In all the hullabaloo over the monthly HHS report yesterday, not a whole lot has been said about the Medicaid/CHIP side of things. Medicaid/CHIP enrollment has always been much trickier to pin down than private QHPs, partly due to the high "churn" rate of people moving onto & off of it, partly due to about 40% of the states not having implemented any version of ACA Medicaid expansion anyway, partly due to the headache-inducing rules for eligibility and nightmarish paperwork hoops people have to jump through to enroll in some states.
The other reason for confusion is that the HHS reports only state how many people were determined eligible for Medicaid/CHIP in each state. It doesn't necessarily follow that 100% of those folks actually end up being enrolled. This footnote from page 21 should give you an idea of how much of a pain in the ass this is to figure out:
In all the fuss and bother over yesterday's monthly HHS report (which only ran through the 15th), I almost forgot about the HC.gov-only "weekly snapshot" which was also released at the same time. This report only covers the 37 states run via the federal exchange, but is more recent; it goes all the way up through December 26th, just 5 days ago.
I did acknowledge the 96,446 additional QHP selections since the previous week at the very end of my analysis of the monthly report, but didn't look at the rest of the weekly report at the time. There's not a whole lot of new data here, but there are a couple of noteworthy tidbits:
They just released today's daily dashboard report, and the QHP eligibility determinations have gone up by another 6,263 people. Every day since Nov. 15th, roughly 50% of the QHP determinations have gone on to actually select a plan that very same day; the rate has ranged from 45% - 55% but always hovers near the 50% mark. Assuming this is still the case, that should mean at least 3,100 more QHP selections as of last night, for a total of around 80,600 to date.
In addition, MA has confirmed 139,063 new Medicaid/MassHealth enrollees, which have immediate effect.
As a side note, this means that MA has now enrolled more than 2.5x as many people in private plans for 2015 as they did all of last year.
I've been saying this for several days now, but yesterday's monthly HHS report confused the hell out of a whole bunch of people by making it sound as though the "current" number of private healthcare policy enrollments via ACA exchanges is only around 4 million. This was especially confusing to some given that a week ago they issued a "weekly snapshot" with nearly 6.4 million via HC.gov alone, and another weekly snapshot yesterday bumping that number up to nearly 6.5 million.
Now, I've been saying for a week or so now that the actual total is up to 8.65 million or more (more like 8.84 million as of today), but the headline above refers to the officially confirmed total. That doesn't mean estimates or speculation; that's the total number reported in official press releases from ACA exchange representatives.
Fewer Ohioans choose a health plan in 2015 enrollment
Nearly 89,000 Ohioans chose a health insurance through the Affordable Health Care marketplace during the second open enrollment in November and December, the federal government reported Tuesday.
Vermont Health Connect Open Enrollment and Renewal Update
The following numbers are up-to-date as of 11:59pm Tuesday, December 30, 2014.
Renewals: 23,356 individuals have been checked out into 2015 health plans.
New to Vermont Health Connect: 6,881 individuals have been checked out into 2015 health plans.
Customer Support Center Metrics (Week of Dec. 22-27)
Number of calls: 6,154
Average wait: 14.1 seconds
Number of calls answered in less than 30 seconds: 93.1%
Tracking Progress of New Applications
The following graph shows where new applicants are in the process between submitting their application and being covered by a qualified health plan. Please note that applicants who qualify for Medicaid are not included. The numbers are up-to-date as of Monday, December 29, 2014.
I know I said I would save any further analysis of today's monthly HHS report until tomorrow, but when I started plugging in the state-by-state numbers, I came up with some really strange discrepancies between the QHP selection number in the report and the corresponding report from some of the state exchanges for the same date.
It got to be so strange that I actually whipped up a little spreadsheet for all of the state-based exchanges (minus Massachusetts, which is a special case anyway; plus Oregon, which is running off of HC.gov this year but has a large discrepancy from the official State of Oregon Website which is reporting enrollments this year as well). The yellow lines are the states I'm most concerned about (the others all have either obvious explanations or are minor enough not to worry about). Afterwards I'll run through the problems with each one.
As I noted on Saturday, I was out of town for a few days (at a water park resort in Ohio, if you really want to know) with my family. We had a good time at the actual water park, but I strongly recommend avoiding the TGI Friday's attached to it. HHS Sec. Burwell noted last week that the first Big, Official, Comprehensive Monthly ASPE enrollment report (broken out by state and other demographics) would be released sometime this week. I knew it would come out either today or tomorrow; I was hoping they'd hold off for one more day, but I guess they wanted to put it out there so the HHS staff could go home for New Year's, which is reasonable.
As a result, I was driving back from Ohio (well, my wife was anyway...I drove down, she drove us back) when the news hit earlier today, and wasn't really in a position to do a full analysis from a moving car, though I did tweet back & forth about it quite a bit.
Ah, now that's more like it. I don't know how many of these folks are facing a 1-month coverage gap (40,581 were enrolled by 12/14; the rest came in sometime after that; I'm assuming perhaps 8,000 made it in under the wire on the 12/15 deadline?), but considering that Oregon had around 77K people enrolled in 2014 plans, this is a much better batting average for 2015 total coverage:
Open enrollment weekly updates
The Insurance Division will collect enrollment information from carriers each week throughout 2015 open enrollment. Updated numbers will be posted each week on this web page.
Members enrolled, Nov. 15-Dec. 21 On Healthcare.gov 67,467 Outside of Healthcare.gov 31,599
Total 99,066
About the data: Enrolled means a person has selected a plan. Consumers must pay the first month's premium for their coverage to become effective. These numbers do not identify whether the first month's premium has been paid. These numbers do not include Oregonians enrolled in the Oregon Health Plan (Medicaid).
A nice fully-detailed enrollment report out of Rhode Island, although there's a rather curious wording decision for an even more recent update:
PROVIDENCE – HealthSource RI (HSRI) has released enrollment data, certain demographic data and certain volume metrics through Saturday, December 20, 2014, for Open Enrollment.
Enrollment data (November 7, 2014 through December 20, 2014) 56% of Year One Customers Have Renewed Plans for 2015.* Total New Customers: 3,841
Total Renewed Customers: 13,780
Total HealthSource RI enrollments for 2015 coverage (including those who have not yet paid): 17,621
*HealthSource RI reports as of December 23, a total of 68% of Year One customers have renewed plans for 2015.
