A couple of weeks ago, Ariel Hart of the Atlanta Journal-Constitution reported that after over a decade of refusing to consider ACA Medicaid expansion for over 400,000 state residents, Georgia's Republican-controlled legislature may finally be warming up to the idea of embracing full expansion of the program:

For the first time in a decade, high-ranking Georgia GOP legislators on Thursday convened a meeting to hear testimony on full Medicaid expansion to all the state’s poor people.

At the hearing Thursday, the idea was floated over whether to expand Medicaid in exchange for a political deal to roll back regulations that restrict who can open a new health care business. Those regulations are called Certificate of Need, or CON.

 

A week or so ago, when the Centers for Medicare & Medicaid Services (CMS) issued their first official "snapshot report" of the 2024 Open Enrollment Period, I noted that unlike most states which have seen dramatically higher initial enrollment numbers, Virginia saw a dramatic drop in initial 2-week enrollment:

At the opposite end of the spectrum, Virginia is running a whopping 64% behind their 2023 OEP enrollment at this point, almost certainly due to the state moving off of the federal exchange onto their own platform; since current enrollees have to actively log into a whole new account and go through a different interface to enroll for 2024, there's no doubt a lot of confusion at the moment. Hopefully this will straighten itself out by the time OEP ends, however.

Obamacare Logo

The 2024 ACA Open Enrollment Period is going on right now and will continue through January 16th in most states. So far, I've confirmed that over 4.7 million Americans have enrolled in either ACA exchange Qualified Health Plan (QHP) policies nationally or Basic Health Plan (BHP) policies in New York & Minnesota specifically; the odd are that the combined total will be over 18.5 million by the time the dust settles in January.

BeWell NM

BeWell NM, New Mexico's state-based ACA exchange, has launched a very handy new Enrollment Data portal which includes plenty of info for a data hound like myself to pore over. The initial 2024 Open Enrollment Period numbers are impressive...but also a bit misleading if you don't know how the exchange enters data.

First, the top line numbers (as of 11/26/23):

  • Number of enrolled consumers: 47,212
  • Consumers enrolled in Medical coverage: 46,614
  • Consumers enrolled in Dental coverage: 11,272

While dental coverage is also important, standalone dental plans aren't considered Qualified Health Plans (QHPs); it's the "Medical Coverage" which is the key number here.

Also, the total number above may look confusing, but most of the Medical & Dental coverage enrollees overlap:

Via Access Health CT's News/Press Releases page:

Stats as of November 24, 2023

Qualified Health Plans (QHP):

  • QHP Enrollment In 2023 Coverage: 97,004
  • 2024 OE Acquisition Summary: 6,962

Medicaid:

  • Completed applications/redeterminations processed through the integrated eligibility system: 25,244

It's my understanding that "Acquisition Summary" refers to CT residents who are brand-new enrollees (never enrolled via the exchange before).

Obviously this 97K figure includes auto-renewals being piled on top of the new/active renewal tally, which stood at 19,145 a week earlier.

By comparison, last year Access Health CT reported enrolling 87,161 people through Nov. 25th (one extra day since Nov. 1st fell on a Tuesday last year); this also included auto-renewals:

Earlier today I posted the initial above-the-fold numbers for the 2024 ACA Open Enrollment Period as reported by the Centers for Medicare & Medicaid Services (CMS):

...The graph below shows how these numbers have increased since the same time period last year. I've had to adjust slightly for the fact that there's one fewer day included for both the federal exchange (18 days vs. 19) and the state exchanges (11 days vs. 12).

I've also had to adjust for the fact that Virginia moved from the federal exchange to its own state-based exchange this year, which is further complicated by CMS reporting 3 weeks for the federal exchange but only 2 weeks for state-based exchanges. I've done my best to adjust for all of these factors below (the subtotals are accurate; the new/returning breakout for 2023 are estimates but should be pretty close):

Back on November 9th, President Biden issued the first hint suggesting that the 2024 ACA Open Enrollment Period would be the most successful ever:

In the first week of Open Enrollment, 1.6 million people have signed up for a plan at HealthCare.Gov, including 301,000 new consumers – that’s a 50% increase from last year.

Join them by visiting HealthCare.Gov today.

— President Biden (@POTUS) November 9, 2023

via CoverME.gov, Maine's state-based ACA exchange:

Plan Selection Snapshot

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2024. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2024 is December 15, 2023. Consumers who select a plan between December 16, 2023 and January 16, 2024 will have coverage beginning February 1, 2024. 

CoverME.gov Activity Through November 14, 2023 

For ten years, Georgia has remained one of the states which, frustratingly, has refused to expand Medicaid to all adults earning up to 138% of the Federal Poverty Level (FPL)...a bit over $20,000/year for a single adult; roughly $41,000/yr for a family of four.

If the state were to join most of the country, an estimated 434,000 Peach State residents would finally be able to enroll in comprehensive, nominal-cost healthcare coverage: Around 252,000 who earn less than 100% of FPL and another ~182,000 who earn between 100 - 138% FPL (the second batch 

After years of pressure, a few years back GOP Governor Brian Kemp kind of, sort of agreed to a partial expansion of Medicaid...with a pretty big caveat:

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