The New York Times, December 2nd:

“The idea that you can repeal the Affordable Care Act with a two- or three-year transition period and not create market chaos is a total fantasy,” said Sabrina Corlette, a professor at the Health Policy Institute of Georgetown University. “Insurers need to know the rules of the road in order to develop plans and set premiums.”

Having talked to a number of CEOs & states, @SabrinaCorlette is right, if not understating.https://t.co/Ri5TtkHz7Z

— Andy Slavitt (@ASlavitt) December 3, 2016

I'm stuck in a loop of:
1. Reading this article... https://t.co/QjH2Evfldw

As anyone who's visited the site the past few days knows, I've spent countless hours digging up data to find out exactly how many people are enrolled in Medicaid/CHIP specifically due to the ACA's expansion provision. This is much more difficult than you'd think for a variety of reasons. For one thing, each state seems to have different methodology for how they track and report Medicaid enrollees (some weekly, some monthly, some quarterly, etc). For another, there's a wide variety of eligibility thresholds under pre-ACA Medicaid for different groups of residents in each state (pregnant women, infants, children, parents, etc), and since the funding mechanism varies depending on whether the enrollee qualifies for "normal" Medicaid or "ACA expansion" Medicaid, categorization can be tricky. Finally, due to the churn factor (people moving up and down the income scale as well as gaining or losing job-based or other forms of coverage), the numbers can jump around from month to month or even week to week.

Earlier today I posted fully broken-down estimates of just how many people would be directly impacted by a full & repeal of the Affordable Care Act this spring, assuming that the repeal took immediate effect and there was no replacement plan in place for the various provisions of the law.

The largest single category of enrollees in my estimates are those enrolled in Medicaid/CHIP due specifically to the ACA's Medicaid expansion provision. I estimated this to be roughly 11.3 million people nationally.

However, I was just informed of a new report released by the Foundation for Government Accountability, an anti-ACA think tank, which has compiled their own estimates of ACA Medicaid expansion enrollment on a state-by-state level. Here's what they've come up with:

01/12/17: PLEASE NOTE: I know there's a whole bunch of updates/revisions below; this is because I'm constantly updating both the Medicaid expansion and exchange policy numbers daily, in real time as I'm able to compile the most recent enrollment numbers. In most cases the numbers are quietly increasing, although in a few cases I've revised them downward.

I operate this site by myself and I do have a day job, family, etc, so if I haven't updated your state, be assured I'll get to it as soon as possible.

Now that we're past Thanksgiving weekend and the big December 15th deadline (for January coverage) is coming up fast, OE4 enrollments should have started ramping up significantly, on the order of 250,000 per day or more nationally (around 190K via HC.gov).

As noted last week, so far, total enrollments have been pacing my overall projections almost perfectly...slightly ahead of my estimates for the first month, in fact. Assuming this continues, national QHP selections should have broken 4.1 million nationally sometime Monday night (12/05), with around 3.1 million of those coming via the federal exchange.

The Connecticut ACA exchange, AccessHealthCT, issued a press release today reminding Connecticut residents in general of the December 15th deadline for January 1st coverage. They also stressed, however, that while most current enrollees will be automatically renewed into either their existing policy, there are about 26,000 current enrollees who can't be auto-renewed because their carrier is leaving the exchange in 2017:

On December 1st, AHCT’s automatic renewal process began. The AHCT eligibility system will automatically enroll into 2017 coverage customers who have selected auto-renew and whose plans are still available. “But, there are 26,000 people who currently have coverage through AHCT who cannot auto-renew and must take action to renew their 2017 plans,” Wadleigh noted. Wadleigh reminds all customers “they should shop around and compare your options for 2017– that’s the purpose of the marketplace.”

NOTE: I've toned down the title a wee bit.

Read this (12/01/15):

Hey, remember the Risk Corridor Massacre? The one which is at least partly responsible (and in some cases, mostly responsible) for a dozen ACA-created Co-Ops (as well as at least one private insurance carrier in Wyoming) going out of business?

Well, there's two more rather interesting developments to the Risk Corridor mess.

Connect for Health Colorado just posted an official enrollment update:

DENVER — More than 37,000 Coloradans selected healthcare coverage for 2017 through the state health insurance Marketplace in November, a rate 23 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®.

“The pace of sign-ups during the first month of this Open Enrollment has been very heartening,” said Connect for Health Colorado CEO Kevin Patterson. “We know that there is a lot of discussion now about the future direction of healthcare, but what remains constant and true is the importance of protecting the health and financial future of all Coloradans. I encourage everyone who needs health insurance to check to see if they qualify for financial assistance, review the available plans, and complete an enrollment before the last-minute rush.”

In the first month of the annual Open Enrollment period, Coloradans selected 37,948 medical and dental insurance plans. That compares to 30,777 such plan selections in November 2015.

 

Every month, the Kaiser Family Foundation conducts an extensive national survey about various issues, mostly having to do with healthcare for obvious reasons. Their November survey results are both facepalm-inducing and completely predictable at the same time.

Plenty of other outlets are doing full analysis of the survey, such as this one by Jonathan Cohn of the Huffington Post, and I'm swamped today, so I'll just focus on a couple of the charts.

Yesterday, over at the NY Times, Paul Krugman, writing about the supposedly imminent repeal of the Affordable Care Act, tried to answer the question "How many people just shot themselves in the face?"

After giving it several shots, a Twitter follower of mine suggested that he bring me in on the issue:

@paulkrugman You really need state-level data (hint: @charles_gaba). Trumpier states didn't expand Medicaid or encourage/support exchanges.

— (((MikeRose))) (@MikeRose2d) November 29, 2016

In my latest exclusive post over at healthinsurance.org, I did my best to come up with the answer. Check it out!

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