Louisiana

Louisiana was one of the last states I ran rate hike analysis on just a month ago: Three carriers on the exchange (plus the "Freedom Life" phantom carrier), averaging around 21.4% rate increases on the assumption that CSR payments won't be made. According to the Kaiser Family Foundation, loading CSRs onto Silver plans only would bump them up by an additional 20 points; this translates into roughly 14.2 points if spread across all metal levels on & off the exchange. Based on that, I estimated LA's rate increases at 21.4% without CSRs but only 7.2% if they actually are paid.

Thanks once again to Louise Norris for doing the grunt work regarding the approved rate changes, which are...pretty much identical to what was requested by the carriers:

Proposed 2018 rates much higher than they would have been if CSR funding had been appropriated early in 2017

On Sunday, HHS Secretary Tom Price officially called it in Texas:

Health and Human Services Secretary Tom Price, MD, declared a public health emergency in Texas on Saturday as Hurricane Harvey was pounding the state's coast.

Harvey made landfall late Friday night with winds topping 130 mph. Forecasts called for the storm to hover over the state for 5 days or more, possibly drenching some areas with as much as 50 inches of rain. Hundreds of thousands were without power and the National Weather Service said parts of Texas could be "uninhabitable for weeks or months."

"Many Medicare beneficiaries have been evacuated to neighboring communities where receiving hospitals and nursing homes may have no health care records, information on current health status or even verification of the person's status as a Medicare beneficiary. Due to the emergency declaration and other actions taken by HHS, CMS is able to waive certain documentation requirements to help ensure facilities can deliver care," an HHS statement read.

Louisiana has 3 individual market carriers for 2018 (technically there's 4, but "Freedom Life" is basically just a shell company with a placeholder filing). Officially, they're requesting average rate increases averaging around 21.4%...but all three carriers state point-blank in their filing letters that a huge chunk of their request is due specifically to the CSR reimbursement and mandate enforcement issues. The Kaiser Family Foundation estimates the CSR issue alone adds around 20 points to Silver plans, and 71% of Louisiana exchange enrollees chose Silver, so that translatest into roughly 14.2 points across the whole market. This results in just a 7.2% average rate hike if CSR payments are made vs. 21.4% if they aren't:

Of the 31 states which have expanded Medicaid under the Affordable Care Act, only a handful issue regular monthly or weekly enrollment reports.

I noted in February that enrollment in the ACA's Medicaid expansion program had increased by around 35,000 people across just 4 states (LA, MI, MN & PA).

It's early June now, so I checked in once more, and the numbers have continued to grow. I have the direct links for 5 states now (including New Hampshire)...

Of the 31 states which have expanded Medicaid under the Affordable Care Act, only a handful issue regular monthly or weekly enrollment reports.

I noted in February that enrollment in the ACA's Medicaid expansion program had increased by around 35,000 people across just 4 states (LA, MI, MN & PA). By the end of March, the numbers in these 4 states had gone up by another 19,300.

It's the end of April now, so I checked in once more, and sure enough, the numbers continue to grow:

Of the 31 states which have expanded Medicaid under the Affordable Care Act, only a handful issue regular monthly or weekly enrollment reports.

Back on February 28th I noted that ACA Medicaid expansion enrollment across three states (Michigan, Louisiana and Pennsylvania) had grown by about 35,000 people since mid-January, to 667K, 406K and 716K people respectively.

Today, a month later, I decided to take another look at all three states, along with Minnesota (which I forgot to check last month). Sure enough, enrollment has continued to grow in all four, albeit at a slower pace:

Over the past month or so, I've been tallying up the number of people who would lose their healthcare coverage if and when the GOP actually does proceed with repealing the Affordable Care Act, breaking the totals out by both County and Congressional District in every state.

While this project has received high praise as a useful resource, one problem with it is that the numbers aren't static--between the high churn rate of the individual market and Medicaid, as well as the fact there's no limited enrollment period for Medicaid (you can sign up year-round), the enrollment figures are constantly changing.

Case in point: Just two weeks ago, roughly 400.000 Louisianans were enrolled in ACA Medicaid expansion. As of yesterday that number had increased to nearly 406,000.

I'm updating the spreadsheet versions now, but in the meantime, here's the latest county-level breakout:

UPDATED 2/19/17 with more recent data (final OE4 exchange enrollment data & February 2017 Medicaid expansion data):

Louisiana just expanded Medicaid via the Affordable Care Act last July, and as of Februay 16th had over 400,000 residents enrolled in the expansion program. All of those people would be kicked right back off of that coverage again if the ACA is repealed. In just 7 1/2 months...

  • 58,713​ Adults have received preventive healthcare or new patient services

I know you're supposed to only use a brief paragraph or two, but this Sept. 19th AP/New Orleans Times-Picayune story only consists of five sentences anyway:

BATON ROUGE — The number of people who have signed up for Louisiana's Medicaid expansion program continues to grow, surpassing 300,000.

The Louisiana Department of Health released the latest figures Monday, saying more than 304,000 people are enrolled for the coverage that began July 1.

The department says nearly 12,000 Medicaid expansion enrollees have received preventive services through the government-finance insurance program so far, like cancer screenings, colonoscopies, and mammograms.

 The maximum number of Louisianans eligible for Medicaid expansion in the state is supposedly around 375,000. Enrollment began in June (though the program didn't actually go into effect until July), so that's 81% of the total enrolled within just 3 1/2 months.

A quickie: Just 5 days ago it was reported that...

As of the beginning of August265,723 low-income Louisianians have newly signed up for Medicaid, according to state officials.

Well, according to NOLA reporter Kevin Litten just now...

INBOX: Medicaid expansion in Louisiana topped 278,000 people on Wednesday. That leaves about 100k people to sign up to hit goal by 2017.

— Kevin Litten (@kevinlitten) August 10, 2016

That's a net increase of 12,277 people in just 9 days, or over 1,300 per day.

There are an estimated 375,000 Louisianans eligible for ACA Medicaid expansion. If they can enroll another 700/day, they'll have maxed out by New Year's Eve.

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