This may seem like common knowledge now, but in 2014, it felt like I was one of the only people who recognized that there were millions of people enrolling in ACA-compliant policies off of the ACA exchanges, directly via the insurance carriers themselves. My best estimate for 2014 was that in addition to the 7 million or so exchange-based individual market enrollees, there were another roughly 8 million people who enrolled off-exchange (although several million of those were in non-ACA compliant policies).

Wyoming

Just hours ago I posted a lengthy screed about the first clear victim of the Great Risk Corridor Debacle of 2015. In that case, both the culprit (the GOP's insistence on cutting off government funding guarantees for the risk corridor program) as well as the victim (the Kentucky Health CO-OP) both originated with the Affordable Care Act itself.

This time around, however, the victim (well, in addition to its current enrollees) is a private company, albeit a not-for-profit one: WINhealth Partners:

We’re a not-for-profit managed care company founded by professionals, and we’re changing the way that healthcare works for you – because we believe your insurance should help you to be at your best in life.

It occurs to me that I haven't really written a lot about the ACA's CO-OP organizations, which were created by the Affordable Care Act in order to help spur competition and keep prices down. Here's a basic summary of what the CO-OPs are about from the Commonwealth Fund:

The nonprofit, consumer-governed health plans were included in the law as an alternative to the so-called public plan option. Modeled on successful health insurance cooperatives such as Group Health Cooperative in Washington, the CO-OPs were designed to broaden the coverage options available to consumers, inject competition into highly concentrated health insurance markets and provide more affordable, consumer-focused alternatives to traditional insurance companies.

To help these new plans find footing, the health law offered low-interest loans that were tied to a number of requirements designed to differentiate CO-OPs from traditional insurers (which were barred from the program). Recipients were required to:

Thanks to Zachary Tracer for the heads up.

The other day I wrote a general overview of the ACA "Risk Corridor" debacle.

The short version is that there were 3 funding programs put in place under the Affordable Care Act designed specifically to help smooth the waters and keep insurance carriers afloat for the first few years until they got past the bumpy transition period. One of these was called the "Risk Corridor" program. Basically, the carriers who lose their shirts the first 3 years were supposed to have at least a portion of their losses covered to tide them over; call it "training wheels" for the insurance industry. The funding was supposed to come partially from the other insurance companies which did better than expected...but any shortfall was supposed to be covered by the federal government, with the caveat that any surplus paid to the government stayed there as a type of profit.

In my most recent Maryland exchange update, I noted that after months of ACA exchange enrollments increasing during the off-season (if slowly), net policy cancellations finally started to outweight off-season additions starting in August:

As of Aug. 13th, 606,226 Marylanders have enrolled in quality, affordable health coverage for 2015 through Maryland’s state-based insurance marketplace.

That includes 123,673 people enrolled in private Qualified Health Plans (QHP) and 482,553 people enrolled in Medicaid through the marketplace since open enrollment for the year began on Nov. 15, 2014. Nearly 94 percent of all Marylanders who have enrolled through Maryland Health Connection for coverage this year received financial assistance.

Today, the exchange tweeted out a quickie update ahead of the 2016 Open Enrollment period:

A couple of days ago I noted that Covered California is adding a very good feature this year: They're opening up 2016 enrollment nearly 3 weeks early...for those who are already currently enrolled. Starting this monday, Oct. 12, current enrollees will be able to renew or switch to a different CoveredCA plan, 19 days ahead of he official Nov. 1st Open Enrollment launch.

Today I discovered that at least one other state-based exchange (Kynect, in Kentucky) is doing this as well...sort of:

I clicked through and saw this listed under the Frequently Asked Questions:

1. How do I enroll in kynect?
Simply visit kynect.ky.gov or talk to your insurance agent. If your insurance plan is up for renewal, you may be eligible to enroll through kynect today. You can also call Customer Service at 1-855-4kynect (459-6328).

A couple of weeks ago I wrote about a "new" Scary Headline® story from the AP about cybersecurity at the federal ACA exchange, HealthCare.Gov.

My entry was about how the AP utterly misrepresentated the actual security situation a year ago, then compounded their mistake (I'll be gracious and assume it was done out of ignorance, not malice) a year later in their follow-up story. As for the actual HC.gov security situation, the short version was:

Just a couple of quick social media notes:

  • Those who follow me on Twitter know that I almost always include 3 hashtags with every Tweet: #ACASignups, #ACA and #Obamacare. During the 2016 Open Enrollment Period, I'll be changing the #Obamacare tag to simply #OE3, not out of any disrespect towards the President but simply because of the character limit.
  • Twitter followers also know that my personal feed (@charles_gaba) also includes all sorts of non-ACA-related stuff. If you want to keep up with my ACA-specific stuff but don't care for my unrelated political rantings, just follow the official @ACASignups Twitter account instead!
  • Finally, don't forget you can also follow updates on Facebook!

That is all.

I planned on posting about this earlier today, but had to deal with a crisis for one of my Day Job clients (yes, I still have one believe it or not).

Early this afternoon, Covered California, the largest state-based ACA exchange in the country, held a conference call accompanied with a lengthy press release and a very nice slideshow full of pie charts and data points, giving a comprehensive overview of where things stand in the Golden State.

With 47 states plus DC under my belt, at this point I'd say I have a pretty good feel for the overall national premium rate increase scene; it still looks like around 12-14% nationally on average, ranging from a low of under a 1% average hike in Maine and Indiana to a high of 40% or so in Alaska and Minnesota.

However, I admit it would be nice, as a point of personal pride, if I could squeeze in the last three states: Nebraska, Pennsylvania and Wisconsin. Fortunately, Louise Norris has brought to my attention the fact that the Nebraska Dept. of Insurance has issued the final approved rate changes for the individual market:

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