A few minutes ago, a guy named Ed Lyons tweeted the following:

The new @HealthConnector exchange launches tomorrow, 8 am. As I have said for a couple of months, I think it will be fine this time. #mapoli

— Ed Lyons (@mysteriousrook) November 14, 2014

This is huge. Why?

Because Ed Lyons is the same guy who wrote The Health Connector Autopsy Report, which documented everything that went wrong with the MA ACA exchange project, from before the beginning until after the end. I mean, everything.

All 31,000 words of it.

It's difficult to get across just how in-depth, comprehensive or well-researched/documented that report is. It's also important to understand that a) to the best of my knowledge, like myself, Mr. Lyons didn't do it for money or for fun; it was something of an obsession for him. It should also be noted that Mr. Lyons is a Republican.

Lots of people have spent today saying stuff like this:

OK, the numbers have barely moved, and technically this update is missing 3 days (it only runs through 11/11 instead of 11/14), but MNsure has been the only exchange, federal or state, which has provided an almost odometer-like frequency of off-exchange updates.

Therefore, in a tribute to MNsure, here's their final 2014 QHP update before #OE2 kicks off:

Latest Enrollment Numbers

November 11, 2014

Health Coverage Type Cumulative Enrollments
Medical Assistance 234,751
MinnesotaCare 80,387
Qualified Health Plan (QHP) 55,900
TOTAL 371,038

  • QHPs wrap things up at 55,900 (adding 21 more people over 2 days)
  • Medicaid has added another 53 people
  • MinnesotaCare is actually down by...4 people. Presumably some family of 4 moved onto better times?

And that's a wrap, folks.

Yes, of course it's blank. As you can see, I'm doing things a bit differently this time around: I'm presenting the full enrollment period all at once (doable since it's only 3 months instead of 6), and I'm including the official "targets" from HHS, CBO and myself on the right side.

Underneath, just for posterity, I've posted the final version of the 2014 Graph.

This morning, even as I was posting my official 2015 QHP projection, Gallup came out with two important surveys regarding ACA exchange enrollees:

55% of Americans who currently lack insurance say they plan to sign up for coverage while 35% of the uninsured say they will not get insurance and instead pay the fine as required by the Affordable Care Act, also known as "Obamacare."

Regular readers know that the current QHP enrollment tally for the ACA, which started at around 7.1 million on May 1st (around 900K of the 8.02 million who enrolled through 4/19 never paid their first month's premium), gradually increased over the summer to a peak of around 7.3 million as of August 15th before dropping back again into autumn...right back down to around 7.1 million again as of October 15th.

At the time, ACA critics Megan McArdle and Bob Laszewski were speculating that there would likely be a substantial drop-off after the August peak due to the "3 month grace period" factor: That is, under the ACA, insurance companies aren't allowed to kick people off of their policies for non-payment of their premiums until after that payment is at least 3 months past-due. Their reasoning was that a whole bunch of people had enrolled in the spring, made a single payment but then blew it off for the rest of the summer, mooching 4 months worth of healthcare coverage for the price of one before getting kicked to the curb.

I thought it was an interesting theory which would have at least explained why the 7.3M figure was abruptly given out after months of radio silence from HHS. All year I've only found a single data point about the "3 month grace period" item: Arkansas, which reported only having 2.1% of their enrollees in that status a month or so ago. Still, 2.1% out of 7.3 million is 146,000 people, so it could have been substantial.

VT Digger, September 16:

The Vermont Health Connect website went down Monday night and will remain offline for several weeks to allow for improvements to the user experience and data security, state officials said Tuesday.

Customers who need to report changes in income or make changes to their coverage or personal information will need to contact the customer service call center.

Vermont Governor Shumlin, November 7th:

Gov. Peter Shumlin is “hopeful” that Vermont’s health care exchange website will be online in time for the open enrollment period that begins Nov. 15. But he didn’t sound certain Friday that his team will make the deadline.

“I’ve been discouraged so many times by this website that I’ll believe it when I see it,” Shumlin said on Vermont Edition Friday. “What I’ve been told by my folks who are working really hard on this is that we’ll be ready for open enrollment on Nov. 15.”

I've discussed the "OMG!! ELEVENTYBILLION POLICIES CANCELLED!!" issue many times before.

In the past, I've pointed out that the actual number of policies which were cancelled last year due to not being compliant with ACA requirements was far, far less than the 5, 6 or 7 million that people were hollering about. In the end it appears to only have been around 1-2 million at most, with the rest being extended by 1, 2 or 3 years via President Obama/HHS's "waiver/grandfathering" allowance.

Of course, that does mean that there will be another chunk of policies cancelled this year, and a smaller number next year, with perhaps a handful left over for 2016...at which point everyone should be on a fully ACA-compliant Qualified Health Plan (QHP).

I can't believe I missed this the other day.

When I posted about the HHS Dept. announcing that a) 7.1 million people were still currently enrolled & paying for exchange QHPs as of October 15 and b) that they also issued an official projection of somewhere between 9.0 - 9.9 million enrolling during the 2015 open enrollment period, I only saw what was included in the official press release.

However, it seems that, according to Politico, there was more to this story beyond the PR itself:

First of all, while the range given was between 9 - 9.9 million, apparently HHS Secretary Burwell is actually looking at the lower end of that range:

Speaking at a Center for American Progress event, she stayed on the smaller end of the range, identifying 9.1 million as the actual sign-up goal.

However, the more noteworthy part to me is this passage:

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