Illinois

A couple of weeks ago Adam Cancryn reported that several of the 11 remaining ACA-created Co-Ops had actually reported small profits for the first quarter of 2016.

Today, I'm afraid Cancryn says that this is not the case for Land of Lincoln Mutual Health Insurance Co., the Illinois Co-Op...although they are hoping to take advantage of the announcement made just over the weekend which now allows the Co-Ops to seek outside funding:

Land of Lincoln Mutual Health Insurance Co. plans to look for outside investors to boost its financial resources after federal regulators indicated they would loosen funding restrictions on consumer operated and oriented plans.

I admit that given the carnage of the past couple of weeks, I'm almost afraid to post this entry...but I had to write something positive about the CO-OP situation.

With the ACA-created CO-OPs seemingly dropping like flies due to the #RiskCorridorMassacre, I thought this would be a good time to flip things around and look at which CO-OPs are doing well (or at least not badly).

This isn't much, but it'll do for now:

Wisconsin's insurance department says it has no intention of shutting down its #ACA co-op, which appears it will remain solvent next year.

— Bob Herman (@MHbherman) October 22, 2015

@charles_gaba and at this point, other than Maine, it's difficult to expect many others will last beyond risk corridors.

— Bob Herman (@MHbherman) October 22, 2015

IMPORTANT: See this detailed explanation of how I've come up with the following estimated maximum requested weighted average rate increases for Illinois

As explained in the first link above, I've still been able to piece together rough estimates of the maximum possible and most likely approved average rate increase for the Illinois individual market:

Again, the full explanation is included in the Missouri estimate linked at the top of this entry, but to the best of my knowledge, it looks like the companies with rate increases higher than 10% come in at a weighted 32.7% increase, but only make up about 57% of the total ACA-compliant individual market, with several other companies with approved increases of less than 10% (decreases in some cases) making up the other 43%.

Hot on the news that HHS Secretary Sylvia Burwell decided to channel the Bridgekeeper from Monty Python & the Holy Grail ("Right! Off you go then!!") when it came to Pennsylvania and Delaware's "state-based exchange" requests, here's what's going on in three other states facing possible tax credit loss from an adverse King v. Burwell decision:

ILLINOIS: Hospital group says Illinois could lease Healthcare.Gov

A hospital group in cash-strapped Illinois says the state might be able to set up a health insurance exchange at a lower cost by "leasing" the federal government's technology, an option that could appeal to as many as 34 states where subsides could be jeopardized by an unfavorable U.S. Supreme Court decision.

OK, this one is a bit vague, but for the moment I'll take it. "Land of Lincoln Health" is an insurance CO-OP which operates, as you'd imagine from the name, in Illinois. I'm fairly certain that's the only state they operate in, so this number should be restricted to IL:

Land of Lincoln has enrolled “several hundred people” since open enrollment began this past Saturday, and the plan is already receiving payments from consumers, said Dorgan, who is in charge of finding and renewing members. About 6,000 people visited Land of Lincoln's website over the weekend with no apparent technology issues—an auspicious start for a plan that hopes to have 50,000 covered lives for 2015.

For the moment I'll assume "several hundred" means "300 - 400" and will go with 350 until better data comes out.

This is excellent news for another reason as well: Land of Lincoln only scored about 2,500 enrollees for 2014 open enrollment, so they're at something like 14% of their entire 2014 number in just 2 days.

At the end of August, Illinois' Medicaid expansion program was up to around 452,000 people (including 93,000 transferred over from the existing CountyCare program). As of the end of September, that total was up another 16,000:

The video also coincides with the release Tuesday of new data by Quinn’s administration that showed 468,000 people enrolled in the expanded Medicaid program since last year, more than double original forecasts.

Of course, the larger point of the article in question is that if Democratic Illinois Gov. Quinn's Republican opponent had been calling the shots, he would have told all 468,000 of his fellow Illinoisians (?) to go pound sand:

SPRINGFIELD — Newly surfaced video of Republican Bruce Rauner obtained by the Chicago Sun-Times shows him telling conservative activists in Lake County last year that, as governor, he would have blocked Gov. Pat Quinn’s 2013 expansion of Medicaid.

My in box is once again flooded with ACA-related stories which are interesting but which I just don't have time to do full write-ups on...

