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.  

OK, not exactly an eruption of new enrollees, but add 265 more people to the list...

Total since October 1, 2013

3,879 Enrollments in the Individual Marketplace

Happy Valentine's Day!

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.

First of all, as I announced last night, I've added a "90% Either Paid or Unpaid for Legitimate Reasons" marker to address the "Paid/Unpaid" issue.

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.

First, let's use the official CMS Projection percentages. These absurdness of these numbers has already been discussed repeatedly, so I won't rehash that here, but we should at least check it out before looking at a more rational measurement.

SEE UPDATE BELOW!!

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 coverage start 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:

Larry Levitt of Kaiser makes an interesting observation in a couple of Tweets yesterday:

States with big increases in ACA enrollment since December:

  • Mississippi ↑ 116% 
  • Florida ↑ 88% 
  • Louisiana ↑ 87% 
  • Texas ↑ 75% 
  • Georgia ↑ 73%

This list is all fed marketplace states. Growth generally lower in state exchanges because enrollment was higher to begin with.

Let me point out a few things that are worth noting here:

Less than 8 hours after the HHS Dept. released their big January enrollment report, Nevada has already issued another update to their numbers: 

Update as of 2/8: 23,686 consumers have confirmed Qualified Health Plan selections, 16,030 have paid.

The 16,030 number is a 7% bump over a week earlier (14,999), and the unpaid number (7,656) is slightly higher than the prior week (7,598).

With all the focus on fixing the problems with the individual/group healthcare exchanges, there's been far less attention paid to the more-troubled SHOP (Small Business) exchanges. The administration had already announced that the HC.gov version (covering 34 states*) wouldn't be launched at all until this fall, and 2 of the state-run exchanges (Oregon and Maryland) recently announced that they'd be offline until well after the end of the March enrollment period as well.

Today, Covered California announced that while their SHOP exchange has been operational (with a small number of enrollments to date), they're shutting it down until this fall as well. This leaves 14.5 state-run SHOP exchanges in operation (and yes, that's 14.5, not 15...Washington State's SHOP is only running in 2 counties at the moment).

Still, the press release does give a slight bump in CA's SHOP enrollment before they stop taking new signups: 4,490 individuals covered, plus another 1,200 being processed, for a total of 5,690. That's where it'll stay through the end of the March enrollment period unless they reverse themselves between now and then.

OK, given how messy and confusing the Medicaid/CHIP situation is, I had to think through the best way to incorporate the January HHS Report into the mix. The problem is that not only are the monthly HHS reports only part of the equation (the January CMS report probably won't be released for another 10 days or so, based on prior months), but it's not a simple "add HHS now, then add CMS later". The two actually intermingle, and some of the caveats and overlapping data changes from month to month, which means that some of the data I include today will have to be modified or removed after the CMS report is released, and some of the data which I've removed will have to be added back in...or part of it will, anyway.

Having said all that, I think I have a pretty good grip on how to do this now:

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