Things have been happening so quickly of late that I'm getting farther and farther behind on some important healthcare policy developments, particularly at the state level. There are two extremely important Public Option announcements which could be game changers if they make it through the legislative process.
Since I don't have time to do full write-ups on either one right now, I'll just present these summaries:
DC Health Link Extends 2019 Open Enrollment Deadline to Wednesday, Feb. 6
Washington, DC – DC residents will have an additional six days to sign up for 2019 health insurance coverage through DC Health Link. The new deadline to sign up is 11:59pm on Wednesday, February 6. Individuals who sign up by that deadline will have coverage beginning March 1, 2019.
DC Health Link customer service representatives will be available today at (855) 532-5465 from 8:00am to 8:00pm and on Monday, February 4th through Wednesday, February 6th to work with individuals seeking to enroll in health insurance coverage effective March 1. In-person assistance will also be available at enrollment centers throughout the District to assist residents with the enrollment process through February 6th.
As I noted a few weeks ago, I haven't written a whole lot about the idiotic (but terrifyingly so) TexasFoldEm lawsuit in awhile. Part of this is because I was out of the country over the holidays; part is because there hasn't been a whole lot of movement on the case since right-wing federal Judge Reed O'Connor ruled that the ACA was unconstitutional using a legal argument so thin it hula hoops with a Cheerio.
I debated whether or not to upload another update now instead of waiting for DC & NY to wrap things up, but figured what the hell.
I still expect the final national QHP selection tally to increase by around 35,000 more when the dust settles, including perhaps 1,000 more from DC, 5K - 10K more from New York and around 28,000 from Vermont (which hasn't reported anything so far this Open Enrollment Period). If so, the official total should end up around 11.47 million nationally, with the 12 State-Based exchanges coming in around 1.6% higher than last year (an all-time high for them collectively) vs. the 39 states on the federal exchange, which dropped another 3.8% this year. Nationally, the official total should end up around 280,000 enrollees short of last year.
Last night, in response to CMS Administrator Seema Verma taking shots at both Covered California (for blaming their drop in new enrollment on the federal mandate being repealed) and New Jersey (for seeing a 7.1% exchange enrollment drop in spite of reinstating the mandate), I wrote a long analysis which noted that:
Verma may have a valid point, but...
There's not nearly enough data available to know one way or the other (especially the missing off-exchange data for this year), and...
Even if she turns out to be correct about NJ's total enrollment drop, NJ reinstating the mandate still resulted in a substantial premium drop for well over 100,000 residents.
Today, I was able to fill in some of that missing data...although some of it is still frustratingly absent.
So, a couple of hours ago, CMS Administrator Seema Verma tweeted out the following:
.@coveredca blames subpar enrollment on no federal mandate penalty, but NJ kept penalty and saw much, much bigger drop. Forcing Americans to buy insurance they can’t afford isn’t the answer.
Last fall, I reported that thanks to the one-two punch of a) reinstating the ACA's individual mandate penalty at the state level and b) using the revenue generated from the mandate penalty to help fund a robust reinsurance program, the state of New Jersey had successfully lowered average unsubsidized premiums for 2019 individual market policies by a net swing of nearly 22 percentage points.
I say nearly all because there are still three numbers missing:
Vermont has yet to release any 2019 enrollment data. This is the 3rd year in a row that they've been radio silent. Assuming they're close to last year (28,763 QHP selections), they should add around 28,000 to the national total.
New York still has 2 days left for people to #GetCovered. I'm going to assume they'll tack on perhaps 5,000 more people today and tomorrow.
The District of Columbia hasn't posted any updates since December 11th, which means not only do they still have 2 days for people to sign up, they're actually missing a whopping 51 days worth of enrollment data. Again, assuming they wrap up close to last year, that should mean another 1,400 or so from DC.
Between the three, I'd expect another ~34,000 QHP selections to be tacked onto the totals below.
Covered California Plan Selections Remain Steady at 1.5 Million, but a Significant Drop in New Consumers Signals Need to Restore Penalty
Covered California finishes open enrollment with 1.5 million plan selections, which is virtually identical to 2018’s total, despite federal changes.
A key reason for the steady enrollment is that more people entered the renewal process for 2019 coverage after a strong enrollment period for 2018.
The federal removal of the individual mandate penalty appears to have had a substantial impact, leading to a decrease of 23.7 percent in new enrollment.
SACRAMENTO, Calif. — Covered California announced that more than 1.5 million consumers selected a health plan for 2019 coverage during the most recent open-enrollment period, a figure in line with last year’s total. There was a 7.5 percent increase in the number of existing consumers renewing their coverage and a 23.7 percent drop in the number of new consumers signing up for 2019.
