Illinois

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!

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