Yes, I'm quoted extensively in this CNBC piece by Dan Mangan, and yes, I rip on the HHS Dept. quite a bit in it (towards the end) for their continuing failure to issue monthly ACA enrollment reports during the off season. However, in terms of actual new enrollment data, there's a bit earlier in the story which caught my eye:

...at least 10 of those [state-run] exchanges have disclosed, at some point, how many people have paid their first month's premiums.

For example, a spokeswoman for Colorado's exchange, in a statement to CNBC, said: "As of June, we received data from the health insurance carriers that show 89.9 percent of Coloradans who purchased private health insurance through Connect for Health Colorado paid their first-month premium. There is some lag in data, so we anticipate that percentage may actually be higher ... we obtain this data from each of our 17 carriers and anticipate more complete information as we move forward."

A few days ago, AccessHealthCT (Connecticut's state-run ACA exchange) gave me their exact total enrollments as of 8/02: 250,633. Unfortunately, they were unable to provide a breakout between QHPs and Medicaid/CHIP enrollments. Yesterday the Hartford Courant reported a higher combined total:

Access Health CT, the state-run onlinehealth insurance marketplace created under the federal Affordable Care Act, has enrolled more than 256,000 state residents in private health plans or Medicaid since the website launched last fall.

The open enrollment period total of 218,100 (including everything through 4/19) broke out roughly 36:64. Assuming "more than 256K" is roughly 256,100, that means about 38,000 more people since then. If that ratio has stayed consistent, it should be around 13,700 QHPs and 24,300 Medicaid. However, as I noted the other day, with off season enrollment being limited for QHPs but open-ended for Medicaid/CHIP, the ratio has almost certainly shifted substantially in Medicaid's favor.

Hmmm...another unusual slowdown for Oregon; total QHPs are only up 873 since 7/28, and net QHPs are actually down 63, presumably due to purging of unpaid enrollments and cancellations of existing policies. Medicaid enrollments, meanwhile, are up another 499.

August 6, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 337,518
Total private medical insurance enrollments through Cover Oregon: 96,910      

Oregon Health Plan enrollments through Cover Oregon: 240,608
 

Dental enrollments 
Total private dental insurance enrollments through CoverOregon: 19,489

Net enrollments 
Net private medical: 82,305
Net private dental: 15,605

Me, June 26, 2014:

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. They don't have to make it that complicated...just have big Yes/No radio buttons once you log in that says "Have you had any significant changes in (income, dependents, etc...provide a list) since (date of existing policy enrollment)?" If no, then you click "Save" and you're done. If yes, then you go ahead and make whatever changes are necessary.

OK, they can't make it quite that simple because...read on...

Yesterday, the Big News on the ACA front was a new state-by-state survey from Gallup which showed the overall impact to date on total uninsured rates across the country.

Not surprisingly, the main takeaway, as noted by Jeffrey Young over at the Huffington Post, is that states which have embraced the law (Medicaid expansion, their own exchanges) have done a much better job overall of reducing their uninsured numbers than those which shunned it.

It's an interesting survey and an interesting piece, complete with a color-coded map which shows how the different states have fared (although I really wish they'd used higher-contrast colors; it's hard for me to distinguish some of the ranges from others).

However, there's one state which really stands out to me, and it's smack in the center: Kansas.

Yesterday I put out an open call for off-season QHP data from California, New York and Rhode Island, none of whom have released this info since 4/19 (Connecticut hasn't either...they gave me their combined total for QHPs + Medicaid, but I can't use that for a proper projection until I know the actual breakout between the two).

Today, thanks to Dara Chadwick of HealthSourceRI, I can cross Rhode Island off the list:

We had 25,767 total paid QHP enrollments during the open enrollment period, including all individuals who enrolled by March 31 and paid by April 23. 

As of August 2, 2014, 26,686 Rhode Islanders are enrolled in QHPs. Of those, 25,892 have paid.

OK, I'll have to reverse engineer things slightly here, since the paid number is given for both August 2nd and March 31st, but the total number is only given for August 2nd. Looking back at my last entry for Rhode Island, the 3/31 total was 27,968.

NOTE: I originally posted this as an update to my Florida rate increase entry this morning, but it's important enough that I figured I should repost it as a separate entry.

Thanks to Caitlin Sweany of PricewaterhouseCoopers for explaining an interesting discrepancy I noted in at least one state (my own state of Michigan). This is another example of how difficult it is to nail down the actual impact of these rate changes (and remember, in many cases these are still just requests, not approved rates, subject to change). Case in point:

According to the Detroit Free Press's original story on the subject, Michigan's "average" premium rates are only going up 0.8%. Yayyyy!!!

A couple of caveats: This report from private online insurance broker eHealth Insurance a) only reflects off-exchange enrollments, b) only includes people who enrolled through their brokerage, not directly via the companies themselves, and c) is, frankly, kind of difficult to actually read as presented, but contributor Esther F. noted an important section:

Outside of open enrollment, health insurance shoppers may only be able to purchase individual and family major medical coverage when they experience a qualifying life event such as marriage, divorce, the birth of a child, the loss of employer-based health insurance, etc. A June 2014 analysis of eHealth shoppers has shown that nearly half (49%) of those who reported a qualifying life event selected "loss of coverage" as the qualifying life event which they had experienced. More than one-in-ten (11%) indicated that they had moved to another city or state, while six percent (6%) indicated that they were recently married or divorced and three percent (3%) reported the birth or adoption of a child.

Most of the states which have released their proposed (or final) 2015 rates have looked pretty good so far, with Rhode Island (4.3%), Connecticut (appx. 4.5%), California (4.2%) and Oregon (6.8%) only going up between 4-7% on weighted average, and Mississippi actually seeing an overall weighted average decrease of around 2%.

The exceptions to date include Michigan (9.4%), New York (13.4%)...and now, it appears, Florida:

Floridians who buy health insurance on the individual market for next year will face an average increase of 13.2 percent in their monthly premiums, according to rate proposals unveiled Monday by the state’s Office of Insurance Regulation.

Of the 11 returning plans, eight filed average rate increases ranging from 11 to 23 percent, and three filed rate decreases ranging from 5 to 12 percent, the state’s insurance regulator reported.

Minnesota keeps cranking along, up another 310 QHPs and 4,888 Medicaid/CHIP enrollments in the past week.

latest enrollment numbers

August 3, 2014

Health Coverage Type Total Enrollments 
Medical Assistance 165,740
MinnesotaCare 60,435
Qualified Health Plan (QHP) 53,169
TOTAL 279,344

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