The impending King v. Burwell Supreme Court decision will cast an even larger shadow over the ACA over the next 2 months (the decision is expected to be announced in June), as exchanges in 6 of the 14 states running their own (State-Based Marketplaces, or SBMs) are at risk of either being abandoned, dissolved or otherwise moved over to the federally-run Healthcare.Gov exchange:
The federal government is threatening to take over Hawaii's health insurance exchange within months and has restricted grant money to support operations of the Hawaii Health Connector.
Jeff Kissel, the Connector's executive director, told lawmakers at a briefing Thursday that if the exchange created by the Affordable Care Act does not get state funding soon, the federal government will abolish Hawaii's marketplace and run it directly.
The good news is that MNsure is continuing to provide off-season enrollment reports. The only bummer is that they appear to have switched to monthly reports, but I guess I can live with that:
Latest Enrollment Numbers
March 12, 2015
MNsure provides a robust enrollment metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. This page will be updated on board meeting days.
Health Coverage Type Cumulative Enrollments
Medical Assistance 90,839
MinnesotaCare 31,070 Qualified Health Plan (QHP) 61,109
TOTAL 183,018
Unlike today's DC update, which seems highly questionable due to the "...since Oct. 2013" wording, MNsure's report only includes 2015 enrollments, and the numbers, while still impressive, are much more reasonable.
Now that the King v. Burwell Supreme Court oral arguments are out of the way (with radio silence expected until they announce the decision sometime in June) , the next Big Development to keep an eye on ACA-wise is...Tax Season! There will be plenty of stories about how many people have to pay back some/all of their 2014 tax credits, how many will receive additional tax credits...and, most germane to this site, how many additional people enroll via the exchanges to avoid having to pay (most) of the higher tax penalty next year for not being covered in 2015 during the Tax Filing Season Special Enrollment Period (SEP), or #ACATaxTime as I prefer to call it.
This isn't an exact apples-to-apples comparison, since the Massachusetts number includes the "overtime" extension period while the other 5 states only run through 2/15/15, but I thought it would be useful to see how the 6 exchanges which had widespread technical issues last year fared this time around. Obviously other states like Washington and California had some snafus, but these are the ones which were seriously hosed last year to the point of requiring massive overhauls or which were completely scrapped in favor of a new platform (I'm not including HC.gov itself here since everyone already knows what massive technical improvements they've made).
The chart below refers specifically to QHP selections only (whether paid or not), and compares the 2015 open enrollment period (11/15/14 - 2/15/15...or 2/26 in the case of MA) against the 2014 open enrollment period (10/1/13 - 4/19/14). I've also included some notes for context.
First, as noted this morning, California has tacked on an extra 2 days to their "In Line by Midnight" period (previously ending on 2/20; now extended to 2/22)
Second, Vermont, which didn't appear to be allowing for any extra time beyond postmarking a paper application as of Tuesday, has apparently decided to go ahead and allow an "In Line by Midnight" exception thorugh February 23rd:
But by February 18, the exchange was offering an extension to people who tried to enroll by February 15 but were unable to do so by the deadline. This has not been published on the exchange website, but an exchange representative confirmed that the extension runs through February 23, and that the call center (855-899-9600) will help enrollees complete the process between now and then.
MNsure Announces Special Enrollment Period for Consumers "In Line" to Enroll at Midnight February 15
Special Enrollment Period planned to ensure all Minnesotans have the ability to get covered
ST. PAUL, Minn.—Today MNsure announced a plan to ensure all Minnesotans “in line” have the ability to obtain affordable, comprehensive coverage. The Special Enrollment Period will make certain that Minnesotans who were “in line” to enroll—those who began the enrollment process but experienced difficulty, preventing enrollment in time to beat the February 15 deadline—will have their enrollments processed during a special enrollment period.
“In line” is defined as anyone who took any of the following steps with the MNsure system:
Hmm...well, things are starting to pick up heading into the final weekend of Open Enrollment in Minnesota...
Latest Enrollment Numbers
February 13, 2015
MNsure will release 2015 enrollment metrics weekly, and will present a more robust metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. During weeks that MNsure is closed on Friday, the enrollment metrics update will be released earlier in the week.
Health Coverage Type Cumulative Enrollments
Medical Assistance 66,538
MinnesotaCare 24,457 Qualified Health Plan (QHP) 49,238
TOTAL 140,233
The last MNsure update was 1/25, when they had 44,331 QHP selections. Since then, they've added just 1,642 more...or about 150/day. In order to reach their lowered target of 67K by 2/15, they'll need to add 2,100/day for 10 days straight. I just don't see them pulling that off.
Still, if they can reach, say, half of that, they'll add another 11K, which would bring their total up to perhaps 57,000, which isn't unreasonable.
Meanwhile, Minnesota's Medicaid/MinnesotaCare tally is up to 78,863 combined.
February 6, 2015
MNsure will release 2015 enrollment metrics weekly, and will present a more robust metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. During weeks that MNsure is closed on Friday, the enrollment metrics update will be released earlier in the week.
Health Coverage Type Cumulative Enrollments
Medical Assistance 57,593
MinnesotaCare 21,270 Qualified Health Plan (QHP) 45,973
TOTAL 124,836
Huh. The actual QHP numbers are fine--that is, Minnesota is still lagging behind where they should be, but they've added 201 over the past couple of days, which is fine given that we're in the slowest part of the enrollment period.
However...what's going on in the lower-left? "Advanced Premium Tax Credits" is the government-ese name for "Tax Subsidies'. In most states they're averaging somewhere between 80-90%...yet in Minnesota, it's less than 50%? What's up with that?
MNsure will release 2015 enrollment metrics weekly, and will present a more robust metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. During weeks that MNsure is closed on Friday, the enrollment metrics update will be released earlier in the week.
Health Coverage Type Cumulative Enrollments
Medical Assistance 44,308
MinnesotaCare 17,506 Qualified Health Plan (QHP) 44,130
TOTAL 105,944
* (actually as of 1/22)
OK, let's see here...that's exactly 400 more QHP enrollees since 1/19, or 133/day, although they've averaged 194/day since New Year's Eve.
At that rate (with no mid-February bump), they'll add another 4,600 by 2/15, or 49K, well short of their target of 67K. However, it's more likely to be more like double or even triple that when you include the final surge, for a total of perhaps 58,000 or so. Reaching their internal target may still be feasible; reaching mine (75K) seems very unlikely at this point, but anything's possible.
