(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).
The following is an actual email exchange from last spring between someone working at a private, for-profit insurance company and myself. I've blocked all personally identifiable information as a courtesy, even though I probably shouldn't have. I had completely forgotten about this incident until the Huffington Post's Jeffrey Young tweeted something which reminded me of it.
Hello Charles,
I work for an insurance organization in (city, state) and have been following your information as it relates to enrollment. I have been tracking competitor information manually as our state insurance department has not, up to this point, provided any enrollment information.
We are extremely interested in enrollment numbers for (competitor) and (competitor) in the state of (state). Here is a link to some more enrollment numbers for (competitor) - (link), however, they are old because we currently got some information that they are now up to (number) total enrollment members. Please, if you do report these numbers, I wish to keep my identity confidential.
When you're deep in the weeds on this stuff, you tend to take things for granted. Case in point: I kind of figured that it was obvious that everyone who purchases private insurance coverage in the 34 Federal Exchange states will be utterly screwed in the event of the plaintiffs in King v. Burwell winning (assuming, of course, that the GOP Congress doesn't show a lick of decency for once and none of those states slap together an exchange-in-a-box, that is).
Apparently I was mistaken about this, so to review:
Under King premiums for subsidized enrollees would ↑ 256%. As the risk pool deteriorates, premiums for all in the individual market also ↑.
UPDATED w/explanation (although this really isn't a serious analysis, just trying to make a larger point:
The conventional thinking now seems to be that Roberts and Kennedy are likely to side with the 4 liberal/Dem-appointed Justices to rule against the plaintiffs, 6 to 3.
This translates to roughly, say, a 75% chance of the federal exchange subsidies continuing, 25% chance of them being cut off:
A couple of weeks back, CoveredCA reported that they had renewed 944,000 2014 QHP enrollees, and added another 474,000 new enrollees for 2015, for a grand total of around 1,418,000 private policy enrollees (payments pending, of course). Like every other state, CA tacked on an "overtime" period for people who were waiting "in line" by the 2/15 deadline but hadn't completed the process. I was assuming this might push their grand total up to perhaps 1.5 million or so.
Today, CoveredCA released their final official numbers, and they're...underwhelming:
Obamacare: @CoveredCA says newly enrolled 2015 was 495K, total enrollment including renewals is 1.41M #ACA
Some people were disappointed (and others no doubt relieved) that after flapping my gums about it for the past 9 months, I didn't have anything to say about the actual King v. Burwell oral arguments yesterday. As I noted, I'm neither an attorney nor a SCOTUS or Constitutional scholar. I really don't know much about the actual mechanics of Supreme Court procedures--heck, until yesterday evening, I didn't even realize that the 2-3 hours of lawyers and Justices chit-chatting was the whole ball of wax:
@onceupona@nicholas_bagley Stupid question: Was today IT? that is, was the whole #King thing a 1-day deal, followed by 3 mo of waiting?
The Silver Lining: Medical Tax Breaks Can Offset Health Care Costs
Everyone needs medical services at some point in their lives. Yet, annual expenses rise every year: health care costs increased 22% from 2010 to 2013 alone. Now that health insurance has become mandatory, many fear that their health expenses will increase even more. Luckily, Americans may be able to offset some of their health care costs by by deducting applicable medical expenses.
Long-time followers of this site know that I attempt to track every person who gets enrolled in healthcare coverage through the Affordable Care Act, whether it's via individual/family exchanges, Medicaid expansion, off-exchange QHP enrollments...or the SHOP (Small Business) exchanges. They'll also recall that last year, due to the massive technical problems which most of the exchange websites faced, only a handful of SHOP exchanges were even usable, much less actually signing people up. The exchanges were, for the most part, so busy scrambling to get the individual enrollment side working properly that they pretty much put the SHOP exchanges on the back burner. Only about a half-dozen states had theirs running at all, and the total enrollment topped out at only around 83,000 people nationally.
A couple of weeks ago, Gallup released a massive Health Insurance Survey which noted that the uninsured rate nationally fell from 17.3% to 13.8%. On the one hand, yay Obamacare! On the other hand, this drop in the uninsured was far less impressive-sounding than earlier surveys put out by the Urban Institute, Commonwealth Fund, RAND Corporation...and even Gallup itself.
There was an obvious reason for this, however:
In other words, they surveyed a mountain of people, but the polling was spread out over the full course of each year. These are full-year averages. There's nothing wrong with this, and 10 years from now it will be more practical to look at historical data from a year-to-year perspective. At the moment, however, things are changing very rapidly as enrollments/expansion/policy implementation goes into effect, and a month-to-month or quarter-to-quarter perspective is far more telling.
Today is his birthday. In honor of Chris, I'd like to ask visitors to consider making a donation to him today. Just visit Eclectablog, scroll all the way down and look for this PayPal area in the lower-right corner:
P.S. I'll have plenty to say about today's King v. Burwell developments this afternoon or tomorrow, I'm sure, but for the moment there's not much more I can add. I'm neither a lawyer nor a Constitutional scholar; others are far more knowledgable about the particulars of the Supreme Court as well as the personalities/idiosyncracies of the individual Justices.
