Minor update out of the only state whose ACA exchange is still officially open: QHPs up around 1,400, paid up around 200 since last week:

Update as of 5/10: 47,245 Nevadans confirm Qualified Health Plan selections. 35,034 have paid.

— Nevada Health Link (@NVHealthLink) May 14, 2014

Minnesota's official exchange QHP tally has dropped by a whopping...9 people  since the end of April. Meanwhile, their Medicaid tally has shot up another 10,262 people:

As of 5/13:

  • 120,749 Medical Assistance
  • 50,540 QHP
  • 45,121 Minnesota Care
  • Shop: 761 x 1.8 = 1,370

Not exactly the most shocking headline of the day, but this is still a great story by Jason Millman of the Washington Post (full disclosure: Millman wrote a nice feature piece about me a few months ago):

The Hospital Corporation of America, which has facilities in 20 states, reported a big gap in Medicaid and uninsured admissions between expansion and non-expansion states. In the four states it operates where Medicaid expanded under the ACA, the company saw a 22.3 percent growth in Medicaid admissions, compared to a 1.3 percent decline in non-expansion states. The company also had a 29 percent decline in uninsured admissions in the expansion states, while non-expansion states experienced 5.9 percent growth in uninsured admissions, chief financial officer William Rutherford said.

I may have had some issues with Avalere Health's methodology in the past, but they're pretty well respected in the industry, and they've certainly brought up legitimate issues with my own methodology as well (they're the ones who pointed out that the early version of my Medicaid/CHIP estimates was mixing "baseline churn" into the mix, which has since been corrected).

Anyway, they're out with an interesting new study which estimates that there of those newly-added to the Medicaid/CHIP roles, roughly 550,000 of them--specifically in the 24 NON-expansion states--rightly belong in the "woodworker" category: People who already qualified for Medicaid under the pre-ACA rules, but who didn't enroll until after October 1, 2013 for any number of reasons (not knowing they qualified, not knowing how to apply, being embarrassed about doing so, etc). Since the ACA exchanges also included a massive education/outreach effort (some of which even spilled over into the states which didn't expand the Medicaid program), and since the application process was streamlined in many states as part of the law, these folks who "came out of the woodwork" to enroll in Medicaid are rightly considered part of the success of the ACA specifically.

Some more fantastic numbers out of Ohio after the earlier ones from Michigan: 185K strict expansion, 124K woodworkers and another 146K in the works:

Through April though, 184,671 newly eligible applicants were approved for coverage, the state said Monday.

About 563,000 Ohioans became eligible for Medicaid when the state agreed to accept federal support provided under the Patient Protection and Affordable Care Act to pay for broadening the health insurance program. The change raised the household income eligibility limit to include families earning up to 138 percent of the federal poverty rate -- about $32,500 for a family of four. They became eligible for coverage in January.

Another 124,195 people, meanwhile, were also added to Medicaid when it was determined they qualified for the program under the old guidelines. State officials had said they expected the public attention on expanding Medicaid would also draw in people who were already eligible but who had not signed up.

...But about 146,000 applications from that time period are still being processed and could add to the totals.

Michigan may have been 3 months late to the Medicaid expansion game, but once we got started, things really took off. The original target was 320,000 adults in the state...and MI has already reached over 74% of that goal:

Healthy Michigan Plan Enrollment Statistics
Total Healthy Michigan Plan Beneficiaries: 237,329

*Statistics as of May 12, 2014 
*Updated every Monday at 3 p.m.

My own calculations (based on KFF.org data) give the total number of Michigan residents eligible for Medicaid expansion as about 500,000; even at that number, 237K still represents over 47%, which is fantastic.

My estimate for "woodworkers" in non-expansion Georgia has been around 63,000 people; this article pretty solidly places that number at about 1/3 higher: 91,000 to date:

As of Thursday, DCH has received more than 40,000 “account transfers” from the exchange, “with about 2,000 arriving every hour,’’ an agency spokeswoman, Kallarin Richards, told GHN.

These potential sign-ups in Georgia have been stalled for months due to technological snags.

Community Health said Friday that it’s waiting until all of the transfers have been received from the exchange before processing them. “This will ensure DCH is working from the most recent data and can identify any duplicative applications that may exist,” Richards said in an email.

Federal health officials recently reported that more than 91,000 Georgians were identified through the health insurance exchange as eligible for Medicaid or PeachCare.

Looks like last week's claim of 9,800 QHPs was a bit of an error...according to the official exchange update, the combined total of QHPs + SHOP enrollments is around 9,800:

Total since October 1, 2013

31,378 Applications completed in the Individual Marketplace
9,217 Individuals and families enrolled in the Individual Marketplace
588 Employers applied to SHOP Marketplace
628 Employees and dependents enrolled via SHOP Marketplace

BCBSNC reports 232,000 QHPs sold on the ACA exchange...but that's out of about 273,000 total enrollees; they've removed the other 15% who haven't paid their premium yet:

The Blue Cross enrollments reflect insured customers who signed up from October through May 1 and are still paying premiums. About 15 percent of customers who signed up never paid a premium and are not included in the 232,000 figure, Burke said. 

So, fine: 85% for Blue Cross of NC. As it happens, NC sold a total of 357,584 policies total, which means BCBSNC sold over 76% of the total.

Now, it's conceivable (but not likely) that 100% of the remaining 84,500 enrollees snapped up by other companies did pay their premiums, but even so, that would only bring the paid percentage up to about 88.5%. So, I think it's safe to say that for North Carolina, 85% is a reasonable "How many have PAID???" figure for the full state until more solid numbers are released.

OK, I know I recently posted my "final" update to The Graph for the first Open Enrollment period...but I included an asterisk next to "final" for two reasons: First, because there will obviously still be more enrollments added throughout the summer and fall (Medicaid, SHOP, etc); second, because I've been debating one other major addition for awhile.

As regular readers know, when the famous RAND Corp. survey came out a month or so ago, there was a lot of hubbub about their claims of up to 7.8 million OFF-exchange QHPs between October and mid-March. I made a note of this figure, but eventually downshifted in favor of the 5 million off-exchange QHP figure estimated by the CBO.

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