The typical agreement a QHP issuer enters into if selling on the FFM requires them to keep the policy in force for the entire calendar year. [This exit clause] gives them option to term the policy abruptly if the Courts rule, or a Trump administration decides, that it won't pay CSR offset payments to carriers. Because this won't hit the Supreme Court until late 17 or early 18, I think this is as much about assuaging carriers fears of a Trump admin trying to destroy the marketplaces as anything else.
OK, it's really important to note that a) this is a very simplified rendering of the true situation and b) this only applies to two populations: The individual market (around 20 million people) and the medicaid expansion population (around 14 million, plus another 2.6 million being denied thanks to 19 states refusing to expand it). In other words, it has nothing to do with the large group market, small group market, Medicare, the VA/TriCare, federal/state/local public employees and so on. This chart only applies to around 37 million people in the U.S. Got it?
Having said that, what I've tried to do is to provide a visual representation of, among that population, who the ACA is working well for, who it isn't working so well for, and who can legitimately complain about feeling screwed by it:
Oops. Last week I reported that Access Health CT appeared to state that they had a total of 114,421 QHP selections during the current open enrollment period. The wording was slightly squirrelly ("currently active for 2016 and/or 2017"), especially since I also knew there were around 12,000 existing enrollees who still hadn't chosen a new policy...but an earlier update had given the number as "around 113,000" in a seemingly less-confusing way, so I assumed that all 114,421 applied to 2017.
22 Percent Increase Over Last Year • New Yorkers Show Demand for Quality, Affordable Healthcare
ALBANY, N.Y. (January 6, 2017) – NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.4 million people have enrolled in health insurance through December 24, 2016.
With almost a month to go until the end of the 2017 Open Enrollment period, participation in the NY State of Health Marketplace has already increased more than 22 percent since the last Open Enrollment period ended, January 31, 2016. Enrollment has increased in all 62 counties of the state. The overall share of New Yorkers now enrolled through the NY State of Health has reached nearly 18 percent of the state’s population.
Last March I cobbled together this pie chart, which attempted to break out the health coverage status of every single person living in the United States (yes, including undocumented immigrants). It gained quite a bit of attention at the time from healthcare reporters, wonks and so forth. While my numbers may have been slightly fuzzy here and there, it received a general seal of approval from Larry Levitt of the Kaiser Family Foundation, who stated "Obviously some of the estimates are approximations, but I don't see any glaring problems."
OK. Today saw fresh enrollment updates from Rhode Island (nominal), Covered California (impressive) and, most significantly, HealthCare.Gov (which not only covers 39 states, but also finally includes auto-renewals). I now have auto-renewal for 48 states + DC included in the mix, and the numbers are current through 12/31/16 or later for 41 of them. I still have no data whatsoever from Vermont (ironic, given their history of progressive healthcare policy, Bernie Sanders, etc), and only very limited data out of New York (they mentioned 55,000 enrollments over a 3-day period just ahead of the December deadline, but nothing from before or after that).
As i noted last week, with all renewing enrollees accounted for, Rhode Island's ACA exchange is likely to come up short not only of my pre-election projection (40,000 enrollees), but will likely see a drop from last year's 34,670 QHP selections. They had only hit 29,312 QHPs as of Christmas Eve, and have only tacked on another 580 people since then:
INDIVIDUAL AND FAMILY ENROLLMENT • As of December 31, 2016
Hot on the heels of Covered California's update just moments ago, the HHS Dept. has posted their latest bi-weekly Snapshot report. While the extra 2 weeks of data is obvoiusly important, the key number I've been anxiously awaiting is the auto-renewal number, which is finally included in today's report:
Biweekly Enrollment Snapshot • WEEKS 8 AND 9, DEC 18 – DEC 31, 2016
8.8 million Americans have signed up for coverage through HealthCare.gov since Open Enrollment began on November 1st. This compares to about 8.6 million plan selections last year at this time, demonstrating Americans’ strong and growing demand for affordable, quality coverage. Total plan selections as of December 31st, which include auto reenrollments, consist of 2.2 million new consumers and 6.6 million returning consumers. Among returning consumers, two thirds, or 4.4 million, actively selected a plan, an increase from last year’s already high levels of consumer engagement.
