Hawaii

The overall story out of Hawaii is pretty ugly, but the QHP number is actually good news, given what a mess HI's exchange has been: QHP enrollments are up from 4,969 as of 3/08 to 5,400 as of yesterday, an increase of 431. While this isn't exactly worth cheering about, it does raise Hawaii's daily average up from 37/day in February to 46/day in March...a 24% increase.

Tom Matsuda, the interim executive director of the Hawaii Health Connector, told lawmakers at a Senate hearing Monday that the nonprofit is woefully behind its projections of individual enrollment, with only about 5,400 people fully through the process of buying coverage. While that number doesn't count those still in "a backup in the system," Matsuda said, it's far behind the projected pace of 50,000 enrollees through 2014 it would have needed to break even.

OK, talk about an 11th-hour development: The Hawaii Health Connector, which has been competing with Oregon and Massachusetts for the "worst exchange" award, may have actually turned the corner just in time for the final 2 weeks of the ACA enrollment push.

If this development doesn't turn out to be another false promise (Hawaii's exchange has had several "It's working NOW! Oh, wait..." moments since October), there could be up to 16,000+ people who get piled onto the Hawaii tally over the final two weeks of open enrollment:

The Hawaii Health Connector, in its final stretch of open enrollment, says it has fixed a substantial number of system glitches that have frustrated consumers and stifled enrollment.

Hawaii continues to creep along...

Connector Updates for March 8, 2014

Total since October 1, 2013

  • 4,969 Enrollments in the Individual Marketplace

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!

Hawaii's private QHP exchange may still be a mess, but there's great news out of the Medicaid side: Over 48,000 new enrollees since October 1st. The article specifies that these are a combination of "strict expansion" and "woodworkers", though it doesn't break the total out between those two, which would have been nice to have, but so be it. Based on existing data, I'll assume roughly 25% woodworkers to 75% strict expansion for now, or 12K / 36K.

Hawaii has seen a spike in Medicaid enrollment since eligibility was expanded under the federal Affordable Care Act, with more than 48,000 new enrollees since October.

“The expansion (to 138 percent of the federal poverty level) meant Hawaii was expecting about 48,000 additional beneficiaries because of the mandate that you have to have insurance,” said Kayla Rosenfeld, spokeswoman for the Hawaii Department of Human Services, who noted that enrollment has exceeded that benchmark to date. Increasing enrollment is also due to greater awareness rallying Medicaid-eligible individuals “out of the woodwork.”

Another nice find by contributor Denver11. Family Health Hawaii is a new insurance company that is apparently not on the Hawaii exchange, meaning that any enrollments they sign are off-exchange by definition. The article doesn't give a specific number of ACA-compliant plans, leaving it an amorphous "most" out of 3,400. I'm figuring 60%, which would be 2,040 employees. Using my standard (and very conservative) 1.8x people-per-household (per employee) ratio, that comes to around 3,672 total individuals covered.

If I'm not missing something, this brand-new startup company has single-handedly enrolled 80% as many Hawaii residents as the state exchange has. Not sure if this says more about the company or the exchange.

He [Family Health Hawaii CEO JP Schmidt] estimated that around 3,400 employees are enrolled to date, with the goal of enrolling 50,000 employees by the insurer’s five-year mark in 2018. And while the insurer offers some grandmothered 2013 plans, most seem to be opting for the new Affordable Care Act 2014 plans, he noticed.

I know Hawaii has a small population to begin with, and a very small number of uninsured residents out of those, but this is still a bit underwhelming: Private QHPs are up less than 200 from 2/22 to 3/01, to 4,661.

Total since October 1, 2013

20,018 Applications completed in the Individual Marketplace
4,661 Enrollments in the Individual Marketplace

Using my new (upcoming) "potential pool" methodology, after removing undocumented immigrants and assuming that 60% of QHP enrollees were previously uninsured, Hawaii is now at:

  • 2,797 out of 35,000 potential QHP enrollees (8%)
  • 14,746 out of 58,000 potential Medicaid/CHIP enrollees (25.4%)

Looks like the previous update claiming over 5K in Hawaii was mistaken. Not that it makes much difference, but I have to lower HI's tally by 533:

Total for the period of Feb. 16, 2014 through Feb. 22, 2014:

4,467 Enrollments in the Individual Marketplace

Well, this isn't exactly a positive article, but more enrollments are more enrollments...this brings Hawaii up about 700 people since the previous update.

The Connector had enrolled more than 5,000 people as of Friday, according to interim Executive Director Tom Matsuda. However, more than 18,000 applications have been processed as of Feb. 15.

Hawaii's private QHP enrollments continue to crawl along, increasing from 3,879 as of 2/08 to 4,297 as of 2/15.

Total since October 1, 2013

18,752 Applications completed in the Individual Marketplace
 4,297 Enrollments in the Individual Marketplace
 444 Employers applied to SHOP Marketplace

They also list the number of employers enrolled in their SHOP system, but there's no update on the actual number of people covered by those plans, so it stays at 307. No Medicaid/CHIP update either.

The good news is that Hawaii becomes the first state of the 11 for which I have partial February data to actually increase it's enrollment rate over January. The bad news is, Hawaii's numbers are so tiny that this is a drop in the bucket, only reducing the overall drop percentage by 0.2%.

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

Nothing to get excited about here, folks: Hawaii, with one of the most screwed-up exchanges (although also, in their defense, one of the lowest uninsured rates on the country to begin with) has added a whopping...488 people to their Private QHP roles since January 18. Still, a person covered is a person covered...no Medicaid update, however.

Total since October 1, 2013

3,614 Enrollments in the Individual Marketplace

This is one of those cases where percentages mask the real picture. Yes, Hawaii has seen their Private QHP enrollments increase by an impressive 43% since December 28. However, they only had 2,192 people enrolled in the first place...the actual increase is only 934 people, to 3,126.

Furthermore, those 934 have to be subtracted from the almost half-million "Not Broken Out By State" tally at the top of the spreadsheet, since they came in before 1/24/14.

On the other hand, this also gives the first SHOP (Small Business Exchange) entry for Hawaii...another 307 people.

Hey, a person is a person...

As of Jan. 18 the Connector enrolled 3,126 people, though 13,000 applicants were deemed eligible for tax credits to reduce the cost of coverage. Of the 373 small-business groups that applied, only 75 employers were enrolled with 307 workers selecting plans.

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