ILLINOIS: Clock Ticking For Illinois To Form State-Run Obamacare Exchange

Unless Illinois acts quickly, it will leave hundreds of millions of federal dollars on the table that would go toward building its own health insurance marketplace, potentially upping the cost of coverage for nearly 170,000 Illinois residents. State lawmakers, unable to break a years-long standoff, have not passed a law authorizing a state-based exchange, the marketplaces created under the Affordable Care Act that allow consumers to compare and buy health coverage, often with the help of federal tax credits. As a result, Illinois was one of 36 states that relied on the federal government to host its marketplace on HealthCare.gov, the website that survived a disastrous launch late last year to enroll about 217,000 Illinoisans, 77 percent of whom received federal help.

Holy smokes! This may seem a bit anticlimactic after this morning's surprise announcement by CMS Administrator Marilyn Tavenner, but it's still just as important in other ways:

@JeffYoung @philgalewitz I can tell you there are now roughly 450,000 newly eligibles who enrolled so far in Medicaid in Illinois.

— Peter Frost (@peterfrost) September 18, 2014

When I inquired, he explained:

@charles_gaba @JeffYoung @philgalewitz Sure. Those are the figures from @CoveredIllinois. They say total is now 670,000 (mktplc + Medicaid)

— Peter Frost (@peterfrost) September 18, 2014

When I asked for a link for confirmation, Jonathan Ingram helpfully chimed in:

Last October, at the height of the botched HC.gov rollout, I repeatedly commented over at Daily Kos:

 I still don't know why they didn't roll it out one state per day; if they'd gone alphabetically, they would have had a solid week to work the kinks out with a (relatively) low volume before hitting a big state:

  • Alabama, Alaska, Arizona and Arkansas are all relatively low-population.
  • California, Colorado, Connecticut and Delaware* are all state-run exchanges.
  • That means they wouldn't have hit Florida on the federal site until tomorrow.

I know that the system still would have had serious software issues, but at least they wouldn't have to deal with the massive overload of traffic at the same time that they were trying to fix the issues.

*(Obviously I was mistaken at the time about Delaware running their own exchange, but it's still a low-population state so my point was still valid...and of course the District of Columbia does run their own exchange).

Well, obviously it was too late for that at the time, and they've since scrambled to get their act together on the individual exchange side.

Shades of John "OMG!! Papa Johns will be forced to raise prices by 14¢ a pizza!!" Schnatter in Chicago this week...

The Chicago Cubs denied an assertion by the Chicago Sun-Times on Friday that the tarp debacle earlier in the week against the San Francisco Giants happened because the club short-staffs the grounds crew at Wrigley Field in order to avoid paying health insurance.

The short version: The nasty storm last week ended up making Wrigley Field unusable because the grounds crew was shorthanded. According to the Sun-Times, the reason they were shorthanded is because the team management slashed their hours in order to avoid having to pay for (gasp! the horror!) healthcare coverage for the staff.

As writer David Brown notes, if true, this is pretty slimy behavior for two reasons:

If a grounds crew person needs to work at least 130 hours a month to meet the requirements for health care, that's the cost of doing business. But the Cubs have gone on the cheapsince being sold by Sam Zell, and it's not just in the free-agent market. 

The good news: Illinois ACA Medicaid expansion is up to 350K, a 20K increase from 2 weeks ago. This represents 44% of the 800K eligible for the expansion program in the state.

The bad news (or good news, depending on your POV): There's nother 250K still in the hopper to be processed. Assuming the same 70% approval rate, that should increase the enrollment number by another 175K.

As of last week, Illinois' backlog of unprocessed Medicaid applications stood at 250,000, up from about 200,000 state officials reported in mid-March, but down from a peak of nearly 500,000 in early April, according to state data.

Since Oct. 1, the start of open enrollment in an expanded Medicaid program authorized by the federal health law, the state has received nearly 900,000 applications for public aid, most of which included Medicaid. Thus far, it has processed about 650,000 of them, granting coverage to about 450,000.

Roughly 350,000 gained Medicaid coverage under the health law, which expanded eligibility to all adults who make less than about $15,500 a year. The remainder gained coverage under old Medicaid parameters, which generally covered children, families and a category of older, sicker patients.

Don't let the snarky headline fool you; I'm still very much a single-payer guy. However, anyone who still claims that the ACA exchanges are "socialized medicine" doesn't have the slightest clue what they're talking about. In case you needed even more proof that the ACA is very much private-market friendly:

Illinois:

After sitting out the first year, UnitedHealth Group Inc. intends to offer individual policies on the Illinois health insurance exchange next year, according to sources familiar with the company's plans.

The decision by UnitedHealth, the nation's largest and the state's No. 2 insurer, has the potential to shake up the Illinois market, which was dominated in 2014 by Blue Cross and Blue Shield of Illinois, the state's dominant insurer.

...United's participation also could help lower rates for consumers, a key concern among the law's supporters.

