As I noted this morning, the Maryland Health Exchange has released an updated enrollment report running through the end of May (the June report will be out at the end of July):

As of May 31, 300,310 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage. 
As of May 31, 72,207 individuals have enrolled in a qualified health plan. 

Compared with the previous report, MD had a 4,300 QHP increase from 5/10 - 5/31, and an increase of 4,450 since the end of the open enrollment period. This means that they're averaging around 106 per day, or 31% of their average rate during open enrollment...which has had a significant impact on the Off-Season Projection Chart that I started posting yesterday (as you can see, MD had been only running 2% of the OE rate until now).

Not sure how I missed this yesterday; thanks to Steve C. for the heads' up:

The Obama administration on Thursday plans to issue much-anticipated instructions for Americans to reenroll for next year in the new federal health insurance marketplace — a set of rules intended to make it easy for consumers but that nevertheless will require some people to reapply through to preserve their subsidies or coverage.

Under the rules, people will need to do very little to remain in their health plans if their incomes and covered family members are not changing and their plans are offered again for 2015.

All 17 of the insurance companies participating in the federal ACA exchange this fall for Year Two of open enrollment have released their preliminary rate requests for 2015. It's important to stress preliminary, since the rates still have to be approved by the HHS Dept. Update: State insurance commissioner.

There could be some sticker shock, but some welcomed price cuts as well, when consumers go shopping for insurance this fall on the Michigan Health Insurance Marketplace, according to numbers the state released earlier today.

Overall, it appears that Michigan’s proposed average rate increase of just 2.2% is modest compared to changes in some other states, according to an ongoing analysis by consultant PricewaterhouseCoopers that so far has compared insurance pricing on more than a dozen state marketplaces.

That means the average premium cost in Michigan — $326.74 — remains lower than the national average premium of $360.

...At least four companies propose boosting premiums 9% or more, while others plan to slash those monthly costs by double-digit percentages. (See table: 2015 Michigan health insurance rates)

I gave a general overview of the reasoning behind my 200K - 300K per month off-season QHP enrollment estimate a couple of weeks ago, but I didn't get around to actually plugging the numbers into a spreadsheet and running the calculations until today. Here's where things currently stand:

As you can see, just as I did with my enrollment period projections (which were consistently proven to be 99%+ accurate), I'm using the data provided by the state-run exchanges since April 19th as the basis for my "off-season" projections. Unfortunately, not only is the HHS Dept. refusing to provide their monthly enrollment reports during the off season (which I've ranted about several times), but New York isn't doing so either (I already asked), and so far there's no word from California, Connecticut, Rhode Island or Vermont.

Only 58 more QHPs but, interestingly, 104 more people on SHOP plans...

Connector Updates for June 21, 2014

32,802 Applications completed in the Individual Marketplace
9,586 Individuals and families enrolled in the Individual Marketplace
643 Employers applied to SHOP Marketplace
965 Employees and dependents enrolled via SHOP Marketplace

Over the years there have been a whole mess of court cases challenging the ACA, either en masse or sections thereof, and most of them have either been dismissed or absorbed into the law. The most famous of these was NFIB v. Sebelius, otherwise known as "the SCOTUS decision which upheld the ACA overall but made Medicaid expansion optional instead of mandatory."

Basically, the SCOTUS ruled that Congress couldn't enforce the individual mandate using a financial penalty, but it was all good because it isn't really a penalty, it's a tax, which Congress has every right to impose. Yup, the entire law hung in the balance over the semantics of a single word, which happens more often in court cases than you'd think.

However, there's still a half-dozen assorted cases left to be decided, and while most of them nibble around the edges of the law, one of them could potentially cause an epic clusterf*ck if it's successful: Halbig v. Burwell.

Three stories which didn't seem worthy of their own full blog entry but each of which are pretty interesting...

Washington State, 06/25/14: Kreidler calls for health insurers to end discrimination based on gender identity

OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler is asking all health insurers doing business in Washington state to end discrimination in health insurance based on gender identity and related medical conditions.

In a letter sent to health insurers this morning, Kreidler reminded health insurers that exclusions and denials of coverage on the basis of gender identity are against the Washington Law Against Discrimination (RCW 49.60) and the federal Affordable Care Act (Section 1557).

...“Transgender people are entitled to the same access to health care as everyone else,” said Insurance Commissioner Mike Kreidler. “Whether specific services are considered medically necessary should be up to the provider to decide on behalf of their patient.”


I contacted the NY State of Health exchange a couple of weeks back and spoke a couple of times with a very nice media relations woman who explained that yes, a highly-detailed, comprehensive enrollment report would be released sometime in late June, but that no, it wouldn't include any information about exchange enrollment since the end of the first Open Enrollment period (ie, the extension period which ended on April 15th).

She said that she'd see about trying to get "off season" enrollment data back on the agenda, but just like the HHS Dept. running 36 other states, it looks like NY has decided not to bother. This leaves me crossing my fingers that California will release their off-season data sometime soon; since CA handles almost 20% of the total enrollments by itself, that (combined with the other half-dozen state exchanges providing regular updates) should be enough to extrapolate for the rest of the country. NY is the 2nd largest exchange, however, so it would've been helpful if they'd done so as well.

Not much time to post today, but remember all the fuss & bother about how the ACA was going to cause massive increases in healthcare spending? Yeah, about that...

Pretty much everyone was stunned to see Q1 GDP growth slashed to -2.9% from an earlier estimate of -1.0%.

The revision largely boils down to one thing: healthcare spending.

"Two thirds of the revision is in consumption, cut to +1.0% from +3.1%," said Pantheon Macroeconomics Ian Shepherdson. "Almost all of this huge hit is in the healthcare services component, cut to -1.4% from +9.1%."

According to the BEA, healthcare spending went from adding 1.01 percentage points to subtracting 0.16 from the headline GDP growth number.

"So much for the BEA's initial view that the start of Obamacare triggered a surge in spending on healthcare," said Shepherdon. "The press release offers no detail on what triggered this massive revision."

Yesterday I tore apart a rather idiotic story by Sharyl Attkisson at the Daily Signal in which she bullshits her way through various ACA numbers, culminating in a completely absurd "infographic" which I helpfully corrected for her (so far she has yet to thank me for the assist).

Today I see that Hannah Bleau of the Daily Caller picks up Attkisson's ball o' crap and runs with it. I really don't have time to do another takedown today, so instead I'll just present two screen shots.

The first is the headline itself:, Ms. Bleau, there has been no survey released which has made any such claim whatsoever. The Kaiser Family Foundation survey you're referring to states that 57% of the people who enrolled in QHPs via the ACA exchanges were previously uninsured. That is, 57% of the 8.02 million people who enrolled via the exchanges, or around 4.6 million (or, if you subtract those who haven't paid their first premiums yet, around 4.1 million).