Alaska

Three ACA-related stories which are all interesting but which I don't have a whole lot to add to:

The trouble with trying to sign people up for health insurance when care is already free

It’s hard work trying to get people to sign up for health insurance when their care is mostly free to them. Andrea Thomas is working to get Alaska Natives in Sitka, Alaska, to do just that. She’s the outreach and enrollment manager at SouthEast Alaska Regional Health Consortium (SEARHC), and it’s her job to sign people up for health insurance coverage through exchanges created as a result of the Affordable Care Act.

To get a sense of just how uphill Thomas’s battle is, consider this: Of the more than 100,000 people who live in Alaska and self-identify as Alaska Native or American Indian, only 115 had signed up for health insurance through an Affordable Care Act exchange as of March 31.  Alaska Natives and American Indians are exempt from tax penalties for not signing up for health insurance.

A nice little final-day wrap-up report out of Alaska: 13K on the exchange and another 2,700 off-exchange QHPs. Premera is part of BCBSA, so I can't double-count their off-exchange number, but Moda Health isn't:

About 13,000 Alaskans signed up for health insurance on healthcare.gov during the open enrollment period that closed March 31st. The two insurers offering plans on the exchange in Alaska shared their enrollment figures today with APRN. Moda Health says it has about 7700 healthcare.gov enrollees in Alaska and the company is still processing some additional sign ups.

Premera Alaska enrolled 5300 people on the exchange. Before the troubled launch of healthcare.gov, the company had hoped for more customers. But Premera spokesperson Melanie Coon is satisfied with the numbers:

“I think we readjusted our expectations. We’re very pleased with how enrollment went, based on the slow start to the exchange and… the last minute changes that were made where people could extend.”

UPDATE: On the down side, I was off by 4% this time around.

On the up side, I UNDERESTIMATED:

Actual Feb. enrollments: 942,833, for a total of 4,242,325 thru 3/01/14.

Sarah Kliff at Vox just announced that the February HHS report is expected to be released today at around 4:00pm. A few items in anticipation of that:

  • As I've noted several times, I'm projecting the report to total around 902,000 exchange-based private QHP enrollments for the month of February (technically 2/02 - 3/01)
  • If accurate, this would bring the cumulative total of exchange-based private QHP enrollments to 4.202 million (from 10/1/13 - 3/01/14)
  • From the data I have, the average daily enrollment rate in February was almost identical to that of January, which had about 1.146 million QHP enrollments. HOWEVER, the January report included five weeks of data (12/28 - 2/01), while the February report will only include four weeks (2/02 - 3/01). Therefore, even at the same daily average, it'll be about 20% lower no matter what.
  • Don't be surprised if Peter Lee of CoveredCA decides to steal some thunder by announcing that California has enrolled 1,000,000 QHPs all by itself either today or tomorrow. However, that would include the past 10 days, while the HHS number will only run thru 3/01.
  • If you want to get REALLY specific, call it 902,800 and 4,202,292.
  • I've been dead-on target 6 times in a row without hyping up my projections beforehand. This time I am hyping myself up beforehand, so I'll probably be way off...but as long as I've UNDERestimated the tally, I'll be perfectly fine with that...
  • The report will be released in about 5 minutes, but my kid gets home from school in about 10, so it'll be a good 20 minutes before I can really post anything. Feel free to follow Sarah Kliff of Vox in the meantime!

Washington State (h/t ArcticStones):

Enrollments in private health plans on Healthplanfinder, the state’s online insurance marketplace, surged past 65,000 as applicants hustled to beat the Monday night deadline for coverage beginning Jan. 1, Washington Health Benefit Exchange officials reported Tuesday. Nearly 69,000 others have completed the enrollment process, but haven’t arranged payment, and another group of undetermined size has begun applications that are in varying stages of completion. ... As of Monday at midnight, about 100,800 people newly eligible for health insurance through the state’s expanded Medicaid program had signed up. Almost half of those were transferring from the now-discontinued Basic Health program or were presumed qualified for a federal assistance program for the disabled. An additional 47,500 enrollments were from those who previously qualified for Medicaid under the old rules — primarily children — but had not been signed up. And more than 88,000 people already covered by Medicaid renewed their eligibility.

For private enrollments, Washington is the only state that distinguishes between "enrolled but not paid yet" and "enrolled and first month's premium paid"; every other state, and the HHS, counts you as being enrolled even if you haven't actually paid yet, so that's the criteria I use, although I did separate out the other 69K on the spreadsheet. For Medicaid, I'm not counting the 88K since they were just renewals, but the 47.5K do count since they appear to fall into the category of people who were already qualified but didn't know about it until the ACA and the state exchange. In addition, as in several other states, another 47,000 people are being automatically transferred over to Medicaid proper from an existing state program; this is one of the "orange cells" on the spreadsheet. Also, h/t to sulthernao, who found the actual WA exchange source that gives the precise numbers.

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