California

Hmmm...this is an unexpected development:

Looking to change health plans for 2016? Member renewal begins on October 12. http://t.co/3OVo9UaOpA pic.twitter.com/33eCPY0H5P

— Covered California (@CoveredCA) October 7, 2015

The tweet includes this graphic, which seems pretty clear cut to me:

I noted yesterday that 3 states (Maryland, Idaho and California) have already opened up window shopping to prospective 2016 enrollees.

However, it was my understanding that no one was allowed to actually enroll (ie, "select or renew a Qualified Health Plan") until 2016 Open Enrollment officially starts on November 1st.

A few days ago I noted that the Maryland Health Connection has officially launched window shopping for the 2016 open enrollment period (#OE3).

As it happens, at least two other state-based exchanges have done so as well:

COVERED CALIFORNIA: It's pretty obscure for the moment, but if you click the "Shop & Compare Tool" link at the lower left-hand corner of the CoveredCA website, you'll be given the option to shop around for 2016 plans (you can also choose 2015 plans in case you've had a qualifying life change and need coverage for the last 2 months of this year, or even 2014 plans if you still need that information for tax purposes or whatever):

YOUR HEALTH IDAHO:

Anonymously Shop and Compare Health and Dental Plans on Your Health Idaho

This Just In...

FOR IMMEDIATE RELEASE Media Line: (916) 206-7777 July 27, 2015

COVERED CALIFORNIA HOLDS RATE INCREASES DOWN FOR SECOND CONSECUTIVE YEAR

Average Increase Is 4 Percent; Consumers Who Shop Can Lower Their Premium by an Average of 4.5 Percent

SACRAMENTO, Calif. — Covered California announced its rates for 2016 and unveiled which health insurance companies will be offering plans through the marketplace. The statewide weighted average increase will be 4 percent, which is lower than last year’s increase of 4.2 percent and represents a dramatic change from the trends that individuals faced in the years before the Patient Protection and Affordable Care Act.

Over the past couple of months, the proposed 2016 individual & small business market premium rate filings have mostly been released. These are requests only, and have yet to be approved by state regulators in most states (Oregon and Kentucky are the only ones I know of which have actually approved theirs so far), but it at least gives us a general idea of where things are likely to stand next year.

One major exception to the above so far, however, has been California. The Golden State has been conspicuously absent in all of the 2016 Rate Review fuss so far. The rate review tool on their own insurance commissioner website only runs through 2015, and plugging in 01/01/2016 for California at HealthCare.Gov's rate review site brings up nothing either.

This AP article provides snippets about a handful of states; it'd be nice if they just released the actual report so we could see the hard expansion numbers (as opposed to the total increase numbers, which are still obviously useful but don't distinguish between traditional Medicaid and ACA expansion enrollees):

In Kentucky, for example, enrollments during the 2014 fiscal year were more than double the number projected, with almost 311,000 newly eligible residents signing up. That's greater than what was initially predicted through 2021. 

...At least 14 states have seen new enrollments exceed their original projections, causing at least seven to increase their cost estimates for 2017, according to an Associated Press analysis of state budget projections, Medicaid enrollments and cost details in the expansion states. A few states said they could not provide original projections.

Huh. This is kind of weird...two completely different stories, from two different reporters (although both are via the Associated Press) about the latest Medicaid expansion numbers from two of the largest states at opposite ends of the country: California and New York.

This wouldn't be surprising if there had been a major report/press release regarding Medicaid enrollment nationally broken out by state, of course, but as far as I know there hasn't been (the last report from CMS came out in early June, only runs through March and doesn't distinguish between "traditional" and "expanded" Medicaid anyway).

In any event, I'm happy to report that the numbers actually line up pretty closely with what I already had estimated for each state:

OK, this is kind of amusing. Over at right-wing nutbag-conspiracy-theory-repository/occasional-real-news site Breitbart.com, there's an attack piece hyping up the expected 2016 individual insurance market rate increases, based on various recent articles such as Robert Pear's piece over at the New York Times last Friday, which I talked about this morning.

Needless to say, being Breitbart, they lay on the "OMG!! SKY IS FALLING!! MASSIVE RATE HIKES!!" stuff pretty thick, and as I've noted repeatedly, in some cases that may very well be true. I didn't bother reading most of it since I already know what it says.

However, there's one rather curious passage which did catch my eye:

Regulators for Covered California, the largest Obamacare exchange with 1.4 million members, have been mum on just how big their premium rate increase will be. But with the exchange already expected to lose $78 billion in the state fiscal year that began July 1, there is no state money for extra subsidies.

As I noted last week, now that the King v. Burwell debacle is behind us, all options are on the table for the future of the 13 remaining "full" state-based exchanges (Hawaii is in the process of moving over to Healthcare.Gov for 2016, joining Oregon and Nevada). The two additional state exchanges most likely to make the move are Vermont (which is having both serious technical and funding issues) and Minnesota (where neither issue is quite as bad, but still troubling). The other 11 exchanges are in considerably better shape on the technical side, but the financing situation varies widely.

Fortunately, it looks like at least one state exchange has turned the corner, or at least is pretty confident that they're about to: The largest one in the country, Covered California. They just released a report at the Alliance for Health Reform forum; for the most part it's a general overview of CoveredCA's 2015 enrollment situation, rehashing data which was already known (1.3 million currently enrolled, etc.) However, there's a few noteworthy slides which fill out the picture more completely.

This board meeting report from Covered California actually includes a few pleasant surprises! when added to the existing data:

  • The official exchange QHP selection tally in CA as of February 22, 2015 was 1,412,200
  • According to the new report, they've had a total of 117,024 QHP selections since then (through May 10th), including #ACATaxTime enrollments:

  • Add them together and you get 1,529,224 total QHP selections to date (well, as of 5/10, anyway).
  • One interesting side note: CA's final #ACATaxTime tally turned out to be nearly 10,000 higher than expected (they previously reported around 33K with just a couple of days to go in the special enrollment period; apparently a lot of people jumped in at the last second after all)

On the surface, aside from the extra 10K for #ACATaxTime, that doesn't sound too interesting...I already had CA down with 1,503,200 QHPs, so this is just 26,024 higher. Big deal, right?

Except for one thing: I've confirmed that the number below represents actual paid, effectuated enrollments as of March 2015:

The California ACA exchange, CoveredCA, released their 2016 budget today, and the outlook is...well, kind of underwhelming, frankly:

After using most of $1 billion in federal start-up money, California's Obamacare exchange is preparing to go on a diet.

That financial reality is reflected in Covered California's proposed budget, released Wednesday, as well as a reduced forecast calling for 2016 enrollment of fewer than 1.5 million people.

The recalibration comes after tepid enrollment growth for California during the second year of the Affordable Care Act. The state ended open enrollment in February with 1.4 million people signed up, far short of its goal of 1.7 million.

A number of factors contributed to the shortfall, but health policy experts said that some uninsured folks still find health insurance unaffordable despite the health law's premium subsidies.

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