SHOP (cumulative as of December 20, 2014):
Small employer applications completed: 529
Small employer accounts created: 1,901 Small employer enrollment: 437 (representing 3,192 covered lives, based on their submitted census)
Small employers enrolling in Full Choice Model: 76%
Hmmm...OK, I admit I'm starting to get a bit concerned about Minnesota. True, they bumped out their January deadline enrollment date until tomorrow (New Year's Eve), so there's still 5 day's worth of data to go including what I assume will be some sort of surge today and tomorrow, but I was expecting them to be doing a bit better at this point. They had just over 41,000 2014 enrollees as of mid-October. Nationally over 90% of 2014 enrollees should be renewed either manually or automatically, but MN has a special situation given that the largest insurance company on MNsure dropped out, leaving over 60% of the total to find something else or be moved off of the exchange completely.
OK, I actually have 3 different sources for these Massachusetts numbers, and the dates and classifications overlap a bit so bear with me.
First, we have today's daily MA Health Connector Dashboard report, which states that there have been 148,453 QHP determinations thorugh yesterday (12/29). Assuming 50% of these have selected plans, that's around 74,200 QHP selections to date. In addition, the 134,803 Medicaid (MassHealth) enrollments are already locked in.
However, there's also this story from Felice J. Freyer of the Boston Globe from 12/28 (about a jaw-droppingly poor bit of timing by private, for-profit corporation Dell to install some sort of major software update which caused the payment system to be unavailable for 12 hours on the payment deadline), which pins down the numbers a bit further:
As of Dec. 28, a total of 146,529 Marylanders have enrolled in quality, affordable health coverage for calendar year 2015 since the 90-day open enrollment period began Nov. 15. That includes 83,735 individuals enrolled in private Qualified Health Plans (QHP) and 62,794 individuals enrolled in Medicaid.
At 83,735 enrollments so far, MD has now enrolled 24% more people than they did during all of the 2014 open enrollment period (67,757 thru April 19th).
Put another way, they've enrolled 375 people per day since their January deadline, which is still 11% faster than the 338/day they averaged during the first open enrollment period (including the December and March surges).
Add another 62,794 to Medicaid and MD's turnaround for 2015 is quite impressive indeed.
These numbers are pretty good for DC...except that there's an important caveat: They're all cumulative numbers since October 1st, 2013, making it trickier to parse out:
More Than 71,000 People Enrolled in Health Coverage Through DC Health Link
Wednesday, December 24, 2014
Enrollment
From October 1, 2013 to December 21, 2014, over 71,500 people have enrolled in health insurance coverage through DC Health Link in private health plans or Medicaid:
18,773 people, including new customers from the 2nd Open Enrollment Period , have enrolled in private health plans through the DC Health Link individual and family marketplace; 37,457 people were determined eligible for Medicaid coverage through DC Health Link; and 15,284 people enrolled through the DC Health Link small business marketplace and members and staff from US Congress.
Fortunately, I have most of the 2014 data as well so we can break this out:
OK, YES, I know that the HHS's monthly ASPE report on ACA enrollment was finally released today. And yes, I know there's been a ton of other state-level data and other news over the past couple of days. However, as I noted on Saturday, I had to go out of town right in the middle of all of this and just got back, so I have a busy afternoon ahead of me bringing everything up to date...
So, let's start out with one of the less-obvious updates: Medicaid expansion in Michigan.
To recap: Estimates of Michigan's ACA Medicaid expansion-eligible population have ranged from 477K - 500K, thus making the enrollment data from the official state website rather eyebrow-raising:
Healthy Michigan Plan Enrollment Statistics
Beneficiaries with Healthy Michigan Plan Coverage: 507,618
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)
*Statistics as of December 29, 2014
*Updated every Monday at 3 p.m.
...it's almost certainly a scam unless you're expecting the call and have verified their identity otherwise.
Yes, I know I'm violating my own earlier notice that I'm off the grid for a couple of days, but this development seems to warrant a quick post.
Earlier this evening I received the following email. I'm not including the sender's identifying information for obvious reasons:
Someone from this website contacted me to help with enrolling in health insurance. They created an account on healthcare.gov with an id of XXXXXXXX@acasignup.net instead of my email address and did not give me the password. I am trying to make some changes to my healthcare coverage and update my information.
I am very concerned with the safety of my information. I thought they were from the health insurance marketplace.
If you could change my id to my email and give me the password I would very much appreciate it.
If not I will assume you are an identity thief and contact the FBI.
I'm expecting a few major ACA-related announcements between now and Tuesday, including:
The first official Monthly HHS ASPE Report on ACA exchange enrollment (that is, the big, fat, 40-page detailed report with enrollments broken out by state, metal level, including both QHPs and Medicaid/CHIP and so on).
This is the same type of report which HHS released once a month last year, and it's the official record for purposes of tracking enrollment. It should include all 50 states plus DC. However, I have no idea whether it will run:
November 15th through November 30th (ie, a partial calendar month, which wouldn't be particularly useful); if so, I'd expect around 930K QHPs via HC.gov and 1.24M total.
November 15th through December 15th (everything up through the enrollment deadline for January coverage in most states; this would be useful, but wouldn't include any autorenewals); if so, I'd expect around 3.52M QHPs via HC.gov and 4.70M QHPs total.
November 15th through December 19th (actually 5 full calendar weeks, which is what I'm guessing it'll include and which would be the most useful, since autorenewals for most states would be included). If so, HHS has already given the total as roughly 6.39M via HC.gov, and I'm estimating roughly 8.52M total (remember, my 8.65M estimate includes 4 extra days, through 12/23).
I'm also expecting press releases from Minnesota, Washington State and of course Massachusetts. Washington's should include their "deadline surge" day enrollments, and Massachusetts should be revealing how many of the 34,138 people who enrolled by their deadline but hadn't actually paid by then made their payment under the wire.
Otherwise, I'm hoping that both New York and California will provide their respective renewal numbers, which should be roughly 1.1 million (CA) and 310K (NY), give or take. CoveredCA said that they won't be giving out their renewal data until January, but I'm not sure how that will work since HHS is supposedly releasing a comprehensive monthly report next week. If there's a big blank spot under CA, then the report will have a huge hole of over a million people, making my estimates kind of pointless.
However, I won't be able to post about any of this, as I'll be unavailable for a few days due to a family commitment. I should be back sometime Tuesday evening, and of course I'll be posting about any developments which took place while I was gone.
About 2.3 million Pennsylvanians are currently enrolled in Medicaid, Gillis said, and as of Dec. 22, about 88,000 households had applied for Healthy PA, with approximately 30,000 additional applications sent to the state from healthcare.gov. The number of applications from each county is not yet available, Gillis said.
The department is still processing applications but, she said, most of the new sign-ups are going into the Private Coverage Option, which is for people who are newly eligible because Healthy Pa.’s income limits — 133 percent of the federal poverty level, with a 5-percent income disregard — will be broader than Medicaid’s are.
