Most ACA critics now grudgingly admit that people are getting insured after all, but they say there's a catch. "Where are we going to get all the doctors?" a social worker asked me recently. "We're overwhelmed as it is." A letter in the local paper said, "People aren't really covered unless someone accepts their 'insurance', and if nobody is accepting it, then why should people pay for it?"
I briefly answered the letter writer online, saying that the solution was in the provisions of the Affordable Care Act to increase the primary care workforce, not only with more primary care doctors but also more nurses, nurse-practitioners and physician assistants. I was then curious to find out more about what the ACA has been doing to upgrade primary care in the U.S. and found that it has already made major improvements.
NewA couple of weeks ago I predicted the total January Private QHP enrollment number with accuracy that surprised even myself (I called it at precisely 3.3 million; it came in at 3,299,492).
I also gave airy, back-of-the-napkin predictions for February and March, figuring that February would come in at around 1.14 million in Febuary and between 1.5 - 2.0 million in March, for a final total of roughly 6.0 - 6.5 million enrollments. Note that this does not take into account the "paid vs. unpaid" factor, since some people won't be paid in full until mid- to late-April or beyond.
This just in...Kentucky's latest update has KY Private QHP enrollment up to 49,662 from 48,611 on February 1st (a modest 2% increase) and Medicaid enrollment up to 181,705 from 155,172 (a 17% increase).
231,367 Kentuckians are enrolled in new health coverage through @kynectky. If #ACA is repealed, 231,367 Kentuckians are SOL. #kysen
Maryland's Private QHP enrollment is up to 31,112 (up from 29,059 on 2/01), and their Medicaid/CHIP enrollment has increased to 52,091 people plus another 95,889 transfees from the Primary Adult Care program; this is up from 44,592 Medicaid + 95,824 PAC transfers a week earlier.
Through February 8, 31,112 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.
95,889 Marylanders signed up through the Primary Adult Care (PAC) program were automatically enrolled in Medicaid coverage on January 1, 2014, and now have full Medicaid coverage. As of February 11, 2014, an additional 52,091 individuals were newly enrolled in Medicaid effective January 1.
Now that the dust is settling on the January HHS Report and I've had a chance to fully tackle the "But how many have PAID???" issue, I decided this would be a good point to do some cleaning up of The Graph.
Secondly, now that I've switched both the Medicaid and Private QHP numbers over to a "range" format, I've decided to drop the Grand Total numbers from 2 decimal points to one (that is, the range is now 8.8 - 14.4 million instead of 8.78 - 14.46). All of the numbers involved are large enough now that it doesn't make sense to be so anal about it anymore (don't worry, the actual spreadsheets will remain as precise as I can make them).
Well how do you like that? Here I go and spend all morning crunching numbers, reviewing different state reports and so forth...and a few hours later the New York Times goes and makes my point for me:
WASHINGTON — One in five people who signed up for health insurance under the new health care law failed to pay their premiums on time and therefore did not receive coverage in January, insurance companies and industry experts say.
Paying the first month’s premium is the final step in completing an enrollment. Under federal rules, people must pay the initial premium to have coverage take effect. In view of the chaotic debut of the federal marketplace and many state exchanges, the White House urged insurers to give people more time, and many agreed to do so. But, insurers said, some people missed even the extended deadlines.
OK, now that the January numbers are out, let's take a look and see how the individual states are doing. The wonderful Kaiser Family Foundation has a much more sophisticated version of this, but my spreadsheet has two features theirs doesn't: Ugly color-coded cells...and more recent enrollment data for 13 states.
While including post-February 1st data fro some states but not for others does give a bit of an unfair advantage to those states, it's still worth taking a look at to see how the states are faring.
OK, the anti-ACA talking point of "How many enrollees have actually PAID???" has been one of the most commonly-made attacks on the exchanges since the first decent numbers started rolling in at the end of November. It seemed awfully silly back then, since at the time, the actual coveragestart date was still weeks away. Most people I know don't pay their utility or credit card bills until just before they're due, so it seems disingenuous to assume that a health insurance policy (which could be up to $1,000+ per month for some families) would be any different.
Here's what I said about the issue on January 2nd, right after the first wave of policies kicked into effect:
