There was a lot of fuss yesterday about the new CBO report which now projects ACA federal tax credits to end up costing about 20% less than previously estimated over the next decade. This is great news, although the reasons for it can be seen as either good or bad depending on your POV:

The Congressional Budget Office previously projected that 12 million people would be covered by insurance policies obtained via an exchange this year. But it has reduced that prediction to 11 million, in part based on the expectation that a significant number of enrollees will give up this coverage, either to obtain insurance elsewhere or to become uninsured.

Over the past few years, there's been what seems to be a huge increase in incidents of police officers harrassing, arresting, beating up, tasing and/or flat-out shooting black people (and, admittedly, the occasional mentally-troubled white person, as if that makes the situation any better) for no particular reason. Michael Brown. Tamir Rice. John Crawford III. Eric Garner. The list goes on and on.

Anyway. My mom and stepfather are snowbirds, spending the winter in a condo down south. My mom called me this afternoon because she had received a call from the alarm company: The alarm at their house in Michigan had gone off, the police had been notified and were en route to check it out. I know the alarm code and have a spare key, so she needed me to swing by to disable the alarm and see what was going on.

Yup, Michigan's ACA Medicaid expansion is still continuing to grow, although it does seem to be slowing down at last:

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 579,115
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of March 9, 2015 
*Updated every Monday at 3 p.m.

Again, for the record, the prior estimates of how many Michiganders are even eligible for the program ranged from 477K - 500K. We're 16 - 21% above that now.

Not a particularly huge development, but it's nice to receive official confirmation:

Nearly 11.7 million people were enrolled in an Obamacare plan through Feb. 22, Department of Health and Human Services Secretary Sylvia Burwell said Monday.

That number will continue to increase due to extended enrollment periods through April for those who learn of the penalties for not having healthcare while they are doing their taxes. But as of now, Burwell said more than half of those who signed up were new customers.

The Colorado ACA exchange has just released their latest official enrollment report, and while it's chock full of useful data, it's also bit hard to read (physically...it's a low-res version, will swap it out with a higher-res PDF once they post it), and the numbers also require a bit of parsing...and are a bit confusing.

UPDATE: OK, I've found the actual high-res Dashboard report and have swapped out the low-res one below.

the grand total of "submitted enrollments" is just shy of 154,000. However, that appears to include 3,716 SHOP enrollees (the precise SHOP number is a bit fuzzy due to the footnote regarding this being "currently covered lives, regardless of date of enrollment").

So, separate SHOP out and you have 150,229 QHP selections.

This Just In...Maryland has announced their official final QHP selection tally for 2015 Open Enrollment (including the 2-week "wait in line" extension period):

289,131 Marylanders enrolled through Maryland Health Connection from Nov. 15, 2014 to Feb. 28, 2015. That includes 122,778 people enrolled in private Qualified Health Plans (QHPs) and 166,353 enrolled in Medicaid. Due to high demand during the final weekend of open enrollment, Maryland Health Benefit Exchange allowed people who started an application at MarylandHealthConnection.gov or contacted the Consumer Support Center by Feb. 15 to complete the process by Feb. 28.

Now that the King v. Burwell Supreme Court oral arguments are out of the way (with radio silence expected until they announce the decision sometime in June) , the next Big Development to keep an eye on ACA-wise is...Tax Season! There will be plenty of stories about how many people have to pay back some/all of their 2014 tax credits, how many will receive additional tax credits...and, most germane to this site, how many additional people enroll via the exchanges to avoid having to pay (most) of the higher tax penalty next year for not being covered in 2015 during the Tax Filing Season Special Enrollment Period (SEP), or #ACATaxTime as I prefer to call it.

If the Supreme Court does rule in favor of the government, then all of this will be moot (until the next BS, frivolous legal challenge to the law, of course). Healthcare.Gov will presumably be full-steam ahead, the tax credits will flow to all 50 states (+DC), and all will be (relatively) well. In fact, I wouldn't be at all surprised to see some of the smaller states such as Rhode Island, Vermont and Hawaii scrap their own exchanges and move to HC.gov the way Nevada and Oregon did (although in the case of RI, VT & HI, it would be more about funding issues than technical problems).

However, I've laid out a number of potential workaround/solutions in the event that the SCOTUS does rule for the plaintiffs...the massive catch being that all of them would require some amount of cooperation on the part of a) Conservatives on the Supreme Court; b) Republicans in Congress and/or c) Republicans in the 34 states in question.

Today, Dan Mangan of CNBC has written an excellent story with some additional possibilities:

(title corrected...everyone knows it was "licks", not "bites"...d'oh!!)

Last night I got embroiled in a Twitter discussion with Ken Kelly and Seth Trueger about the various categories of policies available (on exchange, off exchange, grandfathered, etc). I got to thinking about it; believe it or not, there are over a dozen that I've tried to track over the past year and a half:

  • 1. ACA Exchange-Based Qualified Health Plans (QHPs)
    Current Paid Enrollment: Around 10.3 Million
  • 2. OFF-Exchange (direct) Qualified Health Plans (no tax credits)
    Current Paid Enrollment: Around 8.1 Million (including #3 below)
  • 3. Off-Exchange ACA-Compliant (but not QHPs)...believe it or not, there are policies available directly via the insurance companies which are compliant with ACA requirements, but which aren't defined as "QHPs" (that is, they still couldn't be sold on the exchanges even if the insurance company wanted them to be).

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