PA has around 600K residents eligible for the expansion program, so that's about 20% who have already signed up so far.
Nearly 15,000 people signed up for coverage through D.C. Health Link to begin by Jan. 1, officials announced this week.
The D.C. Health Benefit Exchange Authority reported 1,886 new enrollees and 13,100 people who have re-enrolled in private health insurance plans so far in this second open enrollment period under the Affordable Care Act. Earlier this month,officials said there could be up to 500 applications that weren't completed by the first deadline to obtain health coverage by Jan. 1 because of a glitch in the system's new features. Officials said all of those impacted enrollees would have coverage by Jan. 1.
Between Nov. 15 and Dec. 21, the D.C. Health Link website had 56,318 visitors with 109,058 visits. It fielded 25,667 calls to its customer service center.
OK, that's 14,986 total for DC, and this gets another chunk of renewals off the books.
Maryland's previous update, which included their 12/18 deadline for January coverage was just shy of 80K QHPs, or an average of 2,353 enrollments per day since 11/15.
This weekly dashboard report is really just an official breakdown of the numbers I reported a couple of days ago, as it only runs through 12/23, but it's still good to have an official confirmation of everything:
Merry Christmas! If you check out The Graph today, you'll note that today's update, in addition to adding yesterday (12/24), of course, also features a 4th color-coded section labelled "Confirmed via Healthcare.Gov".
I thought about whether to add this or not for some time. One of the complaints about the 2014 Graph was that while it was comprehensive, that also meant it was far too confusing for many people, with up to 8 different colored sections & labels all over the place. For 2015, I overhauled the format by a) separating out Medicaid/CHIP onto their own Graph and b) getting rid of off-exchange and SHOP enrollments entirely (at least until I have decent numbers for them). This left just 3 main data points: Total Estimated QHP selections, Total Estimated Paid QHPs and Total Confirmed QHP selections. I also added a dashed-line projection for how many of these I estimated were from the federal exchange (HC.gov) out of the total nationally.
A week or so ago I overlaid the 2015 Graph on top of the 2014 Graph, adjusting the time scale of last year's open enrollment period to account for the fact that this year it's less than half as long (93 days vs. 197 days). The results were pretty striking, but there were still a lot of unknowns regarding the autorenewal factor, among other things.
This Christmas Eve (I'm Jewish, so basically, you know, "Wednesday night" for me), I decided to run an updated version of the comparison, this time including the autorenewals along with other updated data. As a bonus, the dates even match up: December 23rd is 42% of the way through the 2015 OE period (39 days out of 93 total); December 23rd last year also happened to be 42% of the way through the 2014 OE period (84 days out of 197 total), so it seemed like a good point to run the comparison again.
And with that, here's my Christmas present to you: As of right now, the ACA exchanges as a whole have enrolled or re-enrolled 4.7x as many people as they had at the same point last year. Obviously this won't hold--I'm still expecting around 12.5 million by Feb. 15th, which would be about a 56% increase over last year--but symbolically, it's still a BFD, as Joe Biden would say.
As of midnight last night, the Massachusetts Health Connector just reported:
40,065 QHPs selected and paid for
34,138 QHPs selected but not paid for yet
74,203 QHPs selected total, with a 54% payment rate so far
MA has extended the payment deadline until 12/28, so the other 34K still have 5 days (including today) to make their first payment; if they miss that deadline but still pay up, they'll still be covered starting on February 1st.
Assuming 25,200 of these folks make their first payment by the 28th, they'll hit my 88% "rule of thumb" rate for January. Over 8,100 people made payments yesterday alone, so I'm not terribly concerned about this issue. It'll be interesting to see how many make the cut, given all the "but how many have PAID???" fuss and bother last year (last year, MA & WA were the only states which reported paid only numbers to HHS, but it was still messy in MA's case given their technical problems).
Washington Healthplanfinder Reminds Residents to Get Enrolled by 5 p.m. Today
Renewing Customers Must Also Take Action to Avoid a Gap in Coverage
OLYMPIA, Wash. – The Washington Health Benefit Exchange is reminding residents today to select and pay for a Qualified Health Plan through www.wahealthplanfinder.org by 5 p.m. for coverage that begins on Jan. 1, 2015. As of yesterday, more than 92,000 residents have enrolled for coverage that starts in 2015, with 22,710 of those customers enrolling for the first time in a Qualified Health Plan.
Interest surrounding the Dec. 23 deadline has been strong with approximately 30,000 calls to the Customer Support Center since Friday, Dec. 19. Nearly 7,000 customers enrolled in a Qualified Health Plan from Friday to Sunday alone.
Remember last week when I noted that the "Healthy Michigan" program (MI's implementation of ACA Medicaid expansion) had reached 487,000 people, which was actually 2% more than the official estimate of how many Michiganders are even eligible for the program?
I made sure to note that this was just an estimate, after all, and that some other estimates put the number as high as 500,000 even.
Well, guess what?
Healthy Michigan Plan Enrollment Statistics
Beneficiaries with Healthy Michigan Plan Coverage: 501,860
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)
*Statistics as of December 22, 2014
*Updated every Monday at 3 p.m.
Yup. Even using the higher number, Michigan has still broken through it in less than 9 months. And if you go by the 477K estimate, that means my state has managed to enroll 5.2% more than that.
Today is the final day for Massachusetts residents to enroll in a private healthcare plan if they want coverage to start on January 1st. As of last night, they had a total of 248,711 eligibility determinations, of which 131,732 are for private QHP policies (the other 117K have already been enrolled in Medicaid, aka "MassHealth", which is impressive in and of itself).
So, how many of those nearly 132K people have actually selected a plan? Well, since open enrollment started on 11/15, anywhere between 45-55% of total QHP determinations as of that day have also selected a plan. If that was the case here, I'd say that the number is around 50%, or around 66,000, which would be an impressive 4,600 spike over yesterday's confirmed 64.1K.
UPDATE: OK, I've received the official total: As of midnight last night, 67,759 people had selected a policy, or 51.4%. I've also confirmed that about 47% had paid their first premium already...32,000 people, or more than the total enrollees as of last April.
This morning the HHS Dept. announced that QHP policy selections through 12/19 via the federal ACA exchange totalled 6.4 million people.
They also broke this number out (roughly) as being around 1.70 million manual renewals, 2.78 million automatic renewals and 1.92 million new additions.
I had estimated roughly 3.52 million not including autorenewals through the 12/15 deadline; the actual number looks like it was roughly 3.40 million (plus another 220K over the next few days). That means I was over by about 3.5% on that number.
Yet I underestimated by around 9% for the total. How could this be? Because I vastly underestimated the number of automatic renewals which would be put through.