While United would neither confirm nor deny its plans to offer policies in Illinois next year, a spokesman said the Minnesota-based insurer intends to increase its participation over time in exchanges nationwide.

Lots of Medicaid expansion updates today; here's Illinois...

Statewide, about 330,000 have enrolled in the expanded Medicaid program through the end of May, blowing away initial state estimates of about 200,000 for all of 2014, Koetting said.

The total eligible for ACA expansion in Illinois is around 801,000, so they've hit around 41% of that already.

Simple and to the point: These are all expansion enrollees:

In Illinois, an additional 287,000 have enrolled in expanded Medicaid coverage.

(I previously had the total at 350K, but that included determinations, not actual enrollees).

My Medicaid spreadsheet currently estimates Illinois at roughly 200K "strict expansion" and another 115K "woodworkers". This article suggests that the woodworker number may be too high, but the "strict expansion" number may be dramatically low:

For the first time, low-income adults without children are eligible for government health coverage.

 In Illinois, officials expect that'll mean 350,000 new people in Medicaid. And that's not all.

 Julie Hamos, director of the Department of Health Care and Family Services, says the news reports and advertising and community outreach around the Obamacare deadline led to a separate spike.

 "We have 80,000 more than the usual enrollment of people who already were eligible, they just didn't sign up. But because of that activity in the communities, now they're signing up."

Earlier this evening I ran an update on Illinois which claimed 323K total exchange enrollments. Since IL had 114K QHPs and 132K Medicaid enrollments as of 3/01 (246K total) that seemed like a decent, if unremarkable update...about 17% above the February daily rate.

However, contributor deaconblues tipped me off that other Illinois stories floating around today seemed to indicate that the 323K figure might actually be the 3/01 numbers, plus another 77K or so of unspecified enrollments. I double-checked with GetCovered Illinois, and sure enough, received this response:

@charles_gaba 113,733 in QHPs, the other 200K Medicaid (as of 03/01). Tricky in part because Cook County got advance dispensation to enroll.

— Erik Wallenius (@ErikWallenius) March 27, 2014

OK, so never mind the earlier Illinois update; my apologies for the error. This also means that I can't use Illinois in the projection table at all, which is fine, since it was actually dragging the projection down anyway lol...

This number out of Illinois was as much of an eyebrow-raiser as the NC/LA incident a few nights ago. However, it looks like this is a combined total of QHPs and Medicaid, which were at 113,733 and 131,995 respectively as of 3/01. Combined, that's about 246,000, with a 46/54 split.

For now, I'm going to play it safe and assume that this has shifted towards the Medicaid side a bit since then by calling it a 43/57 split, or around 139K QHPs & 184K Medicaid enrollments.

If I'm fairly close on this split, this represents a modest 17% increase over February's rate, which actually drops the projection a bit...but if I'm underestimating the QHP number, then I'm also underestimating the projection impact (sigh)...

To date, 323,000 uninsured Illinois residents have enrolled in health insurance plans, according to Get Covered Illinois, administrator of the state's official marketplace. As the March 31 enrollment deadline approaches, officials with the agency believe they will meet the state's target of having 143,000 more enrolled.

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!

This is an interesting example of the fundamental philosophical difference between those who support the ACA and those who oppose it (well, those who oppose it from the Right, anyway; some people oppose it from the Left because they'd prefer Single Payer, Public Option, etc.).

It seems that Illinois has seen Medicaid enrollments shoot up quite a bit more than expected since ACA Expansion officially went into effect on January 1st. This appears to be primarily due to the "woodworker effect", which the article, as a bonus, breaks out specifically: 200K Strict Expansion + 115,000 Woodworkers:

Illinois has added 315,000 people to Medicaid since Jan. 1. Here’s a breakdown:

The official HHS ACA Exchange Medicaid enrollment figure for Illinois released earlier today was 82,286. However, contributor sulthernao noted that the actual number of people enrolled in Medicaid under the ACA in Illinois is at least 53,714 higher. As he/she put it:

Illinois is a partnership state for Medicaid enrollment, has used SNAP autoenrollment, and early expansion experiment in Cook County. For this reason, the numbers reported by the Federal Government (ASPE) are a severe underestimate of the enrollment. People who apply directly through the state's website may not be counted.

I realize that this probably has no connection to the "mystery" 1.24 million Medicaid/CHIP enrollments that I just wrote about an hour or so ago, but it's been a very long day and I'm extremely tired, so until I hear a better explanation for those 1.24M, I'm lopping the 53K difference out of that "unspecified" total at the bottom of the spreadsheet.

Pages