Rhode Island

The last official enrollment update for Rhode Island was 31,513 people as of 2/23/15, of which 30,001 had paid their first monthly premium at the time.

On the one hand, that makes it look like an amazing 95% payment rate; however, RI also "pre-purged" unpaid enrollments which missed the payment deadline prior to officially reporting them, so their payment rate actually ended up being more like 91% (ie, 30K out of around 33K total selections).

As of July 3rd, the QHP selection total for RI stood at "over 36,000":

HealthSource RI has enrolled over 36,000 Rhode Islanders in 2015 healthcare coverage to date. Some Rhode Islanders may be eligible for a special enrollment period (outside of open enrollment) during which they can get coverage because of qualifying life-change events (such as a change in family status, loss of insurance, and certain hardships).  More information about who qualifies for a special enrollment period is available at HealthSourceRI.com.

You don't hear a whole lot about the other ACA healthcare exchange system, the Small Business Health Options Program (SHOP, although it should really be "SBHOP" which looks like a typo). In fact, to my knowledge, the HHS Dept. has never said a peep about the SHOP numbers in any of their official reports or press releases. There's a reason.

Rhode Island just made an announcement about their SHOP program. RI only has a total population of just over 1.05 million people anyway. so 3,500 people enrolled in the state's Small Business exchange policies actually isn't too bad, really (for comparison, this would be the equivalent of California enrolling around 128,000 people in theirs).

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.

On the surface, this story may seem pretty minor in the scheme of things:

Rhode Island's ACA exchange hasn't suffered from the technical glitches which are still causing problems for some states (particularly Vermont and Minnesota), but HealthSource RI does have one major problem to deal with: Funding. It's a small state with a smaller customer base for the exchange; 31,500 enrollees isn't a lot of people to cover the costs. As a result, the Governor of Rhode Island has come up with a healthcare policy tax idea which is being batted around.

The article goes into the pros and cons of the tax as opposed to simply dropping the exchange altogether and moving to Healthcare.Gov. Aside from the biggest and most obvious downside of doing so (King v. Burwell), it's also not certain that making the move would actually save any money, since HC.gov still takes some bucks to run:

Neither option is free.

Mazel Tov to HealthSourceRI for being the first of the state-based exchanges to release their full 2015 Open Enrollment Period (with #ACAOvertime included) results. HC.gov released their collective total yesterday, but haven't broken it out by state yet; Kentucky released data through 2/19 but their extension period isn't over until Saturday; and I have a rough estimate for Massachusetts, but they won't release their official tally until tomorrow.

Meanwhile, here's Rhode Island's final count:

PROVIDENCE – HealthSource RI (HSRI) has released enrollment data, certain demographic data and certain volume metrics through Monday, February 23, 2015, for Open Enrollment and the Special Enrollment Period (due to previous weather closings at the contact center and walk-in locations).

It's a long press release, but here's the latest update out of Rhode Island (which has a FULL extension/overtime policy through 2/23).

The grand total: 30,744 QHPs, of which 27,487 have paid their first premium (89.4%). The payment rate has gone down because a huge number of those 30,744 just enrolled in the past week or so, and thus their payments aren't due for another week yet.

SHOP enrollments now stand at 3,349.


Posted on February 18, 2015 | By HealthSource RI

PROVIDENCE – HealthSource RI (HSRI) has released enrollment data, certain demographic data and certain volume metrics through Sunday, February 15, 2015, the last day of Open Enrollment.

I've confirmed that Rhode Island's weather-induced enrollment extension is indeed state-wide and is of the "full" variety (ie, people can start the application process, not just finish it), through February 23rd. This is exactly the same policy that the Massachusetts exchange announced the other day.

Also, a late-breaking extension announced from Maryland.

11:45pm: OK, add the DC exchange to the pile.

9:00am 2/16/15: OK, HHS/CMS has clarified the specifics for the 37 Healthcare.Gov states.

11:50am 2/16/15: Idaho's policy took some work to decipher...

2:24pm 2/16/15: ...and Minnesota...



Posted on February 11, 2015 | By HealthSource RI

PROVIDENCE – HealthSource RI (HSRI) has released enrollment data, certain demographic data and certain volume metrics through Saturday, February 7, 2015, for Open Enrollment.

As of February 7, 2015, 79% of Year One customers have renewed (selected a plan) for 2015
(77% of renewing customers paid the first month’s premium).
Total New Customers: 8,547 (7,372 paid)
Total Renewed Customers: 20,240 (19,617 paid)
Total HealthSource RI enrollments for 2015 coverage: 28,787 (26,989 paid)

*Note: Individuals who have selected a plan but not paid by their selected coverage effective date become cancelled; reported enrollment values (plan selections, paid and unpaid) will fluctuate with potential net decrease due to plan selection cancellation, as of the passage of the January coverage payment deadline.

As I noted last week, Rhode Island is doing exactly what every state exchange (as well as HC.gov) should be doing, assuming they have the technical capability to do so: They're updating their "enrollment" data weekly by purging those who didn't pay by the payment deadline, thus keeping their enrollment data as "clean" as possible. As a result, their "total" enrollment tally has actually dropped over the past 2 weeks as they cull unpaid enrollees from the official count. This is a good thing.

Unfortunately, since they're the only state doing this so far (both VT and MA are also tracking payment rates, but they're not lowering the "total" number accordingly), it also means that their "total" data is out of sync with everyone else's. This skews my national payment rate calculation a bit, but RI's numbers are so low anyway that it shouldn't have much of an impact one way or the other.

In any event, as of January 31st:

As of January 31, 2015, 78% of Year One customers have renewed (selected a plan) for 2015 (77% of renewing customers paid the first month’s premium).

As of January 17th, Rhode Island had enrolled about 28.8K people in private plans for 2015, or around 78% of their "official" target (based on the HHS Dept's "30% higher than last year" target).

Today they've released another update, bringing things up to date through January 24:

As of January 24, 2015, 79% of Year One customers have renewed (selected a plan) for 2015 (75% of renewing customers paid the first month’s premium).
Total New Customers: 7,862 (6,539 paid)
Total Renewed Customers: 20,283 (19,189 paid)
Total HealthSource RI enrollments for 2015 coverage: 28,145 (25,728 paid)

Hey, cool! That's a 91% payment rate! Um...except for one thing...somehow they've lost 644 people? Oh, wait...

Hot off the presses... HealthSource RI has posted their latest enrollment report; the new numbers are modest, but the payment data is rapidly improving; they're up to an 84% payment rate and the other 16% still have 6 days (from the 17th) to pay up.


As of January 17, 2015, 81% of Year One customers have renewed (selected a plan) for 2015 (72% of renewing customers paid the first month’s premium).

Total New Customers: 7,660 (5,646 paid)
Total Renewed Customers: 21,129 (18,460 paid)

Total HealthSource RI enrollments for 2015 coverage: 28,789 (24,106 paid)

...Renewed Customers
2015 vs. 2014 Selection by Plan, by Metal Level and by Insurer

Sean Parnell has posted a fairly negative story on the Rhode Island exchange, HealthSource RI. This is fairly unusual, because Rhode Island's exchange is actually one of the better ones...it operated fairly smoothly both last year and this year, and they're the only state which willingly followed the "no autorenewal" advice which I was giving to all of the exchanges way back in June (a few other states didn't allow autorenewals either, but that wasn't their choice...the new software platform wasn't compatible with the old software).

The problem in Rhode Island is that no matter how smooth and drama-free the exchange's operations have been, the actual numbers just haven't been up to snuff:

TODAY, January 15th, is the deadline for anyone who wants to enroll in a private insurance policy for coverage starting on February 1st in most states (or to switch to a different policy if you have one but want to make a change starting in February).

After that, of course, we'll have the big February 15th deadline (for March 1st coverage), which will also be a big deal because it'll be the last chance many (not all) uninsured people have to get coverage before the door slams closed until next fall.

Remember, the penalty in 2016 for not having health insurance in 2015 is considerably higher than it was for 2014: Instead of 1% of your taxable income (or $95/person in your household, whichever is higher), the fee this year is 2% of your income or $325 per person.

No official press release yet, but all of the numbers are here and are (thankfully) properly presented:

Following a flurry of activity leading up to a New Year’s Eve enrollment deadline for coverage on Jan. 1 — and also through the first 10 days of this month80 percent of first-year customers have signed up for a plan for this year, according to figures to be released on Thursday. Of those, 67 percent have followed through and paid their first monthly premium.

...Total enrollments for individuals now stands at 27,690, up from 25,288 just before the start of open enrollment in mid-November.

...“We were preparing for that with a very robust consumer outreach plan,” said spokeswoman Maria Tocco, adding, “I’m not sure we knew what to expect.”

...HealthSource RI reports that, as of Wednesday, 6,918 people who were not previously customers had been signed up for coverage. Wallack called that figure “great.”

...The new subscribers joined 20,772 returning individuals. Together, the two groups combined for an increase of 2,402 covered individuals, up slightly less than 1 percent from just before enrollment began.

Yes, that's right: We're quickly approaching the next big deadline: Private policy enrollment in time for coverage starting on February 1st.

Of the 3 monthly deadlines (January 1st start, February 1st start, March 1st start), this is the one getting the lowest amount of hype, for obvious reasons. The December 15th (or December 18, 23 or later, depending on the state) deadline was a huge deal because millions of people had to be renewed (either actively or automatically) in order to avoid any sort of a coverage gap, while a few million more people new to the exchanges jumped on board in time to start 2015 running. By my estimate, there should have been roughly 8.6 million people whose 2015 policies started on Jan. 1st.