I assumed around 6.1 million total renewals (manual + automatic). The total from HC.gov is around 4.48 million, leaving around 1.62 million renewals (again, manual plus automatic) from the other 14 state exchanges.
6.4 million via Healthcare.Gov (37 states) + more than a million via the other 13 states (+DC) = 7,438,851 confirmed to date.
Note that this is only through 12/19 for most states, and that the January enrollment deadline still hasn't passed for 6 states (the deadline for MA & WA is today; for RI, VT, MN and HI it's not until New Year's Eve).
I'm still pouring over the numbers from the state exchanges (not a typo...I actually spilled hot chocolate near my keyboard...), but in terms of renewals, here's what it looks like so far (remember, there were around 6.7 million potential renewals to start with):
Today should be a big day in ACA enrollment news. It's the deadline for January enrollment in 2 more states (Massachusetts and Washington State). More to the point, the HHS Dept. is expected to release their 5th weekly "snapshot" report. This should be a big one, since it runs through 12/19, meaning it includes the big December 15th deadline which impacted all 37 states being run through HC.gov this year.
I don't know whether they'll just give the weekly numbers (through Friday the 19th) or if they'll also give a 12/15 number (remember, either one would be for HC.gov only, not including the 14 state-based exchanges).
I also don't know how they plan on reporting the millions of autorenewals which should have kicked in on Tuesday the 16th. If the snapshot runs through the 19th, they may be included in the "snapshot" total. Then again, they may be listed separately, or not at all. For all I know, some will be included but not others (it's possible that they've only processed a portion of them).
PROVIDENCE, R.I. (AP) — Rhode Island's health insurance exchange is extending the deadline for residents hoping to sign up for coverage beginning on Jan. 1.
HealthSource RI announced on Monday that people who can't meet the original Tuesday deadline will now have until Dec. 31 to enroll. They must also pay the first month's premium by Jan. 15.
There's a catch, however:
HealthSource officials caution, however, that customers who enroll after Dec. 23 may not receive their insurance cards or have active coverage on the first of the year. That could mean having to pay upfront for any care they receive during the gap and be reimbursed by their insurer after submitting receipts.
Individuals can choose health plans and enroll for coverage through the HealthSource website. They can also call or visit walk-in centers in Providence or Warwick between 8 a.m. and 9 p.m.
That makes 4 states pushing things out until New Year's Eve: Vermont, Minnesota, Hawaii and now Rhode Island.
When we last checked in on New York State, they had added a total of 195,000 new people since November 15th in addition to those already enrolled for 2014. This broke out to around 126.6K added to Medicaid and 68.4K set up for 2015 private policies.
NY's enrollment deadline for January QHP coverage ended on Saturday, and they've just come out with an updated total. Again, this does not include renewals of current enrollees:
NY up to 225,244, enrollment, not counting renewals @charles_gaba hopefully medicaid /qhp breakdown soon
Again, no breakout yet; that usually shows up within an hour or so of the initial total, based on Dan Goldberg's past scoops. Assuming it's roughly a 65/35 split like the prior total was, that should mean roughly 79,000 private policies and 146,000 Medicaid/CHIP.
I'll update this with more details as they come out...
On Friday I discovered that my estimate of roughly 60% of Massachusetts "determined eligible for QHPs" actually selecting a plan was way too high; the actual ratio was closer to 48% overall, meaning that my prior estimate of about 62K QHP selections was too high; the actual number was 53,490 as of Thursday the 18th, which is still excellent, just not as great as I thought it was.
Today I received confirmation directly from the exchange that total enrollments (ie, selected plans) are up to 61,470 as of this morning, which means that the ratio is indeed starting to move up, just later and not as quickly as I had thought (61,470 / 124,403 QHP determinations is just shy of 50%).
I haven't written much about the recent announcement by Vermont's governor that after years of pushing a single payer plan for the state, he's basically pulled the plug on it (at least for the time being). I noted the announcement but didn't have much to add myself.
Part of this is because I'm swamped with the actual ACA open enrollment itself, of course. Part of it is because it's too depressing a development for me to really think about right now. Part of it is because others far more knowledgeable than I am have much more to say about it.
One such person is Vox's Sarah Kliff, and she's written a fairly definitive explanation of what went wrong. The short version: Vermont's tax base is too small to support the initial costs, even if it would save gobs of money in the longer term.
In Vermont, this is massive: the state only raises $2.7 billion in taxes a year for every program it funds. Early estimates said that Vermont's single-payer plan might need $1.6 billion in additional funds — a huge lift. But $2.5 billion was impossible.
Way back in July, when the Halbig v. Burwell case was on the media radar, I wrote about the potential backlash against Republican governors/legislators who failed to take any action towards establishing a state-based exchange to salvage the tax credits for tens or hundreds of thousands of their own residents. At the time, I speculated that doing so could be as simple as slapping up a simple splashpage & redirect to HC.gov, which I termed the "Grand Slam Solution" (ie, "for less than the cost of a Denny's Grand Slam breakfast...")
...the "domain solution" I describe above would still have one more hurdle, of course: You'd still have to get the individual states to agree to pony up $9.95 per year and set up a simple domain redirect. Illinois has already done so; presumably other blue-leaning states would follow. That would leave about 30 states, give or take, including Texas, Florida and so forth.
One persistent Obamacare fear, for years now, has been that the new law would decimate the employer-sponsored insurance system. Why would companies waste money on buying coverage for their workers, the argument goes, when they could hand these people off to Obamacare's new exchanges?
And some high profile companies like Walmart went through and did this, leading to much speculation about whether Obamacare would kill employer-sponsored coverage.
New research from the Urban Institute suggests that, at least in year one, companies like Walmart were the exception rather than the norm: employer-sponsored coverage held steady through the Affordable Care Act's launch.
Huh. OK, this one is unexpected, mainly because they waited until 4 days after the original 12/15 deadline to make the announcement:
The Hawaii Health Connector has extended the deadline for residents to enroll in health insurance that takes effect on Jan. 1.
The extension will be until noon on Dec. 31. The original deadline was this past Monday.
The state's health insurance exchange created by the Affordable Care Act, also known as Obamacare, signed up 3,500 residents in the first month of open enrollment , which started on Nov. 15. To enroll, call 1-877-628-5076 or go to www.hawaiihealthconnector.com.
So, that makes 3 states now which have bumped their deadline for January 1st coverage out until 12/31: Hawaii, Vermont and Minnesota.
A week ago, I reported an update regarding the "Florida Health Choices" website, spearheaded by Florida GOP Senator Marco Rubio, which is a taxpayer-funded healthcare exchange to sell private insurance policies to Florida residents:
TALLAHASSEE — Last year, legislators allocated $900,000 to help Floridians find affordable health care through a new state-backed website.
