Rhode Island

As you can see from the graphic I posted yesterday (and had to revise several times throughout the day), the official enrollment deadline for private policies starting on January 1st, 2015 has now passed for all 37 states operating via HealthCare.Gov, as well as residents of DC, Hawaii and Kentucky. It's certainly possible that any or all of these will announce some sort of "special circumstances" allowance for those who didn't make the midnight cut-off (10pm in Alaska), but I'm assuming those would be done strictly on a case-by-case basis.

OK, so what about the remaining 11 states?

Well, 4 of them (MD, MA, RI & WA) had later deadlines for January coverage all along: Maryland on 12/18 (Thursday) and the other 3 on 12/23 (next Tuesday).

New York and Idaho bumped their deadlines out from yesterday until 12/20 (Saturday), although Idaho had previously claimed that their deadline was 12/23, but are now claiming that it was originally 12/15. I still don't understand what happened there, but so be it: 12/20 it is for ID.

Just a few things to note...

MASSACHUSETTS: The MA Health Connector allows for online premium payments (and in fact, payments have to be made to the exchange, not to the insurance company itself). The good news is that the website & billing system appear to be working properly this year, a vast improvement over last year's disaster. The bad news (or, odd news anyway) is that for some reason the system requires you to pay using only direct electronic fund transfers or a written check--it does not accept credit card payments!

I don't know if this is for technical reasons (which I doubt) or policy reasons (avoiding the 2.5% transaction fees or whatever), but it seems very odd to me.

HAWAII: Not only hasn't the HI Health Connector provided any enrollment updates since open enrollment started again on November 15th, they haven't even updated their enrollment report section since July 26th! Guys, either post an update or at least remove the link entirely; keeping it as is, locked in on 7/26 is just embarrassing.

OK, not sure if this number runs through Thursday, Friday or Saturday given the conflicting wording ("before the week was over"), so I'm playing it safe and going with Friday:

By Thursday, the exchange had received about 25,000 calls and greeted about 1,800 walk-in visitors at its Contact Center at 70 Royal Little Drive. Meanwhile, the HealthSource RI website received about 35,000 hits, half of them from new visitors, an indicator that many may be first-time customers.

All of that activity resulted in 1,850 renewals and 319 new customers before the week was over.

“We are about where we expected to be at this point,” said Director Christine Ferguson, “but we have a long way to go.”

There's also some updated 2014 data:

As of Nov. 1, two weeks before the start of open enrollment, about 26,300 Rhode Islanders were covered by individual and family plans through HealthSource RI. Another 2,400 people had obtained coverage their small employers offered via the exchange. In addition, close to 70,000 enrolled in Medicaid through HealthSource RI.

I've ranted several times before about the importance of current Obamacare private policy enrollees making sure to actually visit the exchange website, shop aroundlog into your account and manually re-enroll for 2015, even if nothing has changed at your end (ie, no changes in income, dependents, residence etc).

There are many reasons NOT to auto-renew, most of which are financial in nature. The short version is, you could easily end up paying more than you thought next year by not switching (in addition to premium changes, your tax credit might drop even if your income hasn't changed due to how it's calculated), and you could pay substantially less next year if you do switch to another policy (premiums are actually dropping in many markets).

NOTE: In light of some serious discussion with IBD's Jed Graham and a lot of thought afterwards, I've decided to run the "attrition" numbers two ways: "Current vs. April Paid" and "Current vs. April Total", for reasons I'll explain soon.

The main thrust of this article is general hand-wringing over how the state of Rhode Island plans on funding their ACA exchange after this year, although it's a bit confusing since it sounds like the problem has nothing to do with having the funding and everything to do with having permission to use it:

Enrollment starts on Nov. 15.

Not long after, the state will have to make its own big decision: how to finance the exchange.

Of the $23.4 million in federal funds budgeted for HealthSource RI this year, only $1,353,570 has been spent so far. The state anticipates — but does not yet have — federal permission to spend any of the remaining dollars after Dec. 31.

However, there's one data point that pops up smack in the middle of my current "mini-project", trying to lock down the current QHP enrollments in each state:

Yesterday I put out an open call for off-season QHP data from California, New York and Rhode Island, none of whom have released this info since 4/19 (Connecticut hasn't either...they gave me their combined total for QHPs + Medicaid, but I can't use that for a proper projection until I know the actual breakout between the two).

Today, thanks to Dara Chadwick of HealthSourceRI, I can cross Rhode Island off the list:

We had 25,767 total paid QHP enrollments during the open enrollment period, including all individuals who enrolled by March 31 and paid by April 23. 

As of August 2, 2014, 26,686 Rhode Islanders are enrolled in QHPs. Of those, 25,892 have paid.

OK, I'll have to reverse engineer things slightly here, since the paid number is given for both August 2nd and March 31st, but the total number is only given for August 2nd. Looking back at my last entry for Rhode Island, the 3/31 total was 27,968.

Usually I'm able to track down my data either by myself or with the help of several people who send me data links on a fairly regular basis. This has resulted in my being able to fill in off-season QHP enrollment data for almost 20 states.

However, there are several states whose data has eluded me so far...and unfortunately, this includes the two largest state-run exchanges: California and New York. I've contacted both exchanges; CoveredCA told me that updated enrollment numbers would be released "soon" but that was a good month ago. The New York State of Health exchange flatly stated that they, like HHS, would not be giving out any sort of official off-season enrollment update. There's also the Rhode Island exchange, which hasn't responded to my requests at all. (Update: Never mind that last one; just heard directly from the RI exchange, hopefully they'll be able to provide an update soon...)

I know I said I wouldn't be posting during the Netroots Nation convention unless something significant happened. Well, thanks to the Kaiser Family Foundation, I've learned of a pretty important development. The state of Rhode Island just released their decision on the APPROVED insurance premium rates for Blue Cross Blue Shield in 2015. Check it out:

As you can see, BCBSRI asked for an average rate increase of 8.9%. The state insurance commissioner approved...4.5%.

Obviously this may not be typical of what will happen in other states or for other companies, but the point is made: the preliminary rate requests are just that: Preliminary. You can REQUEST anything; that doesn't mean you'll get it.

UPDATE: I've found the market share breakout for both companies (the third one is new to the exchange), and it looks like BCBSRI made up almost all of it (98%), so the weighted average looks to come in at around 4.3%.

"But, but...how many have PAID???" in Rhode Island?

Christine Ferguson, executive director of HealthSource RI, said 91% of the 27,968 individuals who signed up for private plans during the open enrollment period from Oct. 1 to March 31 paid their first premiums by the April 23 deadline. Analysts have pointed to that percentage as a key test of whether the enrollment figures were as strong as they looked.

“My takeaway of that 91% is that we have work to do to keep them, but that’s a high conversion rate, and it’s a testament to the work that the staff’s done to really work with people,” Ferguson told WPRI.com.

“I think it’s a reflection of the work that’s been done in the marketplace, the care that we took in the kinds of plans we offered and the range, and I think it is a reflection of the system working reasonably well,” she said. “I think for us the real issue – and I think the thing that people have not paid enough attention to nationally – is retention.”

Rhode Island's ACA Medicaid expansion was at around 65K a couple of weeks ago, so this is a nice small bump:

Through April 19, 70,243 people had signed up for Medicaid under the Affordable Care Act rollout, according to state figures, with federal dollars paying for about two-thirds of those people and state and federal dollars roughly splitting the cost for the other third, because they were already eligible before Obamacare entered the picture.

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