On the one hand, this has nothing to do with the ACA whatsoever.

On the other hand, in a weird sort of way it has everything to do with it.

Last night, the town of Ferguson, Missouri turned into a warzone. I've never seen anything like it...at least here in the U.S. A few days after police gunned down an unarmed black teenager (possibly shooting him in the back) and the refused to release the name of the officer who shot him, I watched live video of the St. Louis County PD very much unallegedly demanding that the news media turn off their cameras, fire tear gas and rubber bullets into an unarmed, fairly peaceful crowd and people's yards and generally terrorize the very populace that they're supposed to be protecting.

And in the middle of this utter mess, White House Principal Deputy Press Secretary Eric Schultz decided it was the perfect time to tweet the following:

Readout of tonight's social gathering coming shortly - spoiler alert: a good time was had by all.

— Eric Schultz (@Schultz44) August 14, 2014

...One of the scariest claims was that premiums were going to shoot up because only the sick and the old would sign up. The danger, of course, was that this would set off the so-called death spiral, where high prices prompt people to drop their coverage until eventually the whole project collapses in failure and shame.

...Here we are five months later, and those insurance officials have begun reporting their premium increases for next year. To put it mildly, those increases do not seem to fit the definition of “skyrocketing."

...The average national increase of 7.5 percent is “well below the double-digit increases many feared,” [PwC] HRI Managing Director Ceci Connolly wrote in ane-mail.

Needless to say, this is quite a bit different than the scenario the Hill laid out in March. A 7.5 percent average increase is somewhat smaller than the 100 percent increase the newspaper was predicting only five months ago.

The only caveat here is that the 7.5% average only covers 27 states; according to PwC researcher Caitlin Sweany, the overall average is actually a bit higher:

This Just In...

I just received a press release from the Centers for Medicare & Medicaid Services (the HHS division which actually operates the federal ACA exchange). The short version: Out of around 970,000 citizenship/immigration data matching issues as of May, they've managed to successfully resolve 450,000 of them and are in the middle of processing another 210,000.

Unfortunately, this means that 310,000 people still have their status in limbo, so they're re-contacting all of them by mail to resolve whatever their issues are by the end of September, or they'll have their policies cut off:

CMS NEWS
FOR IMMEDIATE RELEASE Contact: CMS Media Relations

August 12, 2014 (202) 690-6145

Federal Health Insurance Marketplace: Send in Requested Documents Now to Keep Marketplace Coverage

Administration has closed approximately 450,000 citizenship and immigration status data matching cases and another 210,000 are in progress; warns remaining consumers to respond quickly or their Marketplace coverage could end

Minnesota's QHP enrollment rate is starting to slow down again, but ACA Medicaid enrollments continue at a brisk pace:

enrollment update

latest enrollment numbers

August 10, 2014

Health Coverage Type Total Enrollments 
Medical Assistance 170,470
MinnesotaCare 62,172
Qualified Health Plan (QHP) 53,396
TOTAL 286,038

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 355,699
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of August 11, 2014 
*Updated every Monday at 3 p.m.

Thanks to Charles Ornstein for giving me a heads' up about an article in Yahoo Finance (reposted from Investors Business Daily) today, which has a rather loaded headline and lede:

ObamaCare Enrollment Falling Significantly, Insurers Reveal

ObamaCare exchange statistics should clear up any doubt as to why the Obama Administration has been tight-lipped about enrollment since celebrating 8 million sign-ups in mid-April.

Reality, evidence suggests, could require quite a come-down from those lofty claims.

The nation's third-largest health insurer had 720,000 people sign up for exchange coverage as of May 20, a spokesman confirmed to IBD. At the end of June, it had fewer than 600,000 paying customers. Aetna expects that to fall to "just over 500,000" by the end of the year.

Yup, on the surface that does look pretty bad. Or, at least, it would, if a) that was representative of the trend as a whole and b) if I hadn't already addressed the "attrition" factor several times in the past.

OK, I still have to plug the numbers into the spreadsheet, but here's the major takeaways:

  • Across the 49 states (including the District of Columbia) that provided enrollment data for June 2014, states reported that approximately 66 million individuals were enrolled in Medicaid and CHIP. [actual: 66,112,314]
  • 602,210 additional people were enrolled in June 2014 as compared to May 2014 in the 49 states that reported both June and May data.
  • ...approximately 7.2 million additional individuals are enrolled in Medicaid and CHIP, a 12.4 percent increase over the average monthly enrollment for July through September of 2013.
  • Among states that adopted the Medicaid expansion and whose expansions were in effect in June 2014, Medicaid and CHIP enrollment rose by over 18.5 percent compared to the July- September 2013 baseline period, while states that have not, to date, expanded Medicaid reported an increase of approximately 4 percent over the same period.
  • These enrollment counts are in addition to the enrollment increases from the nearly 950,000 individuals who gained coverage as a result of the Affordable Care Act before open enrollment began. Seven states implemented an “early option” to expand Medicaid coverage to adults with incomes up to 133 percent of the FPL between April 1, 2010 and January 1, 2014, using new state plan authority provided by the Affordable Care Act or a Section 1115 demonstration building upon that authority.

When we last checked in on Arkansas, they had enrolled 185,000 people in their unusual "Private" Medicaid option program via the ACA. That number has since grown to over 192K:

According to the latest information released by the Department of Human Services today, 192,210 Arkansans have gained coverage via the private option, the state's unique version of Medicaid expansion which uses Medicaid funds to purchase private insurance for low-income Arkansans. This includes both beneficiaries enrolling in a private plan and those deemed medically needy and routed to the traditional Medicaid program (around 11 percent of the total). 

In this case it's important to note that these folks have actually gained coverage already. That is, this doesn't include people still "in process" etc. With appx. 225,000 Arkansans eligible for the program, that means AR has reached over 85% of the total possible.

Mitch McConnell just had 71,000 more headaches dumped on him.

OK, I can't embed the video and even the link above just goes to the general Hardball video archive page, but on MSNBC's Hardball this evening, Kentucky Governor Steve Beshear gave an updated total for ACA enrollments via the Kynect exchange: 521,000 Kentuckians. The exact quote, about 2 minutes into the segment:

“The numbers speak for themselves...from the time we opened up our healthcare exchange on October 1 at 12:01am, Kentuckians started swarming all over that website, and today, 9 months later, 521,000 Kentuckians, almost 1 in 10 Kentuckians have signed up for affordable healthcare coverage.”

He repeated the 521K number not once more but twice; obviously this was the key talking point he wanted to emphasize. Unfortunately, as has been typical for Kentucky since the end of open enrollment, he didn't break out QHPs from Medicaid/CHIP enrollments.

Chris Conover and I have developed a sort of grudging respect for each other. This evening he asked me why I use a blanket "90% Paid" estimate for the states for which I don't have any hard data, instead of running a weighted average of the data I do have and using that. This is a fair question.

I partially answered it in an entry from about a week ago, in which I noted that if you average the numbers for the 18 states which have provided at least 1 payment rate update since the end of open enrollment:

...Add all of these up and you get a total of out of 2.542 million out of 2.932 million, or 87%...and again, take a look at how out of date most of those numbers are (especially California, which makes up almost half of the total, yet hasn't been updated since April 21st...a solid 9 days before hundreds of thosuands of their policies even started coverage!).

Once again, I'm quite confident that the true eventual number is around 90%.

Pages

Advertisement