At the same time, they refused to expand Medicaid or work with the federal government to offer subsidized insurance plans.
You know...Obamacare, without the "Obama" part.
It also doesn't offer any tax credits to make healthcare policies, you know, affordable.
Then again, that's kind of a moot point, since it doesn't actually even offer healthcare policies anyway--just "discount cards" for dental visits, prescriptions and prescription eyeglasses.
So...you know, it's basically a coupon store.
Oh, yeah...and even some of those coupons are kind of a scam:
A few days ago, I reported that Oregon had only enrolled 40,581 people in private 2015 policies via Healthcare.Gov as of December 14th. I further speculated that even if you include the big Deadline Spike on the 15th, the grand total for OR was likely around 48,000 total in time for January coverage...and of those, the odds are that around 8K of them are new enrollees, leaving around 40K manual renewals from this year.
At my last count, there were around 77K people still enrolled in 2014 plans as of late October, so that leaves potentially 37K people who will miss the boat for January coverage (at least with tax credits...they can still enroll off-exchange without credits, and almost 27K have done so in the state so far).
Many of those 37K may have dropped off of the exchange voluntarily, due to switching to employer-sponsored coverage, aging into Medicare and so on, while others who don't qualify for tax credits anyway may have gone off-exchange instead this year.
However, politically/image-wise, there are still thousands of people who qualify for tax credits who probably missed the deadline.
I'm not sure what to make of this. "Over a million people enrolled" it says. The embedded image specifically refers to 2015 coverage (and of course that's what they're pushing hard right now). Yet the most recent HHS Dept. weekly "snapshot" report has the number of plan selections as 2,446,562.
So, what does "over a million" refer to? Well, it could be a couple of things. It's most likely referring to the 48% of those who are new enrollees (around 1.17 million)...but if that was the case, it would make more sense to me to include the confirmed renewals for 2015 as well and say "more than 2.4 million enrolled."
At least 1.1 million people have signed up for healthcare through ObamaCare outside of the federal marketplace, according to a review of state data by The Hill.
That tally is on top of the 2.5 million people who signed up for coverage in the 37 states using the federal exchange, putting ObamaCare on track to outpace its goal for 2015.
I have a confirmed total of just over 3.5 million private policy enrollments via the various exchanges (federal + state) to date, so when I read the first sentences, it made me think "Ah ha! They've been reading ACASignups.net and also managed to find at least another 100K policy enrollments that I've missed! I was intrigued. But then...
Out of the 13 states that don’t use the federal exchange, 11 have reported data since Dec. 17 — a total of 1,142,124 sign-ups. Rhode Island and Idaho have not yet reported numbers.
A quick reminder: If you live in Idaho or New York, today is the deadline to enroll in a private healthcare policy if you want coverage starting on January 1st, 2015.
The Insurance Division will collect enrollment information from carriers each week throughout 2015 open enrollment. Updated numbers will be posted each week on this web page.
Members enrolled,
Nov. 15-Dec. 14
On Healthcare.gov 40,581
Outside of Healthcare.gov 26,799
Total 67,380
About the data: Enrolled means a person has selected a plan. Consumers must pay the first month's premium for their coverage to become effective. These numbers do not identify whether the first month's premium has been paid. These numbers do not include Oregonians enrolled in the Oregon Health Plan (Medicaid).
This updated from Oregon doesn't increase the total on the spreadsheet or graph, because it's already included in the HC.gov reports, but it's important for other reasons, including:
When I made my original projection of 12.0 million QHP selections by 2/15/15, I assumed that roughly 6.1 million of the 6.7 million current 2014 enrollees would re-up via one of three methods:
Actively logging into their existing account and renewing their current policy/switching to a different one
Actively creating a new account (in states like MA, MD, OR & NV) and enrolling the same/a different policy for 2015
Taking no action whatsoever and being automatically re-enrolled in their current account (or one nearly identical if the current one is no longer available).
In other words, I was operating on the assumption that roughly 6.1 million (91%) of current enrollees would stay on board one way or another, plus another 5.9 million new folks signing up for the first time.
OK, it looks like my theory about MA's "QHPs as % of Determinations" theory was wrong; I assumed that it would have started increasing from 50% over the past week, intstead it dropped to about 48% (or held steady at 52% if you include the "plans in cart" which neither I nor the MA exchange is doing anyway).
Therefore, the bad news is that the official total is around 8,300 fewer than I thought: 53,490 thorugh yesterday. The good news is that this is still an excellent number, and there's still tens of thousands of people who've started the process who have until next Tuesday to wrap it up.
In addition, remember my snark from 11/16 about "ONLY 3.5% HAVE PAID!!"? Well, guess what: That percentage is up to 34%, and they still have 5 days to pay (I presume they're dealing with a flood of payments at the moment).
The Medicaid tally holds at 98,530 since it doesn't include yesterday.
More Than 136,000 Marylanders Have Enrolled for Jan. 1 Coverage in State’s Health Insurance Marketplace
December 19th, 2014
ANNAPOLIS, MD – Governor O’Malley announced today that Maryland Health Connection, the state-based health insurance marketplace for individuals, families and small businesses, enrolled 136,685 individuals from the start of open enrollment onNov. 15 to last night’s deadline for coverage that begins Jan. 1.
That total includes 79,987 people signed up for private Qualified Health Plans (QHPs). More than three-quarters of QHP enrollees, or 61,448, are eligible for an Advanced Premium Tax Credit (APTC) — upfront financial assistance to reduce their monthly insurance premiums. An additional 56,698 have enrolled in Medicaid since Nov. 15 through Maryland Health Connection. Open enrollment continues through Feb. 15, 2015.
MNsure Extends Enrollment Deadline for January 1 Coverage to December 31
MNsure sent this bulletin at 12/19/2014 11:34 AM CST
December 19, 2014
MNSURE: FOR IMMEDIATE RELEASE
MNsure Extends Enrollment Deadline for January 1 Coverage to December 31
Decision follows transfer of enrollment information to insurance carriers and aligns enrollment deadlines for January 1 coverage
ST. PAUL, Minn.—In an effort to provide more time for Minnesotans who qualify for financial help available only through MNsure, the organization today announced it would extend the enrollment deadline to December 31 for January 1 coverage.
Minnesotans must now enroll in coverage through MNsure by noon on Wednesday, December 31, to have their coverage effective on January 1, 2015. The change comes at a time of high interest in MNsure and as many health insurance companies recently extended their own enrollment deadlines for January 1 coverage.
