Unlike the exchange QHP enrollments, which will always continue to be the heart and soul of this website (it's right there in the name, after all), I've kind of gotten away from trying to track Medicaid expansion on a granular level over the past few months. The main reason for this is that in many of the expansion states, they've simply maxed out on enrollees, and the numbers from week to week or even month to month are simply holding steady at this point.

In 2014, Massachusetts' ACA exchange website was one of the biggest disasters of the site rollouts, managing to enroll fewer than 32,000 people while flushing tens of millions of dollars down the drain. The biggest problem was that the system couldn't accurately determine whether enrollees were eligibile for federal tax credits or not...which was kind of important since around 85% of enrollees nationally qualify for them.

This was especially embarrassing given that not only is Massachusetts considered a major technology base (hey, it's right there in the name: Massachusetts Institute of Technology...), it was also, of course, the home of the precursor to the Affordable Care Act, aka "RomneyCare". You can read the entire ugly story in vivid detail thanks to Ed Lyon's amasingly detailed Health Connector Autopsy Report.

As anyone who's been following the ACA exchange saga over the past few years knows, the original idea was that all 50 states (+DC) would establish their own, individual healthcare exchange, including their own website/technology platform for enrolling residents in private policies (QHPs), Medicaid (supplementing or replacing whatever existing Medicaid system they already had) and small business policies (the ACA's SHOP program). In addition, each state exchange would also have their own board of directors, marketing department, support call center, fee structure for covering the cost of operations and so on.

If things had worked out that way, there would have been 51 different websites where people would enroll in ACA policies, each one independently branded.

(sigh) OK, this one is not related to the Risk Corridor Massacre, since Community Health Options was actually profitable in 2014 and therefore never qualified for any RC payments anyway. Also, unlike the dozen ACA-created co-ops which are in the process of winding down operations by the end of the year, CHO is not going out of business, and in fact is remaining fully operational for 2016.

Having said that, this development is still a serious bummer given the carnage wreaked across the co-op landscape earlier this fall:

Maine's Community Health Options said Dec. 9 that it will cut short its sales of individual policies for 2016, in a sign that it is the latest Affordable Care Act-funded consumer operated and oriented plan to encounter financial difficulties.

So, a couple of days ago I publicly called out Avik Roy over some "math he did as a Republican to make himself feel better" in a Forbes piece he had published on December 6th.

My response received a bit of attention.

Here, again, is the original wording of the passage from Roy's article in question (Google's Cache tool seems to bring up a blank screen for the article for some reason, but I assure you, this was the original wording, verbatim):

Obamacare has reduced the uninsured rate by only 2%

In 2010, when Obamacare was passed, the Congressional Budget Office projected that the law would reduce the number of uninsured in 2014 by 19 million, relative to the number of people without health insurance in 2010. By 2016, CBO estimated that 30 million fewer people would be uninsured.

As expected, the December Surge started in Week 5, and should really be taking off even as I type this on Wednesday of Week 6. I overshot a bit this time:

• Week 5 Projection: 840K / Actual: 804K (over by 4.4%)
• Cumulative Projection: 2.88M / Actual: 2.84M (over by 1.2%)

I'm sticking to my guns for Week 6, projecting an even 1.5 million QHP selections via HealthCare.Gov, bringing the grand total to 4.34 million as of 12/12.

REMEMBER, as always, that this only includes the 38 states included on the federal exchange; when you throw in the other 13 running their own exchanges, the grand total by the 12th should be roughly 5.76 million QHPs nationally.

Thanks to Louise Norris for the heads up! MNsure held their monthly board meeting today as well, bringing their data right up to date through yesterday:

I launched the "State by State" chart feature towards the end of the 2015 Open Enrollment period last time around, and it proved to be pretty popular, so I've brought it back this year.

It's important to note that I'm still missing data from some state exchanges; I have bupkis from DC, Idaho, Kentucky, New York and Vermont. I also only have partial data from others (California includes new enrollees only, while several other states only have data for the first couple of weeks).

In addition, there are three states (Connecticut, Rhode Island and Washington State) where I have the opposite situation--they've front-loaded their autorenewals of current enrollees, with the understanding that those folks can still drop their coverage or switch to a different policy between now and December 15th (CT) or December 23rd (RI & WA).

As I note every week, between Rhode Island's tiny population, tinier ACA exchange numbers and especially their decision to "front-load" autorenewals of all current enrollees ahead of the 12/23 deadline for January coverage, their official QHP selection tally is only going up a few hundred per week. Week Five is no diffferent:

INDIVIDUAL AND FAMILY ENROLLMENT  As of December 5, 2015:

• 31,500 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.
• Nearly all of these individuals are current HSRI enrollees that have been auto-renewed into a 2016 plan.

1,592 individuals have selected a plan for 2016 coverage, and are new to HSRI this year or returning after being enrolled with HSRI at some point during a prior year.

I have a doctor's appointment myself this afternoon which I have to leave for soon (irony!!), so the second half of my weekly analysis (state level) will have to wait until I get back, but here's the major story.

With the December 15th deadline just 1 week away and the December Surge starting to kick in, CMS decided to hold a full press conference call this morning ahead of the Week 5 HC.gov Snapshot report.

Last Thursday, as you'll recall, after an initial lower number, I made the following projection:

UPDATE 12/03/15: OK, strike that. This has been nagging at me all day. I'm bumping my HC.gov Week Five projection up further to 840,000 for 11/29 - 12/05 (2.88 million cumulatively), or around 3.77 million nationally.

Here's the actual numbers, released by CMS just moments ago: