I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick hits:
One of the big news stories in 2013 and early 2014 was the botched launch of the federal Exchange (and several key state Exchanges), which led to many Americans having to wait to be enrolled in an ACA-sanctioned health plan. Although some technical snafus have been addressed, many still remain. For example, a top White House official told Congress recently that the automated system to send payments to insurance companies is still under development, and didn't offer a completion date. The lack of an electronic verification process is only one part of the "backend" of the software that is still problematic five years after the Act was passed.
I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:
ARKANSAS:
Mark Pryor shows Democrats how they should campaign on the Affordable Care Act in a red state. You don't have to mention Obamacare (which technically doesn't even exist), you don't have to even mention the Affordable Care Act. You do have to personalize what the law actually means forreal people with real medical issues which were fixed or improved by the law:
Finally, a solid update out of Vermont; thanks to Morgan True of VT Digger for pointing me towards the most recent Vermont Health Connect report as of just a week or so ago:
There's a lot going on in the table above. For one thing, this demonstrates, again, how stupid it was to hyperventilate about "How many have PAID???" back in February or March, when a good 40% or more of the people who would eventually enroll wouldn't even have their policies kick in for weeks or even months yet. Note that of those whose policies started between January 1 - May 1st, over 95% have paid their first premiums by now:
...After taking political heat for the exchange's technological failure, the appointees of Gov. John Kitzhaber are taking on a more significant role, transforming the agency for the future. At a time when critics of the agency say it should go away, it's the bureaucratic equivalent of an existential moment for an agency considered crucial to federal health reforms.
... The state's planned 2015 partnership with the federal exchange is called a "supported state-based" exchange. But it's supposed to be a temporary fix before setting up a full-fledged state-based exchange. It allows Oregon to keep insurer fees of about 2.5 percent of premiums for itself until the state resurrects its own website.
OK, the Medicaid number is a bit squirrelly since it isn't broken out by expansion/woodworkers/churn; the official number as of 4/19 was 27,268, so I'm estimating it at an even 30K.
Otherwise, the QHP total is for paid enrollees, up from 27,221, and the SHOP number is up from 33,614.
Vermont Health Connect has helped 144,500 Vermonters get health coverage. More than half, 80,400, were enrolled in Medicaid, many as a result of the program’s expansion under the Affordable Care Act.
However, the website was launched with significant problems, and eight months later it is still incomplete. State officials said this week that they will continue to rely on the two participating insurance carriers to enroll small businesses throughout the upcoming open enrollment period that begins Nov. 15. There are currently 34,800 people in that group.
There are also 29,300 people in the individual market who purchased commercial insurance. More than half, 62 percent, qualified for subsidies that lower the cost of those plans, though advocates say they are often still difficult to afford.
As I noted yesterday, there are three states which had unusually large discrepancies between the official HHS and state exchange QHP enrollments:
New York came in over 65,000 lower than the number I had for a simple reason: The New York exchange lumps enrollees in their Child Health Plus program in with QHPs, even though technically this isn't a QHP program. There were over 40,000 of these as of the end of February; this number has climbed to 65,028 as of 4/19.
Since Child Health Plus is privately funded (and therefore isn't on the Medicaid/CHIP side), but also isn't officially a QHP either according to HHS, I've moved it over to the "Off Exchange QHP" column.
• 52,156: Vermonters who used the Vermont Health Connect website, call center or navigators to shop for 2013 health insurance and now have coverage.
• 24,888: Vermonters who purchased commercial coverage through Vermont Health Connect.
• 27,268: Vermonters who shopped on Vermont Health Connect but qualified and are now enrolled in Medicaid. Eligibility expanded under the federal Affordable Care Act.
• 33,549: Vermonters previously covered by the Vermont Health Access Program and Catamount Health who the state enrolled automatically in Medicaid based on income information on record.
OK, looks like I completely misunderstood the Vermont figures from a few days ago; half of them were supposed to go on the Medicaid side after all. From a source at the Vermont Health Connector:
In the meantime, I can provide the enrollment figures: 48,150 are fully enrolled in a plan through Vermont Health Connect; 25,930 of those enrolled in Medicaid or Dr. Dynasaur, our CHIP program.
Doesn't impact the overall national total, but it does change the dynamic for Vermont to something...rational (prior to this it looked like they had hit a whopping 585% of their year 1 target!
OK, in addition to the appx. 7.041 million enrollments on the Federal exchange (HC.gov), I've brought CO, CT, DC, HI, KY, MD, MN, NY, RI and WA completely up to date, with all QHP data through midnight on 3/31 (some of the Medicaid/CHIP data is still missing, but that's a lesser concern at the moment).
However, I'm still missing the following exchange QHP data:
California: 22 hours (that's right...the current tally runs thru 2am on 3/31)
Massachusetts: 3 days (current is thru 3/28)
Nevada: 2 days (current is thru 3/29)
Oregon: 3 days (current is thru 3/28)
Vermont: 1 day (current is thru 3/30)
I can't tell you how frustrating it is to be this close to full data while still missing it.
So, how much is actually missing? Well, if these states were running at their prior average March daily rate, it would be
CA: 11,754
MA: 512 x 3 = 1,536
NV: 427 x 2 = 854
OR: 502 x 3 = 1,506
VT: 775
Total: 16,425
However, this obviously doesn't apply since the final weekend and especially yesterday were insane.
Vermont's numbers can be a bit squirrelly, but in this case they're very specific about 46.8K being exchange QHPs (VT doesn't allow off-exchange enrollments anyway, and the the 30-40K figure is the same from the last update).
As of Monday morning, 46,800 individuals had enrolled to be covered with private insurance either from Blue Cross Blue Shield of Vermont or MVP Health Care. An additional 30,000 to 40,000 people were enrolled through their employers, Yahr said. The federal target enrollment was 56,000 by Monday.
If that's not a typo or a misunderstanding on my part, it means that Vermont has just skyrocketed to 4.5x their February enrollment rate.
