OK, I've had a chance to download the actual Excel file with the raw data and a handy graph already set up; I've cleaned up and color-coded the graph, and it's fascinating to look at, both during open enrollment as well as since it ended The things which stand out the most:
The obvious dead zone in October and most of November, finally coming to live around Thanksgiving time
The gradual rise in December, culminating in a large spike on Christmas Eve (the "official" deadline for January 1st coverage, although that varied in some states)
The massive spike in late March, culminating in a nearly off-the-chart peak on the "official" open enrollment deadline of March 31st, which saw over 200,000 transactions by itself
Yes, I'm quoted in this breaking story; Mr. Ornstein contacted me earlier today to ask my thoughts on his scoop, and I agreed to keep mum until it went public:
For months, journalists and politicians fixated on the number of people signing up for health insurance through the federal exchange created as part of the Affordable Care Act. It turned out that more than 5 million people signed up using Healthcare.gov by April 19, the end of the open-enrollment period.
But perhaps more surprising is that, according to federal data released Wednesday to ProPublica, there have been nearly 1 million transactions on the exchange since then. People are allowed to sign up and switch plans after certain life events, such as job changes, moves, the birth of a baby, marriages and divorces.
Now, before everyone jumps on the "1 million" figure, a few important things:
When I posted my dumb-simple solution/workaround to resolve the Halbig decision back on July 2nd (assuming that it's upheld, which is by no means guaranteed), I meant it seriously, but figured that no one else would. I mean, really...the salvation of the most important healthcare law of the past 50 years and the single most important accomplishment of the Obama administration could end up being as simple as registering 3 dozen domain names and putting up a splashpage?
First, remember the news from yesterday that the ACA had lopped California's uninsured rate in half, from 22% down to 11% as of June? 22% of 38 million people = about 8.36 million; half of that is 4.18 million.
Next, remember that massive backlog of 900,000 new Medicaid (aka Medi-Cal) enrollees that California was working with as of the end of May?
For months, the state has labored under the largest such pile-up in the country, with 900,000 pending cases reported in May—the combined result of unexpectedly high application numbers and bug-ridden computer systems.
Regular readers of this site know that I have a checkered history with Forbes writer Chris Conover. It's been mostly on the hostile side, but he's also occasionally brought up a valid point which I've incorporated into my estimates; in particular, the "Sub26er" estimate has been changed from a flat 3.1 million to a range between 1.6 - 3.1 million in part due to his information (as well as Glenn Kesslers'). I believe the term which applies on both of our parts is "grudging respect" though I could be wrong at his end.
Thanks to the Washington Post's Greg Sargent for the heads up on a new national CNN poll about the ACA. Here's the key findings...and kudos to CNN for clearly distinguishing between those who oppose it for being "too liberal" (which basically means they don't like Medicaid expansion and tax subsidies) and those who oppose it because they want Single Payer (which includes myself, although that doesn't mean I oppose the law, since I see it as a path towards single payer):
According to the poll, only 18% of the public say they or their families are better off now that the major provisions of the health care law have been implemented. Another 35% report that, while their lives have not improved, the Affordable Care Act has benefited other people in the U.S. Add those two numbers together, and that means 53% say that Obamacare has helped either their families or others across the country.
OK, that may seem like an awkward way of shoehorning the Halbig decision into what's otherwise a simple state-level enrollment update entry, but the two are joined at the hip, since the state in question (Arkansas) happens to be one of those being run through Healthcare.gov:
A total of 185,000 persons have enrolled in expanded Medicaid and another 40,000 have bought insurance in the Obamacare exchange—together nearly half of all the previously uninsured citizens in Arkansas. When the new governor takes office, some 215,000 will be enrolled in expanded Medicaid alone. Will Hutchinson and, indeed, most Republican legislators want to end medical coverage for so many of their neighbors and constituents?
OK, now that I've showered, dressed and eaten lunch, let's see what the latest Halbig developments are (I'll explain below just why I didn't pounce all over the story this morning):
President Obama’s healthcare law was dealt a new blow Tuesday as a federal appeals court ruled that due to a wording glitch in the Affordable Care Act, some low- and middle-income residents are not entitled to receive government assistance to subsidize their insurance.
In a 2-1 vote, a panel of judges on the U.S. Circuit Court of Appeals for the District of Columbia rejected the Obama administration’s argument that the problem was triggered by imprecise language in the complex law and that Congress had always intended to offer the subsidies nationwide to low- and middle-income people who bought insurance through one of the state or federal health exchanges created under the law.
OK, I'll have much more to say about today's Halbig decision this afternoon, but for the moment, let me just repost a press release, verbatim, from the campaign of Mark Totten, presumptive* Democratic nominee for Attorney General here in Michigan:
(*ok, technically he's not the nominee until after the MDP convention next month, but I'm pretty sure he's uncontested).
Schuette Forces Massive Tax Hike on Working Michigan Families
July 22, 2014
FOR IMMEDIATE RELEASE
Mark Totten for Michigan Attorney General
July 22, 2014
Schuette Forces Massive Tax Hike On Working Michigan Families
Federal court backs Schuette’s crusade to raise taxes by nearly $5,000 on a half-million Michigan families, while shipping Michigan tax dollars to California and New York
...however, I just finished mowing the lawn and am grungy as hell at the moment. I'll read up on the decision and write something more substantive later on today.
In the meantime, here's the three posts I've written about it so far...
Speaking of which, my potential dumb-simple solution to the problem has been lent support by none other than Larry Levitt of the Kaiser Family Foundation:
If Halbig stands, the administration could try to make it easy for states to set up state exchanges with a http://t.co/GH5hnakhxX back-end.
