Thanks to Richard Mayhew for the head's up:

ALBANY, N.Y. (AP) — The state's health exchange expects to enroll more than 470,000 New Yorkers in its new low-cost option for coverage this year.

Testifying at an Assembly hearing this week, exchange Executive Director Donna Frescatore said New York chose to participate with the Essential Plan. The plan is an option under the federal Affordable Care Act starting in 2016.

It's aimed at adults who don't qualify for Medicaid but have been unable to afford private coverage.

The Essential Plan has no annual deductible before insurance begins paying medical bills.

Premiums are free for those with incomes at or below 150 percent of the federal poverty level.

A couple of weeks ago, I made a bigger splash than I expected in healthcare journalism/wonk circles by posting my best attempt to piece together the current health insurance/coverage status of everyone in the U.S. (and by "current", I mean "as of March 2016", which includes the results of the 3rd Open Enrollment Period). While some of the numbers/estimates are composites of more than one survey/report and therefore may be off here and there, I've been reassured by various industry experts that overall it seems to be pretty close to the mark.

With that in mind, I wanted to highlight an important point. For some time now, Bernie Sanders has been pointing out repeatedly that around 29 million people remain uninsured despite the Affordable Care Act. This has become one of his core bullet point arguments in favor of his Single Payer healthcare plan which, if enacted, would supposedly cover everyone in the country (more efficiently, with more comprehensive coverage, lower overhead, etc etc).

NOTE: To clarify, I'm not saying that Bernie is the one blaming the law for the 29 million, but I keep hearing a lot of other people doing so. I only mentioned him because instead of touting the 20 million people who the law has helped gain coverage, he focuses almost exclusively on the 29 million that it hasn't. A little balanced perspective is what I'm talking about.

I've stated many, many times that in spite of how unimpressed I am with Sanders's plan itself, in the long term I do think that something like it is our best option. However, for the moment I wanted to take a closer look at the breakout of those 29 million people:

  • Uninsured - Medicaid Eligible: 5.0 million
  • Uninsured - CHIP Eligible: 3.0 million
  • Uninsured - Medicaid Gap: 2.8 million
  • Uninsured - Undocumented Immigrants: 4.7 million
  • Eligible for ACA Tax Credits: 6.5 million
  • Ineligible for ACA Tax Credits: 7.0 million

Now, if you want to complain that the ACA is too complicated, pads the insurance carriers's pockets, doesn't keep costs down enough and so forth, those are reasonable arguments.

However, if you're arguing that the ACA is "failing" because it has "only" cut the uninsured rate by about 40% since 2013 instead of down to 0%, that's an absurdly unfair attack for two reasons. First, the ACA itself was never intended to get the U.S. to 100% coverage...nor did anyone ever claim that it would.

Thanks to Sabrina Corlette for the heads up:

UnitedHealth Group will stop offering plans on Arkansas' health insurance exchange next year, a spokesman for the Arkansas Insurance Department said Thursday.

The Minnetonka, Minn.-based insurer offered plans this year for the first time, but it didn't submit plans to the department for 2017, department spokesman Ryan James said.

The deadline for insurers to submit such plans was April 1, he said.

This is hardly unexpected news for a couple of reasons. First, UHC made huge waves last November by making a big, dramatic announcement that they might very well drop out of the ACA exchanges altogether next year after taking large losses on exchange enrollees in 2015. As you may recall, this was a very oddly-timed announcement given that they had issued a glowing quarterly report just a month earlier which made it sound like everything was hunky-dory.

I was flattered to have my U.S. Healthcare Coverage Breakout chart receive the top spot in this week's Health Wonk Review over at Jaan Sidorov's appropriately-titled Population Health Blog:

Charles Gaba of ACASignups has been tracking the progress of the Affordable Care Act. This ongoing labor of love led him to comb through too-numerous-to-count public domain sources to provide an original-sourced summary (with links galore) of the health insurance status for the entire U.S. population in one chart.  He calls it "ambitious."  The PHB calls it gloriously detailed, credible and superb. KHN, you've met your match.

OK, I think that last line is a bit over the top (KHN refers to Kaiser Health News), but I appreciate the sentiment.

Check out the whole thing for some other fantastic Health Wonk writing!

I know I haven't posted much of anything for the past week or so. I'm playing catch-up with my day job and my kid is on spring break this week, so I haven't had much time to devote to the site. Furthermore, we're spending today at the Michigan Science Center, so I can't really do a proper post today either.

HOWEVER, Gallup just released their latest quarterly Gallup-Healthways Well-Being Index Survey, and the results are better than what I expected them to be:

As I said back in January, when the Q4 2015 survey was published:

Every once in awhile, I like to take a look at the analytics reports for ACASignups. Usually it's just keeping track of the number of site visitors; occasionally I'll poke around a bit more in depth, especially when there's a huge traffic spike like the one caused by Michael Hiltzik's L.A. Times story showcasing my "Total Coverage Type" Pie Chart a few days back.

However, once in a blue moon I'll snoop around a bit more and look at who's visiting...and the results can be surprising, even after you cull out the random typo visits and bot crawlers.

Case in point: Check out this map showing where the most recent 1,000 visitors to the site were located. For the most part it's not terribly surprising, with the vast bulk of traffic coming from the U.S. (including at least one visitor from Hawaii) or Europe, followed by scattered instances from other countries here and there...

But wait a minute...what's that?

OK, this is totally off-topic, and I know I'm gonna face an earful in the comments over this, but I have to make a few comments on the ongoing "Democratic Superdelegate" brouhaha amongst Bernie Sanders's supporters.

First of all, there are 712 "unpledged" delegates (or "superdelegates") for the Democratic Party this year out of 4,763 total. That's around 15% of all Democratic delegates. The eventual nominee needs at least 2,382 total delegates to win the nomination.

So, it's important to keep in mind that pledged delegates from primaries and caucuses determine around 85% of the total. It's the remaining 15% who people are getting all worked up about.

Normally, of course, this isn't an issue because one candidate or another ends up securing more than half of the grand total via the caucuses/primaries anyway, making the SDs a moot point.

So, the Big Story today is a new report from the Blue Cross Blue Shield Association revealing that (wait for it)...people who signed up for private health insurance via the new Obamacare exchanges over the past two years are a lot sicker and more expensive to treat than those previously enrolled in the individual healthcare market. From their opening summary of findings:

Comparing the health status and use of medical services among those who enrolled in individual coverage before and after the ACA took effect, as well as those with employer-based health insurance, the study finds that:

UPDATE: I just asked Larry Levitt, Senior Vice President for Special Initiatives at the Kaiser Family Foundation, to take a look at my analysis to see if anything below seems to be significantly off-base in terms of my logic, analysis, estimates and so forth. I was particularly concerned because I've modified/extrapolated from a lot of data which was originally reported on by KFF. His response:

@charles_gaba Obviously some of the estimates are approximations, but I don't see any glaring problems.

— Larry Levitt (@larry_levitt) March 29, 2016

Over the past few days, I've been fine-tuning an ambitious attempt to boil down the entire U.S. population into a single pie chart broken out by type of healthcare coverage (or lack thereof).

(sigh) OK, I guess I lied...it did take another full week for me to get around to the CMS 2015 End Of Year Effectuated Exchange Enrollment Report as well as the final part of my #OE3 ASPE report analysis after all. To review, here was Part One and Part Two.

Today I'm looking at the December 31, 2015 state-by-state data. I'll return to the actual ASPE report (for Part 3) next:

On December 31, 2015, about 8.8 million consumers had effectuated Health Insurance Marketplace coverage – which means those individuals paid their premiums and had an active policy at the end of December. Of the approximately 8.8 million consumers nationwide with effectuated Marketplace enrollments at the end of December 2015, about 84 percent, or about 7.4 million consumers, were receiving an advance payment of the premium tax credit (APTC) to make their premiums more affordable throughout the year. The average APTC for those enrollees who qualified for the financial assistance was $272 per month.

Ouch. There's no putting a pretty face on this number. Last fall I projected that the Q4 (12/31/15) effectuated enrollment figure would be around 9.7 million (although I was obviously proven wrong when the Q3 9/30/15 report was released; the number had already dropped down to 9.3 million by that point). This alone is a large part of the reason I was so far off in my projection of 14.7 million total OE3 enrollees; I assumed 9 million 2015 enrollees would renew, when in fact there didn't end up being 9 million people still enrolled in 2015 policies total. However, the actual number fell short of even the HHS Dept's lower projection of roughly 9.1 million. Needless to say, this is pretty disappointing from their POV.

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