Why has the law been such a flop in a state that had so much to gain from it? When I traveled across Mississippi this summer, from Delta towns to the Tennessee border to the Piney Woods to the Gulf Coast, what I found was a series of cascading problems: bumbling errors and misinformation; ignorance and disorganization; a haunting racial divide; and, above all, the unyielding ideological imperative of conservative politics. This, I found, was a story about the Tea Party and its influence over a state Republican Party in transition, where a public feud between Governor Phil Bryant and the elected insurance commissioner forced the state to shut down its own insurance marketplace, even as the Obama administration in Washington refused to step into the fray. By the time the federal government offered the required coverage on its balky HealthCare.gov website, 70 percent of Mississippians confessed they knew almost nothing about it. “We would talk to people who say, ‘I don’t want anything about Obamacare. I want the Affordable Care Act,’” remembered Tineciaa Harris, one of the so-called navigators trained to help Mississippians sign up for health care. “And we’d have to explain to them that it’s the same thing.”
OK, this is gonna be difficult for people to see, since the Medicaid spreadsheet is so wide (the link goes directly to the spreadsheet itself, which should help somewhat). First, scroll all the way to the right. Then scroll to the bottom. In the lower-right corner, you'll see the following:
Last week I crunched the numbers and pointed out that if the Republican Party ever successfully completes repealing the Affordable Care Act, tearing it out "root & branch" as Mitch McConnell is so fond of putting it, that 638,000 Michiganders would lose their healthcare coverage in one shot.
Beneficiaries with Healthy Michigan Plan Coverage: 433,469
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)
*Statistics as of October 27, 2014
*Updated every Monday at 3 p.m.
Yup. We're up to over 646,000 Michigan residents who'd be pretty much screwed if the GOP gets its way.
In spite of their ugly technical problems, Cover Oregon was surprisingly consistent and reliable with their off-season enrollment updates, issuing them about once a week throughout the entire spring and summer. This came to a halt on September 29th, however; they didn't issue any updates at all throughout all of October. I assumed that this was because they were too busy shutting down the state exchange and moving everything over to Healthcare.Gov for the 2nd Open Enrollment period, and I'm sure they are. However, tonight I was pleasantly surprised to see that they have issued one more update after all, taking things all the way through...today:
October 28, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon
Medical enrollments through Cover Oregon: 416,056 Total private medical insurance enrollments through Cover Oregon: 105,055
Oregon Health Plan enrollments through Cover Oregon: 311,001
When HHS Secretary Sylvia Burwell finally revealed that 7.3 million people were enrolled in policies as of August 15th, most of my assumptions were confirmed...except that the attrition rate, which I had been assuming was around 3% per month, now seemed to be even lower, at 2%. However, I wasn't sure about this until now.
Today I added a whole slew of updated state-level current enrollment numbers, and now I have these for 10 states, comprising nearly 3.2 million of the original 8.02 million enrollees through 4/19/14, or almost 40% of the total. This strikes me as being a pretty good base to extrapolate the other 40 states (+DC) from.
I addressed Nevada's apparent attrition rate about a month and a half ago. At the time, it appeared to be a fairly ugly 7.7% per month...relative to the "high water mark" of paid enrollments they had achieved in July of around 38,000.
However, since then I've realized that given the high amount of churn during the off-season as people enter and leave the marketplace, a far more accurate measure is the number of current enrollees relative to the April tally, since that was the "8.02 Million Total / 7.06 Million Paid" figure that everyone was focusing on anyway. Doing it this way is also far more consistent, since there's a hard 4/19 number to compare against for every state instead of it being all over the map.
In the case of Nevada, I've just received word that the current number of people enrolled in exchange QHPs is exactly 32,460 as of mid-October.
Rounding out today's "Net QHP Attrition Rate" Trifecta is Indiana, which, while not as deep-red as Tennessee, a) also has a Republican administration; b) hasn't expanded Medicaid; and c) refused to set up their own exchange.
This makes it all the more of a positive surprise to see that their ACA exchange QHP attrition rate is even lower than Tennessee--in fact, it's under 1%!!
Excellent news!! I've posted exactly one (1) Tennessee-specific blog entry since I started this site a year ago, having to do with TN's possible caving on Medicaid expansion. Aside from that, I've had bupkus outside of the official monthly HHS reports during the First Open Enrollment period (OE1)...until today.
Today I learned that the number of Tennesseans currently enrolled in QHPs (as in currently in-force policies) via the federal ACA exchange stands at 125,704.
Minnesota's exchange (called MNsure and pronounced to rhyme with "insure") has had it's share of technical problems, but they haven't been nearly as bad as the 4 state-run exchanges undergoing full overhauls (OR & NV are scrapping theirs entirely; MA & MD started over from scratch). They got hit with some bad news recently when the largest insurer on the exchange decided to bail, although that appears to have had more to do with that company's poor business decisions than anything on MNsure's side.
However, they've continued to keep chugging along, quietly adding more enrollees to both private QHP policies (via qualifying life events) as well as Medicaid and MinnesotaCare (neither of which have any deadlines involved). Most relevant to myself, they're also the only exchange which has continued to provide consistent, regular enrollment data updates on a near-daily basis, which is manna from heaven from my POV.
Last year, New Hampshire had but a single participant in the federal ACA exchange: Anthem BCBS. This year, not one, not two, not three, but four other companies have joined in:
Two more insurance companies say they plan to sell policies in New Hampshire’s health exchange in 2015, bringing the total to five carriers. The suddenly crowded field is a sharp contrast to this year, when only Anthem is offering policies through healthcare.gov.
Harvard Pilgrim and Minuteman Health, both based in Massachusetts, announced their intentions to join the exchange earlier this year, and now the New Hampshire Insurance Department says Assurant Health and Maine Community Health Options have also submitted plans for regulatory review.
We don't have a full average-premium percentage breakdown like there are for other states, but this is certainly promising:
