Between the big December deadline (for January coverage) having passed and the holiday season, the actual OE4 enrollment data has been pretty sparse the past few weeks. A few minutes ago, however, Covered California broke the enrollment news drought (no pun intended) with a press release which, while not primarily focused on the actual enrollment data, nonetheless includes a solid update:

Covered California Brings Health Care Within Reach and Shows How Consumers Can Save by Shopping

Hat tip to Dan Goldberg for the heads up. (also thanks to Amy Shefrin)

Yesterday I crunched some numbers and estimated that, assuming a full ACA repeal w/immediate effect and no replacement, roughly 800,000 New Yorkers would almost certainly lose their healthcare coverage, including:

  • ~129,000 highly-subsidized QHP enrollees,
  • ~380,000 Basic Health Plan enrollees, and
  • ~286,000 Medicaid expansion enrollees

However, according to a major press release from NY Governor Andrew Cuomo's office this morning, I massively underestimated the Medicaid total:

Over 2.7 Million New Yorkers Would Lose Coverage
Estimated State Budget Impact of $3.7 Billion
Counties Across New York Would Lose Over $595 Million in Direct Spending
New York Residents Would Lose $250 Million in Health Care Savings Tax Credits

NOTE: I've asked Nicholas Bagley, law professor at the University of Michigan, to chime in to make sure I have everything below correct. I'll post an update if I have any of the details wrong.

UPDATE: OK, I've heard back from Bagley; he confirms that yes, I have it right:

"Yes [you have it correct]. Because of the Byrd rule, the big risk isn't legislative repeal...There are two real risks. First, that the individual mandate is repealed, destabilizing the DC exchange....Second, that Trump changes the OPM rule enabling the feds to cover the costs of congressional insurance."

Over at Daily Kos, diarist "Just Saying" posted a diary yesterday which reminded me of a rather silly ACA provision which I had completely forgotten about:

This is section 1312(d)(3)(D) of the Affordable Care Act. The so-called “Grassley Amendment” says that members of Congress and their staff may only get their health insurance through the exchange or on the individual market. No Federal Employees Health Benefit Plan for them!

Message in the Pence meeting with the House GOP is that they're on "a rescue mission" for Obamacare, rather than repealing and killing it.

— Matt Fuller (@MEPFuller) January 4, 2017

WHOA. Sen. Rand Paul (R-KY) says he will vote NO on the budget - the 1st step in ACA repeal - for other reasons. https://t.co/nfJq3D8i09

— Topher Spiro (@TopherSpiro) January 4, 2017

From the Bloomberg News link Spiro links to:

Republicans will first have to overcome a revolt from Senator Rand Paul on unrelated budget issues, with the Kentucky Republican saying Tuesday in an interview he would oppose the budget resolution because it adds significantly to the deficit.

"It never gets to balance. Not in 10 years, not in 100 years, not in 1,000," Paul said.

Via Abby Goodnough and Robert Pear in yesterday's New York Times:

Justin Kloski learned that he qualified for Medicaid under the worst of circumstances. The student and part-time lawn-company worker had lost 20 pounds, could not shake a nagging cough and was sleeping 14 hours a day when he decided to visit a clinic in Muncie, Ind., that provides free care for the poor and uninsured. A clinic employee invited Mr. Kloski, now 28, to apply for Medicaid.

A few days later, he took his new coverage to the emergency room at IU Health Ball Memorial Hospital in Muncie. A CT scan found a 15-centimeter tumor in his chest, so big it was pressing on his windpipe. In May 2015, he learned he had Hodgkin’s lymphoma, a form of cancer that is curable if caught early.

The Affordable Care Act, and Governor Pence’s decision to go against many other Republican governors and expand Medicaid under the law, may well have saved Mr. Kloski’s life.

A definitely-NOT-comprehensive selection of opinions regarding the Republican Party's imminent "Repeal & Delay" strategy for the Affordable Care Act:

What outside experts are saying about repeal and delay:

American Academy of Actuaries: “Repealing major provisions of the ACA would raise immediate concerns that individual market enrollment would decline, causing the risk pools to deteriorate and premiums to become less affordable. Even if the effective date of a repeal is delayed, the threat of a deterioration of the risk pool could lead additional insurers to reconsider their participation in the individual market.” [Letter to Congress, 12/7/16]

Nick Gerhart (Iowa Republican Insurance Commissioner): “If you're going to repeal this, I hope that there's a replacement stapled to that bill.” [NPR, 11/21/16]

It's New Year's Day, so I figured I should indulge in a little year-end navel-gazing by looking back and seeing which posts generated the most traffic throughout the year. There's a good chance that this site won't survive the new year anyway, so what the heck.

Below is a daily traffic graph showing the days with the biggest traffic spikes, along with the specific stories driving those spikes. I hope you don't mind, but I'd rather not post the actual numbers involved publicly.

As you can see, in 2016, there were 5 stories in particular which captured tons of traffic:

This is just a minor update from a few days ago, but the article does a nice job of breaking the numbers out so it seems worth closing the year out with this Access Health CT update:

The numbers below are as of the end of day on Dec. 29 are:

Every month I post an entry about the official CMS Medicaid enrollment report, documenting the increase in Medicaid enrollment since ACA expansion went into effect. The numbers were increasing dramatically every month for nearly two years, but started slowing down last fall as most of the expansion states started maxing out on their eligible enrollees. I wrote about the August 2016 report back on 11/20, and normally would be writing about the September report today. Instead, however, I'm skipping right past September, because the preliminary report for October was just released today:

UPDATE: Denis Byron, in the comments below, claims that Ryan Cooper's story (and therefore, mine) is "incredibly deceptive" and that I should be "ashamed" of myself for basing this entry on it. I've contacted Cooper about Byron's claims and will update the article if Cooper responds. Byron is correct that I am by no means a Medicare expert, so I'll leave it at that for the moment.

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