Well, that just figures. Right after I post a screed whining about the lack of big numbers since New Year's--in which I specifically call out the DC Health Link for not releasing any data since mid-November--what happens? Whammo: Private enrollments have skyrocketed from 1,115 on Nov. 15 to 15,613, a whopping 14x increase. They also released the first Medicaid expansion figure at all, since neither the HHS nor anyone else has had a number for that since the exchanges lauched on October 1st: 4,677 people.
Amusingly, it looks like the majority of enrollments (up to 10,000 of the 12,000 small business enrollments) were from Congressional staffers who were, ironically, required to do so due to a clause insisted upon by Congressional Republicans.
The top line talking point: More than 20,000 people have secured medical coverage.
But nearly 60 percent, or 11,967, enrolled through the small business side of the exchange, which is designed for companies with fewer than 50 workers but also — via the Republican amendment and Obama administration rules — Congress.
After the massive spike in enrollments seen in mid- to late December, regular site visitors might be a bit disappointed at the relative dearth of increases since New Year's. There have actually been quite a few updates, including several impressive percentage increases, but the actual numbers involved have been relatively small compared to the massive jumps seen just a few weeks ago. In short, you're probably wondering why the total number of private enrollments which shot up to 2.1 million in late December only seems to have gone up about 80,000 more since then.
There are three reasons for this:
First, obviously there was a tremendous sense of urgency for people to enroll in time for January 1st coverage. A drop-off after Christmas has long been expected, although this has been a bit fuzzy as the actual enrollment deadline bounced around, from 12/15 to 12/23, then 12/24 (for most states), then 12/27 or 12/31 for a handful, and finally as late as 01/06/14 for Oregon.
Ironically, even though the article itself is primarily about Medicaid expansion in Nevada (from a newspaper in Georgia), I can't actually use the Medicaid numbers provided since they're fuzzy. It does, however, give slightly higher numbers for private enrollments in NV.
It also mentions 23,000 dental plans, which I'm not even covering. In other news, the spreadsheet includes minor corrections to both Colorado (private enrollment typo had it off by 10) and Minnesota (I had MN down as 26,001 based on "just over 26,000", this article specifies it as being exactly 26,011...or an increase of 10, although that also means decreasing the MN Medicaid number by 10 as well).
Another report presented later Thursday to the board overseeing Nevada's insurance exchange shows 17,946 people who shopped for private insurance through the online portal have confirmed plan selections. Of those, 10,776 have paid the premiums. About 23,000 have chosen stand-alone dental coverage.
It looks like the exchanges are starting to become more sensitive to the distinction between paid and unpaid enrollments; Delaware is the 5th state exchange to start separating these numbers out (or perhaps the media is just starting to do so based on the numbers released). In any event, depending on how you look at it, Delaware's private enrollments have gone up either 44% or 400% since the 793 enrolled as of December 12, and Medicaid enrollees have gone up 3.7x the 1,822 that it stood at as of 11/30.
Delaware officials reported Thursday that 1,145 people have enrolled in the state’s new health insurance exchange and paid their first premiums under the federal health care reform law.
The 1,145 paid enrollees are among 3,183 people who, as of Jan. 3, had chosen one of the health care plans offered on the exchange, suggesting that most of those who have chosen plans have not yet paid for coverage.
For Massachusetts Health Connector’s Board of Directors, which is meeting today, the key question is: How bad do things have to be – and for how long – before the consequence is a brutal decision?
CGI, which has been responsible for development, failed to deliver a working website. Worse than that: after three months, there is still no indication that CGI has the competency required to fix the website.
We’re seeing many types of outreach efforts to reach the uninsured. Navigators are doing their utmost (at least in states where their work is not being obstructed), and many church groups are addressing their congregations. Nevada has mounted a concerted door-to-door effort. Here are the results, as reported by Allison Bell.
Exchange managers want the canvassers to reach 450,800 people who seem likely to need individual or family health insurance. Mi Familia Vota says it made 53,052 total attempts from Nov. 1 through Dec. 31. The organization’s workers talked to people in 7,935 homes, or 18 percent of the homes in the target area, and generated 661 enrollment appointment leads. The canvassers found 8,377 households were inaccessible, and no one was home in 33,875. In 5,596, the residents already had health coverage. In 806 of the homes, residents refused to talk to the canvassers.
We’ve already dealt with Oregon’s recently updated enrollment numbers, but this bit of news from Nick Budnick’s article in The Oregonian the other day really caught my attention:
About half of those who applied for coverage effective Jan 1 were turned away because their applications were not fully filled out, state officials have said. Instead, they'll be processed for insurance effective Feb. 1.
If Oracle had delivered a working website to Cover Oregon, then online applicants would immediately have received feedback that they needed to fill in more information. Clearly this is an added source of frustration for Oregonians who had every reason to think that their paper application was complete and in order.
On the other hand, this speaks to a huge potential. If Cover Oregon can assist those 20,000 applicants quickly, that alone should double the state’s enrollment numbers! Who knows – with dedication and luck, Cover Oregon might well achieve that before the end of January.
No new private enrollment numbers, but Rhode Island's Medicaid expansion jumped from 6,627 at the end of November to 19,941 as of yesterday. For some reason the article claims a "quadrupling" from 5,280, but the official HHS number for 11/30 is 6,627, so I'm not sure what that's about (they also claim the quadrupling was "in December" even though the same number shows up as being "through Wednesday" which was January 8th).
In any event, a nice Medicaid bump (or a horrific one, depending on your POV) for Rhode Island.
The number of Medicaid enrollments through HealthSource RI totaled 19,941 as of Wednesday, with an additional 1,500 sign-ups pending, David Burnett, chief of government and public affairs at the R.I. Executive Office of Health & Human Services, revealed Wednesday in response to a request from WPRI.com.
The number of Medicaid sign-ups on HealthSource RI roughly quadrupled in December, jumping from 5,280 to 19,941, amid a drumbeat of publicity about deadlines to get coverage under President Obama's new health law.
The prior MA update was extremely confusing; this one is more straightforward but is still pretty fuzzy. As far as I can tell, Massachusetts increased their private enrollments by 24% from Dec. 30 to Jan. 7...but that only brings them up from 3,759 to 4,676. There's another 22,000 or so enrollments in semi-limbo which appear to be approved but not fully processed due to the technical problems they continue to have.
The Republican/MassLive.com previously reported that as of Dec. 30, only 497 people were enrolled in permanent subsidized health insurance plans. The state was providing temporary insurance for another 22,000 new enrollees while it worked to process their applications. The state had extended coverage for existing customers of its Commonwealth Care plans through March 31.
Lefferts said that as of Jan. 7, 4,676 people enrolled in both subsidized and unsubsidized plans through the Health Connector, up from 3,759 as of Dec. 30. He did not have a breakdown of how many of those were subsidized. Individuals whose plans are not subsidized have until Friday to pay their premiums, so that number is likely to tick up.
Pretty slim pickings here on the private enrollment front (up just 141 assuming "slightly more than 26K" = 26,001), but the Medicaid number is up 9.6% to 45,981.
Despite MNsure's problems, so far 71,982 people have signed up for insurance coverage through the exchange. According to newly released demographic details, 53 percent are women and the median age is 48. The largest number signed up for mid-level "silver" plans — about 35 percent of total enrollees. Of those nearly 72,000 enrollees, slightly more than 26,000 signed up for private insurance while the rest are on public plans.
