Last week, in light of the #RiskCorridorMassacre debacle, I tried to find some good news on the CO-OP front, and while I didn't find much to cheer about, there were some bright spots in Maine/New Hampshire (where one CO-OP actually turned a profit last year), along with Illinois, Montana, Idaho, Ohio and Wisconsin (where the CO-OPs are still losing money, but seem to have staunched the blood flow and claim to be stable now, to put it in medical terms).

Today I can add one more state to the Good News column...New Jersey:

During the past month, five health insurance co-ops across the country have announced they are shutting down at the end of this year.

Health policy analysts are predicting more closures, but Health Republic of New Jersey probably won’t be one of them.

CNBC's Dan Mangan reports:

HealthCare.gov is going to see some shrinkage in 2016.

The number of health insurance plans available on that huge federal Obamacare marketplace for 2016 is decreasing by up to 12 percent compared with this year, industry sources told CNBC.

And there will be an even sharper reduction — of more than 40 percent — in the number of health plans on HealthCare.gov known as PPO plans, which offer customers the most flexibility in where they can get medical services covered by their insurer, sources said.

At the same time, there will be a marked increase in the number of so-called HMO plans, which do not as a rule cover costs incurred by customers outside of the plan's network of health providers.

The decreases on HealthCare.gov — which serves residents of 37 states — come a year after federal officials boasted about a 25 percent increase in the number of insurers offering plans for 2015.

As regular readers know, I've been trying to figure out whether effectuated ACA exchange enrollments have dropped noticably since the second quarter or not. Since last November, the HHS Dept. has been projecting that the effectuated number will be down to 9.1 million enrollees by December from 9.95 milliion as of the end of June.

However, over the past couple of weeks, I've compiled Q3 (end of September) data from 8 different state exchanges which collectively suggest that current enrollments are actually up since June...or, at worst, have only dropped slightly:

After the first Republican debate back in August, I wrote a piece over at healthinsurance.org titled "Has FOX News surrendered on Obamacare?" in which I noted that the ACA, which had been a near obsession on the part of the GOP for over 5 years, was barely mentioned:

In short, from what I can gather, the Affordable Care Act …

… the law which has consumed 99 percent of the Republican Party’s attention for the past 6 years or so …
… the law which has survived over 50 repeal attempts …
… the law which recovered from an unprecedented epic technical meltdown …
… the law which survived a federal government shutdown designed specifically to destroy it …
… the law which survived hundreds of millions of dollars worth of Koch Brothers attack ads …
… the law which survived two major Supreme Court decisions …

… proved to be worth perhaps three minutes of total airtime and discussion out of nearly four hours of Republican Party Presidential debate.

With the 2016 Open Enrollment Period quickly approaching, here's the most important advice I can give:

  • #1: SHOP AROUND. SHOP AROUND. SHOP AROUND.

Earlier today, the HHS Dept. released an in-depth analysis of the coverage decisions made for by the 4.8 million people who were still enrolled in HealthCare.Gov policies at the end of 2014 who went on to either renew their policies or switch to a different one for 2015 (note that the analysis only covers the 35 states run via HC.gov in both years. Oregon and Nevada ran their own ill-fated exchanges in 2014 and Idaho moved onto their own exchange in 2015, so these 3 states aren't included. Hawaii is moving to HC.gov for 2016 but was on it's own for both 2014 and 2015).

The report itself is quite detailed about how many people actively shopped around, how many of those kept their current plans, how many switched to a different carrier and/or a different metal level, but the bottom line is this:

The thought just occurred to me: Given that 9 of the ACA CO-OPs have closed up shop over the past few months...including no fewer than 6 in just the past 2 weeks (Kentucky, Tennessee, Colorado, Oregon, South Carolina and, just yesterday, Utah), along with at least two private insurers (WINhealth of Wyoming and, to a lesser extent, Coventry of Kansas) due specifically to wha

The HHS Dept's official exchange enrollment projection for the end of 2015 has always been that they expect roughly 9.1 million people to still be enrolled as of December (of which perhaps 8 million will renew their coverage for next year). If accurate, this would represent an 8.5% drop from the 9.95 million enrolled at the end of June.

As regular readers know, for the past couple of weeks I've been piecing together a theory, based on limited data, that ACA exchange QHP enrollment may have actually increased since June...or, at worst, only dropped slightly. Hard numbers from 8 states show a net increase of 2.7% from June through September; removing Massachusetts from the mix (special case) brings this down to a nominal 0.1% net drop:

After not one, not two, not three, but ten of the CO-OP organizations created by the ACA (and crippled from the get-go by being underfunded, not being allowed to advertise, not being allowed to arrange for additional funding and then having their sole lifeline cut off in the middle of the Open Enrollment period) melting down, you just knew that this was coming:

House Energy and Commerce Committee sets November hearing on ACA health co-op program

The House Committee on Energy and Commerce will hold a hearing on the Affordable Care Act's health co-op program in the wake of a string of  collapses of consumer operated and oriented plans around the country, two sources familiar with the matter told SNL on Oct. 27.

(sigh) Details to follow, but for the moment...

Utah insurance department confirms Arches will be the 10th health co-op to wind down. (cc: @charles_gaba)

— Adam Cancryn (@adamcancryn) October 27, 2015

@charles_gaba Yeah, insurance dept. just confirmed. Shooould be the last one, but we'll see

— Adam Cancryn (@adamcancryn) October 27, 2015

UPDATE: OK, here's the actual press release from the Utah Insurance Department, not that there's anything new here:

 

Watch and learn. KFF does an excellent job of boiling down all of the insanity into just over 5 minutes (not that this reduces how stupid the system is, even under the ACA, but it at least explains it).

NOTE: The Open Enrollment dates listed at the end are obviously wrong because this video is from last year. For 2016, Open Enrollment runs from November 1st, 2015  through January 31st, 2016.

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