After yesterday's Obama Dentata* story broke, people asked whether I'm sticking with my official projections of 12 million QHP enrollments (total) and 10.6 million (paid). The answer is yes, and here's why:
First of all, yesterday I discovered that New York State has a much more aggressive target than I thought: 720,000 QHPs, which would be a whopping 94% increase over 2014 (I thought the 350K increase was QHPs + Medicaid combined, but Dan Goldberg of Capital New York specifically asked and was told nope, that's private QHPs only). It's a pretty tall order, but it's also a pretty confident/bold one. If they pull it off, that's 165,000 more people than I was projecting right there.
To recap: In the initial few days of 2015 #OE2, Massachusetts' actual QHP enrollments averaged about 52% of the total "determined eligible" number. The first official weekly report (with "selected plan" QHPs) will be released Monday, so for the moment I'm going with that ratio daily. With that in mind, it looks like MA may have broken the 10,000 milestone in just the first 5 days!
That's 19,957 "determined eligible" for QHPs. Assuming 52% have already selected plans, that's a total of over 10,300 to date.
Again, for comparison sake, last time around MA only 31,695 people were able to enroll. If my 10.3K figure proves accurate, that's 2,060 per day, compared with just 158/day for 2014...or 13x the rate.
Massachusetts is making up for last year's disaster in spades so far.
In addition, check out the confirmed Medicaid (MassHealth) tally: 16,292 people already.
Yes, Republicans are gleeful about having a new pet issue to attack the ACA with. And yes, this one was indeed either a really, really stupid screw-up or purposeful fudging, depending on whether you believe the official explanation or not.
Yes, these are renewals, but this is still extremely impressive, especially seeing how the number has doubled since Monday night:
A new open enrollment period began Saturday, and since then the system has taken in more than 600 new applications and processed more than 3,000 renewals of existing policies.
Vermont Health Connect spokesman Sean Sheehan says the system's performance hasn't been flawless, but he described its improvement over last year as like night and day.
(Yes, I realize that title may be too clever by half. Anyone know if this is actually an offensive reference?)
OK, I wasn't going to post anything else about this today, really. I was planning on holding off until tomorrow. However, it's turned into a Thing (of course), and Things have a way of sucking the oxygen out of the room. So...
First of all, to reiterate: In terms of how the ACA is functioning, the fact that the net attrition rate has turned out to be 2.7% (6.7 million on October 15th / 8.0M on April 19th = 83.75% retention over a 6 month period) was normal and expected. I thought it was about 3% per month until the "7.3M in August" announcement caused me to drop it down to 2%...and it turns out I was right in the first place, both for August as well as October, when I suggested that the number may have slipped to as low as 6.8 million.
This afternoon, HHS Secretary Burwell issued a full apology:
As for how it happened, the HHS Dept. is claiming that it was a genuine mistake for both the August and October numbers; Jonathan Cohn has the official response:
It's also important to remember that unlike HC.gov, CoveredCA was (for the most part, anyway) fully operational from the beginning last year, which makes this a reasonable apples-to-apples comparison.
a) the actual number who've been enrolling daily in the off-season is higher than my 9,000/day estimate, or
b) that the attrition rate after the first month is lower than my 3%/month estimate, or
c) more than 90% of enrollees eventually pay their first month's premium, or
c) some combination of all three.
Considering that NYC has around 400 zip codes by itself, this was no doubt a rather Herculean task.
Today, however, they've gone one step further, with a state-wide map of September enrollments by zip code...and when you include the entire state of NY (not just NYC), you're talking about 2,200 zip codes (!) Excellent job!
On it's surface, this article isn't anything terribly special (although it is well-written). It's a piece by a physician who has been protesting North Carolina's refusal to expand Medicaid under the ACA.
The reason I'm calling attention to it is because The Graph was cited in the 3rd paragraph (see that tinly "1" footnote at the end of the first sentence):
Since passage of the ACA, 23 million to 28 million Americans have gained access to health insurance through insurance exchanges, Medicaid expansions, and the mandate that children be allowed to remain on their parents' policies until the age of 26.1 Several studies have shown a very concrete benefit of expanding insurance: reduced mortality.2 If a Medicaid expansion in North Carolina achieved similar results, hundreds of deaths per year could be prevented. Less tangibly, millions of citizens have had a weight lifted from their shoulders and can now feel free to change jobs or pursue less lucrative careers as entrepreneurs or artists, assured that they won't have to go without health insurance.
