75,394 additional enrollees.
Assuming this is correct, that's 1,614,668 + 75,394 = 1,690,062
Regular readers know that given the HHS Dept's going radio silent on the total ACA enrollment figures since the last official report was released back in May (which only ran through April 19th), I've been patching together bits and pieces of enrollment data from a handful of state exchanges, plus the occasional snippet of info from other states which has managed to find daylight from time to time.
Based on this, I've been projecting roughly 9,000 QHP enrollments being added per day during the off-season, translating into around 270,000 per month, of which about 90% eventually pay their first months premium. That translates to around 240K paid enrollees being added per month, which in turn is being roughly cancelled out by people dropping their policies after the first few months as they move on to other types of coverage (Medicare, ESI, Medicaid and so forth). Based on these estimates, there should now be a gross total of around 9.6 million enrollments, of which around 8.3 million have paid their first premium, and around 7.4 million who are currently enrolled as of October.
If there are currently 74,334 enrolled, that means there are 2% more enrolled (and paying) today than there were 6 months ago, which is right in line with my projections as well as the national 7.3 million figure mentioned by HHS Secretary Burwell as of August.
Meanwhile, Medicaid enrollees via the exchange are now up to 208,468. This is only a small increase over a month ago (around 1,400 people), but there's a very good reason for that:
First, I just want to take a minute to note that over the past year, I've discovered that while there's lots of good reporting on the ACA nationally, there are certain states which have one particular person who's the "go to" journalist for all things Obamacare-related.
A nifty summary of technical data points/specs behind the completely overhauled/revamped state ACA exchange website in Massachusetts after the first one failed spectacularly last year includes the following key points:
306,000 — the latest number of Massachusetts residents enrolled in temporary coverage. Will all these people need to get coverage through the state? No one knows, because there’s been no way to process their eligibility this year. But the total number of people trying to use the site during the three months of open enrollment could be around…
450,000 — which is 306,000 + the 100,000 or so people who are still in subsidized Commonwealth Care plans and another 33,000 or so residents who buy insurance through the Connector.
New Hampshire didn't start their ACA Medicaid expansion program until July 1st, and they haven't ramped it up at nearly as impressive a rate as other states like Kentucky, West Virginia or Michigan, but they're doing pretty well with it:
The state has estimated that 50,000 adults are eligible either through the state's managed care program for Medicaid or through a program that subsidizes existing employer coverage. Hassan says 20,035 have signed up since July 1.
According to the last official HHS enrollment report from back in May, as of April 19, 2014, Washington State had enrolled 163,207 people in private policies via their ACA exchange. Of those, 8,310 people never actually had their coverage start due to non-payment (WA requires payment of the first month's premium as part of the enrollment process, so I'm not sure what happened in these cases, but presumably there was some sort of credit card account approval glitch, insufficient funds in debit card accounts and/or the like).
In any event, that means the actual paid tally as of 4/19 was 154,897, or 95%, which is pretty darned good.
Well, a couple of days ago the WA exchange issued a press release regarding the renewal process for 2015, and included 2 key data nuggets. First up:
Just received the following email from a Kentucky resident. With his permission, I'm leaving out his name but am presenting it verbatim otherwise, with no further comment:
Thanks for discrediting good ol' Mitch. What a joke. I am a resident of Kentucky and here's how the ACA impacts my family with other opinions included for good measure.
We have read and heard the partisan battle waged for and against the Affordable Care Act (ACA). Much has been written and said, but I live it. I experience it. But to truly evaluate it requires good old-fashioned common sense. For some reason, this has gone the way of bipartisan politics.
Since I am a consultant paid on a per hour basis, I do not receive nor do I expect to receive health benefits through my employer. We purchased our health plan through the Kentucky Health Exchange – KYNECT: a marketplace to purchase health plans created via the ACA. We chose a silver plan.
