Some additional positive news out of California today; so much going on I decided to break it out into a second post:

Lee also noted that of those enrolled through Jan. 31, 626,210 are eligible for subsidies, and insurance companies are reporting that 80 percent of all enrollees have paid their first month’s premium. 

The wording of this makes it hard to tell whether "all enrollees" means all of them or only those through Jan. 31, but this CoveredCA Tweet clarifies:

#CoveredCA health insurance companies are reporting that 80% of all enrollees have paid their first month's premium.

— Covered California (@CoveredCA) February 19, 2014

OK, so this really does mean all enrollees. Fair enough. The downside is that I have to move 165,272 people over to the "Unpaid" category. The upside is that the "How many have PAID???" question just became about 12% cleaner.

Well THAT just figures! In the words of Emily Litella..."Never mind..."

Hot off the presses: California has released their first-half of February enrollment data: 100,228 people have enrolled in Private QHPs in "the first 2 weeks" of February (actually February 2 - 15, I assume, since the 728K number includes Feb. 1st). This breaks down to 7,159/day:

Nearly half of those covered [through 2/01] — 728,410 Californians — selected a Covered California health insurance plan. This strong enrollment trend is extending into February, where in the first two weeks more than 100,000 individuals enrolled in Covered California, increasing the cumulative total enrollment in Covered California to 828,638.

California's January enrollment rate was (728,410 - 498,794) = 229,616 / 35 days = 6,560/day, which means that their February enrollment rate is actually increased from that of January, by over 9%!

So, how does this impact the "February Drop-Off" factor? MASSIVELY! Take a look:

Hawaii's private QHP enrollments continue to crawl along, increasing from 3,879 as of 2/08 to 4,297 as of 2/15.

Total since October 1, 2013

18,752 Applications completed in the Individual Marketplace
 4,297 Enrollments in the Individual Marketplace
 444 Employers applied to SHOP Marketplace

They also list the number of employers enrolled in their SHOP system, but there's no update on the actual number of people covered by those plans, so it stays at 307. No Medicaid/CHIP update either.

The good news is that Hawaii becomes the first state of the 11 for which I have partial February data to actually increase it's enrollment rate over January. The bad news is, Hawaii's numbers are so tiny that this is a drop in the bucket, only reducing the overall drop percentage by 0.2%.

I know I've become a bit obsessive about this "February Drop-off" thing, but I couldn't help myself. Since the Jan. HHS report was simply wrong on New York's private QHP figure, I found the closest correct figure to Feb. 1st that I could--an official NY State of Health press release from 2 days later, Feb. 3, which gives the correct private QHP enrollment number as 241,242 as of Feb. 3.

Updating the "Feb Drop-off Chart" with this info as well as yesterday's Nevada update, we now have some more solid Feb-vs-Jan data to work with. I've modified the graph to show how many days are being counted for each state, as well as the starting & ending dates for each month:

This morning I noted that New York has seen a dramatic increase in the percent of their ACA enrollees who were previously uninsured, rising from 66% of the total on 1/10 up to 69% as of yesterday. While a 3% increase doesn't sound like much, this is especially notable because, as I demonstrated, it means that between 92 - 100% of the newest enrollees were previously uninsured (probably around 95%), since that's what it would take to raise the overall enrollment up with such a comparatively small number of additional enrollments.

However, I forgot another, earlier NY update which fills in this picture even further. Back on January 13, there was another press release which noted that as of December 24, 2013, about 50% of the 230,624 New York enrollees were previously uninsured:

Another update from Nevada: Private QHPs up from 16,030 paid / 7,656 unpaid to 17,047 paid / 8,595 unpaid from 2/08 - 2/15.

This also gives some additional data to work with regarding the February Drop-off issue...and there's some good news here, whether you look at total QHPs or paid only:

Update as of 2/15: 25,642 Nevadans confirmed QHP Selections. 17,047 have paid.

— Nevada Health Link (@NVHealthLink) February 18, 2014

Over the weekend, I threw some cold water on the ACA enrollment momentum theme with a one-two punch: First, I pointed out that the February report will only include 4 weeks of data (2/02 - 3/01) vs. January's 5 weeks (12/29 - 2/01); then I looked into the actual data to see if this story from Yahoo Finance was correct in suggesting that enrollments have dropped off even on a daily-average basis since January.

Ah, just in time to help clear up my confusion about the New York situation from over the weekend: The latest tally has NY with a total of 266,177 private QHP enrollments, up 14,871 from 251,306 a week earlier. Medicaid enrollment via the exchange is up to 189,865 from 160,915, an increase of 28,950.

This is noteworthy for a couple of reasons. First of all, this gives some additional, solid data to plug into my weekend "NY Enrollment Number Mystery Project" that I've written a couple of posts about the past few days. Connected to this, however, is something which may be cause for a bit of concern--up until now, New York has been bucking the tide and averaging around a 60/40 split in favor of private QHP enrollments. Today's additions, however, reverse that with the numbers switching to 34/66 in favor of Medicaid enrollments:

Another 44,000 people enrolled in a health insurance plan through the state's exchange over the past week, pushing the total to 456,042, according to the state Department of Health.

Earlier today, I pointed out some potentially bad news for total ACA enrollmentthat February's enrollment tally is likely to be a good 20% lower than January's for the simple reason that the February HHS report is only going to include 4 weeks' worth of data, while January's included 5 weeks. Nothing neferious or evil going on here, just measuring 28 days instead of 35 (for the record, the final report for March will include 30 days' worth of data (March 2nd - 31st)).

While writing up the main part of the entry, however (which addressed a Yahoo Finance article which claims that February enrollments will be way down for a variety of unrelated reasons), I noticed something very curious about New York's enrollment numbers. I went into this in the earlier entry but decided that it's important enough to merit it's own full repost.

Here's the official enrollment numbers from the October, November, December and January HHS Reports...and the most-recent official press release from the NY State of Health Exchange:

Most ACA critics now grudgingly admit that people are getting insured after all, but they say there's a catch. "Where are we going to get all the doctors?" a social worker asked me recently. "We're overwhelmed as it is." A letter in the local paper said, "People aren't really covered unless someone accepts their 'insurance', and if nobody is accepting it, then why should people pay for it?"

I briefly answered the letter writer online, saying that the solution was in the provisions of the Affordable Care Act to increase the primary care workforce, not only with more primary care doctors but also more nurses, nurse-practitioners and physician assistants. I was then curious to find out more about what the ACA has been doing to upgrade primary care in the U.S. and found that it has already made major improvements.

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