Thanks for Chris Savage of Eclectablog for reminding me to check in on the latest Medicaid expansion numbers here in Michigan...

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 385,541
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of September 15, 2014 

Yup, that's up another 9,800 in the past week. With roughly 500,000 Michiganders eligible for the ACA Medicaid expansion program, my state has reached 77% of the total potential enrollment in just 5 1/2 months.

As expected, right on the heels of the CDC report comes the Census Bureau report:

The percentage of people without health insurance coverage for the entire 2013 calendar year was 13.4 percent; this amounted to 42.0 million people.

Remember, that's before any of the ACA exchange enrollments took effect starting in January 2014, and is also before any Medicaid expansion took effect (also January 2014 for most states; Michigan didn't start until April, and New Hampshire didn't start until July).

It's important to note that the Census Bureau has changed their methodology with this report, so it's difficult to do a true "apples to apples" comparison with prior years. However, they do include the following note:

According to the American Community Survey, the percent of people without health insurance coverage declined 0.2 percent between 2012 and 2013.

So, as Dylan Scott at TPM noted yesterday (and as I noted in kind), the Census Bureau is expected to release a Big Report at 10am with insurance coverage data. However, it turns out that the CDC (Centers for Disease Control) beat them to the punch by releasing their own report at midnight:

Obamacare cut the share of people in the U.S. without health insurance by two percentage points this year, the Centers for Disease Control and Prevention said in a report today.

In the first three months of 2014, 18.4 percent of adults under age 65 lacked health insurance, down from 20.4 percent last year, according to the CDCsurvey. The fall in the uninsured rate was helped by 3.7 million people who bought private health insurance sold under the Patient Protection and Affordable Care Act, the CDC said.

So, here's the big news from CMS/HHS today: Remember the 966,000 people whose citizenship/immigration data didn't match up last May? Well, they've managed to resolve about 851,000 of those cases, yay! Also, remember the 1.2 million households with discrepancies regarding their income levels? Well, that represented about 1.6 million actual people, and they're reporting having resolved about 897,000 households, leaving around 279K to go (representing 363,000 individuals).

Assuming these numbers don't overlap (and they probably do in a few cases), that means CMS has worked through about 2.088 million data discrepancies, leaving around 478K to go. So...yay, team and all that.

As for those who remain, the 115K with immigrant/citizenship status issues need to send their correct documentation to Healthcare.Gov by the end of September to avoid losing coverage. They did say that there would be some sort of special enrollment period for those folks as long as they keep paying their premiums, but they were pretty clear about the September 30th deadline.

Two Big ACA-related Announcements are coming up in the next 24 hours; one is pretty much meaningless, the other could be meaningful:

First, as reported by Dylan Scott over at TPM:

At 10 a.m. Tuesday, the Census Bureau will release a new report on health insurance in America.

...The problem with the new numbers, according to the Kaiser Family Foundation's Larry Levitt, is that the Census Bureau's survey cuts off at March 31. That means 3 million people-plus who signed up in the law's final weeks of enrollment will still count as uninsured, even though they have since been covered.

"I think it’s fair to say tomorrow’s release will be essentially meaningless in judging the effects of the Affordable Care Act," Levitt told TPM in an email.

  • 1. October 2013: "No one can enroll!!"

(ok, this one is a gimme; the technical mess at and some of the state exchanges did make it almost impossible for anyone to sign up the first month.)

  • 2. November 2013: "No one will enroll!!"

...which was clearly already being proven wrong by the time Thanksgiving rolled around.

  • 3. December 2013: "Hah! They'll never break a million!!"

...that is, until the Christmas/New Years spike, which brought the total enrollee figure up to over 2.1 million.


...which actually turned out to be only around 1-2 million people at most, the vast majority of which (including myself) simply swapped out their old policies for new ones.

Me, June 26:

As an aside, I also question the wisdom of not requiring everyone to re-enroll each year. Obviously HHS is trying to minimize the inconvenience/hassle factor, but it seems to me that this is just going to cause even greater confusion than it would if they simply issued a blanket statement: If you enrolled via an ACA exchange, you have to renew once a year even if nothing else has changed.

I don't see doing this as a big deal; people have to renew their license plates every year even if it's for the same car, for example.

Sam Baker, National Journal, August 6th:

"We get into a very dangerous situation if we just tell everybody they can just auto-enroll," Houchens said.

Again, all of this is avoidable. These are the risks of auto-renewal. Anyone who goes back in to to get a new eligibility determination will see their updated subsidy as well as the current list of available plans.

I'm about to show you a chart which demonstrates several noteworthy things about QHP enrollment in Oregon (which, in spite of the terrible technical problems their site has had, has managed to enroll a similar ratio of their uninsured residents in private policies (around 34%) via their exchange to Kentucky, which is considered one of the most successful exchanges).

First, here's the latest numbers, as of 4 days ago:

September 10, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 353,454
Total private medical insurance enrollments through Cover Oregon: 101,092

Oregon Health Plan enrollments through Cover Oregon: 252,362*

*OHP enrollment data is current as of August 13, 2014. An updated number will be posted soon.

Dental enrollments 
Total private dental insurance enrollments through CoverOregon 1: 20,686

Net enrollments 
Net private medical: 78,616
Net private dental: 14,603

1 Total numbers are the number of enrollments that have occurred through Cover Oregon.

Last week I noted that the "OMG!! GAZILLIONS OF POLICIES CANCELLED!!!" freakout over non-ACA compliant healthcare policies being sunsetted to be replaced by policies which are compliant with the law is about to raise its ugly head again this fall. Sure enough, we're off and running in Virginia:

After a year’s reprieve, up to 250,000 Virginians will receive notice by the end of November that their health insurance plans will be canceled because the plans do not comply with the Affordable Care Act and accompanying state law.

The affected policyholders were allowed to renew their old plans late last year, even though the plans did not provide all of the benefits required under the health care law, but they won’t have that option when the policies expire this year.

I went with 240K instead of 250K because later in the article it says:

OK, I admit that aside from tracking the actual enrollee numbers, I don't know a whole lot about the inner workings of Medi-Cal, California's version of Medicaid. However, if accurate, this just sounds...wrong:

California Governor Brown Still Wants to Steal My Home

I posted a diary here on August 26 about California turning Medi-Cal into a long term loan for recipients aged 55+ by billing their estates after they die for all of their Medi-Cal expenses.  The bureaucrats call that “estate recovery.”  I call it legal theft. A bill to remedy this situation and protect low income property owners has unanimously passed the California legislature. The bill has now gone to the governor to be signed. But he is  planning to veto it!

Today, many organizations are jointly sponsoring a call-in to the governor's office to put pressure on Governor Brown to sign SB 1124.  More information about the call-in is at the bottom of this diary.  But first, some background information.