Margot Sanger-Katz has a fascinating story today about the "woodworker" effect in non-expansion states. I've written about woodworkers many times before; the short version is, these are people who were already eligible for Medicaid even before/without the ACA expansion provisions, but who never actually enrolled in the program for any number of reasons. Their reasons could be personal (embarrassment/shame over taking a "handout"), it could be because they didn't know that they were eligible (the rules vary from state to state), it could be because the enrollment process is too confusing (again, not an easy process in some states).
The 51 states (including the District of Columbia) that provided enrollment data for October 2014 reported nearly 68.5 million individuals were enrolled in Medicaid and CHIP. This enrollment count is point-in-time (on the last day of the month) and includes all enrollees in the Medicaid and CHIP programs who are receiving a comprehensive benefit package.
428,311 additional people were enrolled in October 2014 as compared to September 2014 in the 51 states that reported comparable September and August data.
(And yes, the "51 states" wording is CMS's, not mine)
Chalk up another 4,433 QHP eligibility determinations for MA yesterday. Assuming 60% of those have selected a plan, the cumulative total for 2015 should be up to around 61,800 people to date.
As of mid-April, Massachusetts had only enrolled a total of 31,695 people. That means that assuming I'm close, the Bay State should double their 2014 QHP enrollment by tomorrow.
In addition, their Medicaid enrollments are closing in quickly on the 100K mark (98,530), and should easily cross it tomorrow as well.
Exhibit A: I'm way behind on several projects from, you know, my day job.
Exhibit B: As you can see from The Spreadsheet, the enrollment data from every one of the state-based exchanges is current within the past week (WA is from 12/10, VT from 12/11, RI from 12/13 and all others are from the 14th, 15th or 16th).
Therefore, aside from the daily dashboard from Massachusetts (or if there's some huge ACA enrollment development), I'm taking the day off.
Hawaii's updates are particularly frustrating because they have a tendency to only give the cumulative plan selections to date, mixing together 2014 & 2015 numbers regardless of whether they've actually enrolled/re-enrolled for 2015 or not. Therefore, it's refreshing to see a (relatively) straightforward update out of the Aloha state:
The Hawaii Health Connector enrolled 3,500 people in its first month of open enrollment, which ended on Monday, the exchange confirmed Tuesday.
The state's online health insurance exchange saw more than an eleven-fold increase in enrollment in comparison to its first month of enrollment last year, when the just 300 signed up for health insurance on the Connector.
Of course, they couldn't help but mix numbers together later in the story:
...To date, roughly 13,500 residents have signed up for health insurance coverage that will begin on Jan 1.
Kissel noted that the Connector has also connected 50,000 to the expanded Medicaid program, which came in with the Affordable Care Act at no cost to the state.
OK, that's more like it...about 500 people in DC are being contacted by exchange personnel regarding technical issues, but over 2,600 made it through under the wire:
D.C. Health Exchange Director Mila Kofman said as many as 500 applications were left in limbo at 9 p.m. Monday, the cutoff for selecting coverage that would take effect on Jan. 1.
Kofman said 2,631 people enrolled successfully.
Employees at the exchange, known as D.C. Health Link, will spend the next several days contacting each applicant by phone or e-mail to walk them through a follow-up process to ensure unfinished applications are processed and those residents can begin receiving coverage beginning next month as planned, Kofman said.
DC had around 10,000 enrollees to start with; presumably the 2,631 figure is a mix of renewals and new additions.
A nice, no-BS, pretty comprehensive enrollment update out of Colorado:
DENVER, CO – In the first month of Open Enrollment, 136,315 Coloradans enrolled in healthcare coverage for 2015, either in Medicaid, Child Health Plan Plus (CHP+) or in commercial health insurance purchased through the state health insurance Marketplace, according to new data released today by Connect for Health Colorado® and the Colorado Department of Health Care Policy and Financing.
“These initial sign-ups during this first month were consistent with our projections and culminated with a single-day record of 12,600 enrollments on December 15th,” said Connect for Health Colorado Interim CEO Gary Drews. “It’s also important to remember that it’s not too late for people to purchase health insurance for 2015. Open enrollment continues until February 15th.”
Dec. 15 was the deadline for individuals and families to select plans for coverage to begin on Jan. 1. Connect for Health Colorado will continue working with those who started their application by Dec. 15 to help finish it so they can be covered by the New Year. Customers also have to take the last step to ensure their coverage: make the first payment on time.
Just over a month into open enrollment at HealthSource RI, nearly half of the people who purchased health insurance in 2014 have renewed coverage for another year, the state-based exchange created under the Affordable Care Act announced Wednesday.
Through Dec. 13, 9,825 people, or 48 percent had renewed coverage, with close to 60 percent opting to switch to different plans.
Another 2,522 have signed up for health insurance for the first time, bringing total enrollment to 12,347.
The numbers in RI are small, but there's some important data points here:
Massachusetts continues to chug along, with another 4.243 QHP eligibility determinations; assuming a minimum 60% plan selection rate, that should add another 2,500 or so to the total, for around 59K QHPs to date.
Meanwhile, Medicaid (MassHealth) enrollments have broken 94,000:
OK, strictly speaking this isn't directly ACA-related, but come on...
Shumlin: "The time is not right"
Vermont has long had a two-pronged approach to building a single-payer health care system. First, they would figure out what they would want the system to look like. Then, they would figure out how to pay for it.
The state passed legislation outlining how the single-payer system would work in 2011. And ever since, the state has been trying to figure out how to pay for a system that covers everybody. Most estimates suggest that the single payer system would cost $2 billion each year. For a state that only collects $2.7 billion in revenue, that is a large sum of money.
What Shumlin appears to be saying today is that the "time is not right" to move forward on the financing of the single-payer system. And that means putting the whole effort aside, with no clear moment when the debate would be reopened.
Ouch.
Thanks to Morgan True for the link to this PowerPoint report which explains why VT is pulling the plug on their ambitious Single Payer attempt:
As of Thursday the 12th, MNsure had enrolled about 14.4K people for private 2015 policies. Thanks to the December Surge Weekend, this has jumped up by more than 9,300 more:
Latest Enrollment Numbers
December 17, 2014
Health Coverage Type Cumulative Enrollments
Medical Assistance 17,888
MinnesotaCare 7,681 Qualified Health Plan (QHP) 23,797
TOTAL 49,366
Hmmm...MNsure is currently enrolling people at 3x the rate they did all of last year. Assuming that this doesn't include automatic renewals, that's pretty good. They bumped their enrollment deadline for January coverage out until Friday afternoon (4:30pm, for some reason), which is even better.
UPDATE: According to this Modern Healthcare article, only about 42% of MN's enrollments to date are renewals. In one sense, this is good since it suggests that they still have a good 31K potential renewals to work with.
No formal press release yet, but CT is the 2nd state (after Kentucky) to announce how many 2014 enrollees were automatically renewed (as opposed to manually renewing):
66,000 of our customers were auto enrolled in our system and continue to have health coverage for 2015. #OEUpdate
The most recent update I have from Connecticut was 13,000 new enrollees, but that was only through last Friday, before the big weekend push. That means they added another 7K over the weekend; not bad!
As CoveredCA has noted before, they have no plans on posting renewed policy enrollments until January, but this at least gives data on the new additions:
COVERED CALIFORNIA AND DEPARTMENT OF HEALTH CARE SERVICES RELEASE EARLY RESULTS FOR FIRST MONTH OF OPEN ENROLLMENT THROUGH HEALTH INSURANCE EXCHANGE
Demand for Coverage Continues to Be Strong, with Applications Submitted for More Than 592,000 People Through Dec. 15
SACRAMENTO, Calif. — More than 592,000 people sought coverage and were determined eligible for private health insurance and eligible or likely eligible for Medi-Cal in the first month of open enrollment, Covered California and the California Department of Health Care Services announced Wednesday.
The consumers, who applied for coverage through Covered California since open enrollment began on Nov. 15, include 157,361 eligibility determinations and an additional 144,178 plan selections for private coverage, as well as 216,423 enrollments into Medi-Cal coverage and 74,965 who are likely eligible for Medi-Cal. So far in 2014, Medi-Cal has enrolled more than 2.2 million consumers.
After all the craziness of the past day or two, I figured this would be a good time for a reality check. I've taken the 2014 Open Enrollment Period Graph, compressed it so that the time period and scale match the 2015 Period (ie, 3 months instead of 6.5) and have overlaid it on top of the 2015 Graph to see how they compare. The comparison is pretty striking.
(NOTE: I've modified this version to make the adjusted timeframes less confusing, and clicking below will now load the full-size version in a new window):
Wow! This was unexpected; while several other states have provided enrollment updates today, and some have broken out (or at least included) both new enrollments as well as manual renewals/re-enrollments, Kentucky is the first one to include automatic renewals as well!
Webb is one of 101,114 Kentuckians who have newly enrolled or re-enrolled in Obamacare health plans during the first 30 days of open enrollment through the state's health insurance exchange, kynect. State numbers released late Tuesday afternoon show that 16,139 residents met eligibility requirements for Medicaid, 9,215 newly enrolled in qualified health plans and 75,760 auto-renewed last year's private kynect health plans since re-enrollment began Nov. 15.
This is important for a couple of reasons: First, it's the first enrollment update of any sort we've heard from Idaho (which was, until tonight, the only exchange I didn't have any info on). Secondly, it's important because Idaho is the only state which moved off of Healthcare.Gov onto their own exchange. Finally, the number is absolutely fantastic, especially considering that it doesn't include Monday:
BOISE, Idaho – During the first month of open enrollment, Your Health Idaho processed 74,689 enrollments, which includes new applicants and those renewing coverage for 2015. The numbers released by Your Health Idaho at its Tuesday board meeting include enrollments processed from November 15 through December 14.
For comparison, last year Idaho enrolled 76,000 people for the entire enrollment period.
That's right: They managed to essentially equal 6 1/2 months worth of private policy enrollments in just 1 month...and that doesn't include the surge from yesterday (or for the following 5 days, since ID's deadline isn't until the 20th).
On the one hand, I'm a bit pouty today because I was off by about 6% on my HC.gov estimate through the 4th week. On the other hand, this is good news because it means that the actual enrollment total is 126K higher than I thought...and that's just via Healthcare.Gov! Of course, it's possible that the state exchanges will be a bit lower than I thought which might cancel this out, but assuming the 75/25 ratio is accurate, it should mean that instead of the 3.1 million national total I had estimated for 12/12, it should be closer to 3.3 million!
Anyway, here's the hard numbers from HC.gov through December 12th:
The CMS Dept. is holding a conference call with reporters right now. I'll be liveblogging the call and posting updates as quickly as I can for any useful info. It should focus much on the enrollment numbers, of course, but also how well the HC.gov servers held up under yesterday's strain, and I'd expect a lot of discussion of the "autorenewal" issue--how many, how it'll be handled and so forth.
Participants: Lori Lodes, Kevin Counihan & Andy Slavitt
3:04pm: Call hasn't started yet, but HHS just releaced their 4th week enrollment data for HC.gov (thru 12/12)...and it's actually 5.4% higher than I thought! (thanks to Bob Herman for the tip!)
My estimate: 2.32 million
Actual: 2,446,562
still 52% renewals / 48% new
Call starting:
first 8 hours: 20K applications
last 3 days: more than 3 million unique site visitors
HUGE news day, of course. In addition to HC.gov overperforming my estimate by 6% (2.46M as of 12/12 instead of 2.32M), Maryland and Massachusetts are out with their latest numbers.
MA still isn't including an actual QHP selection update, but it should be roughly 56,600 based on the "QHP eligibility determinations" total of 103,591.
In addition, they're about to break 90K even added to Medicaid:
Hmmm...this is different; I'm pretty sure this is the first time that I've been quoted in a formal enrollment data press release...
MARYLAND HEALTH BENEFIT EXCHANGE BOARD CELEBRATES PROGRESS OF OPEN ENROLLMENT
Exchange enrolls more than 100,000 at one month mark
BALTIMORE (Dec. 16, 2014) — The Board of Directors of the Maryland Health Benefit Exchange (MHBE) today celebrated the progress of the Maryland Health Connection one month into its open enrollment. More than 100,000 Marylanders have signed up for 2015 health coverage.
Maryland Health Connection has enrolled 105,902 people — including 61,031 in Qualified Health Plans (QHPs) and 41,871 in Medicaid. By comparison, during the first open enrollment a year ago, 1,278 Marylanders enrolled in private QHPs through the marketplace during its first 30 days.
A rebuilt website that enables consumers to “browse” plans without needing to create personal accounts, a much larger schedule of enrollment fairs across the state than a year ago and additional “storefront” spaces where Marylanders can get assistance enrolling in person have helped propel the improved results. The changes have been noted in the media, including:
Beneficiaries with Healthy Michigan Plan Coverage: 487,190
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)
*Statistics as of December 15, 2014
*Updated every Monday at 3 p.m.
In all seriousness, obviously that 477K eligibility figure could be off; I've heard other estimates as high as 500,000, for instance.
The point is that the Medicaid expansion well in Michigan, along with many other states, is already running dry less than a year into the program (and in Michigan's case, less than 9 months into the program).
As you can see on The Graph, I'm also assuming roughly an 88% payment rate (ie, how many of those 12.5M I expect to pay for their first month's premium), which should be roughly 11.0 million even.
However, there's one number missing, which I left off in the interest of avoiding confusion: How many I expect to still be enrolled by the end of 2015. This is pretty simple, though: Around 10.5 million. How do I arrive at that number? Well, this year the net attrition rate resulted in around 6.7 million people still being enrolled nationally as of mid-October. That's around 84% of the 8.0 million "total" enrollment figure as of last April. In other words, out of 8 million people, about 12% never paid and another 4% gradually dropped off the exchanges by October.
Assuming a similar pattern next year, 84% of 12.5 million is 10.5 million who should still be enrolled via ACA exchanges as of next October.
I've received some interesting information regarding just how CMS/HHS plans on handling autorenewals (aka "passive re-enrollments") for those people who are currently enrolled in ACA exchange QHPs, but who took no action whatsoever as of midnight last night. It's important to note that this information only relates to those enrolled in 35 of the states run through HC.gov (that is, this doesn't relateto any of the state-run exchanges, and it doesn't even include Oregon or Nevada, since everyone currently enrolled in those states has to manually re-enroll).
So, we're talking about a maximum number of perhaps 5 million people here...and even then, a good half of them have likely manually re-enrolled, leaving perhaps another 2.5 million.
Having said all that, here's the info: In most cases, anyone who neither manually re-enrolled nor manually cancelled their policy should be automatically re-enrolled in their current policy (albeit possibly at a higher--or, in a few cases, lower--premium cost).
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.
It's been a crazy day, and there have been some major developments: California, Connecticut, Minnesota and Vermont all announced last-minute deadline extensions of various types for January 1st coverage. In addition, I received an unexpected bounty of enrollment data drops (either partial or complete) from California, Connecticut, DC, Hawaii and Massachusetts. On top of all that, there was big Medicaid news out of Pennsylvania and Tennessee.
So, after this massive information overload, have I changed my projections at all? Well, I may still adjust my calls for future milestones, but I'm sticking to my guns for Week 4 (December 12th) and Deadline Day (December 15th):
I'm actually a bit curious about the "new" specification here. Last week the head of the HI exchange gave an interview in which he gave the number as being 12,000, but it turned out that was a cumulative number which included all of the enrollments from last year (whether they had renewed yet or not) as well as the new additions. I thumbnailed it as being around 1,200 enrollments for 2015.
Therefore, I'm not sure how to take "nearly 1,500 new residents" in this case; that may mean "new for 2015 including renewals" or it may mean "new for 2015 not including renewals". Either way, the number isn't large enough to impact my spreadsheet/projections, but it's still a bit irritating:
Hawaii: Hawaii Health Connector has enrolled nearly 1,500 new residents as of Dec. 5. Last year glitches to the website caused enrollment to be delayed by two weeks. According to HealthInsurance.org, the state’s uninsured population has gone down from 8 percent of the population to 6 percent of the population since Obamacare went into effect..
District of Columbia: DC Health Link has enrolled 1,413 people, both new and renewed applications, according to data collected by last week Kaiser Health News.
Grammar aside, I'll assume "last week" means "through Friday the 12th".
I wasn't really expecting any data drops today, but I've already received surprise updates from California and Massachusetts, and now I can add Connecticut, DC and Hawaii all in one shot (via separate entries):
Connecticut: Last year the state's uninsured rate dropped by about half – from nearly 8 percent to 4 percent. Likely for this reason Kevin Counihan, the CEO of Access Health CT, was scooped up by the federal government to help fix Healthcare.gov. Latest figures for this year come from Dec. 12, which showed 39,000 new Medicaid enrollees and 13,000 new private health plans, according to an email from a state official. Late Monday, Access Health CT announced that it was allowing a grace period until Dec. 19 for enrollment that would begin January 2015. Consumers who had started an application before Monday could have four additional days to fill out their information.
That's 13K new enrollees only; again, it's safe to assume at least a 1:1 ratio between new & renewed enrollees, so I'm calling it at least 26K total for CT so far.
California’s health insurance exchange extended its deadline for consumers wanting Obamacare coverage in effect by Jan. 1.
Peter Lee, executive director of Covered California, said people who start the application process or make some “good faith effort” by Monday will have until Dec. 21 to finish signing up. Monday at midnight had previously been the hard deadline.
“We are providing this window to get people across the finish line,” Lee said at an exchange board meeting Monday. “We know many of the people applying have never had insurance before, and these are individuals who need to sit down and talk with someone.”
Lee said many insurance agents and enrollment counselors were already fully booked with applicants Monday. He said the deadline extension will allow people to make appointments through Dec. 21.
A nice update out of California...but still a frustrating one. They held an executive board meeting today at which they posted an updated QHP selection total for 2015: 91,693 as of 12/11/14. Unfortunately, this still doesn't include any renewal data for existing enrollees.
As I noted last week, however, I'm extremely confident that CA's renewals/re-enrollments are running easily at the same rate (or potentially as high as 4x as many) as new additions, so I'm very comfortable doubling this number to at least 184,000 total QHP selections as of the 11th.
Wow! I'm impressed! I know Massachusetts said they'd be issuing daily enrollment reports during weekdays, but I really didn't think they'd have time to do so today. Then again, their deadline isn't until next Tuesday (the 23rd), so I guess things aren't too crazy in the Bay State.
Anyway, let's take a look...
Well, they haven't officially updated the "QHP plan selection" tally in a week or so, but I'm reasonably certain that the % of "eligibility determinations", which had been hovering around 50-55% until about a week ago, should have worked it's way up to perhaps 60% in recent days. Assuming I'm correct about this, their QHP selection total should be roughly 52,600 by now, though I'll knock off 600 out of caution and go with 52K even.
Again: During the 2014 open enrollment period, MA only nabbed less than 32K during the full 200-day period, so they're already 60% ahead of last year less than 1/3 of the way through this one.
Meanwhile, they've also added 84K people to Medicaid as well.
STATEMENT FROM ACCESS HEALTH CT ACTING CEO JIM WADLEIGH ON TONIGHT’S OPEN ENROLLMENT DEADLINE FOR HEALTH CARE COVERAGE BEGINNING JANUARY 1, 2015
Hartford, Conn. (December 15, 2014) – In advance of tonight’s midnight deadline for coverage beginning January 1, Access Health CT (AHCT) Acting CEO Jim Wadleigh has released the following statement:
“The deadline to sign up for quality, affordable health care coverage that begins on January 1, 2015 is tonight at midnight. If customers have an application started and select a plan before midnight tonight, they can still get coverage beginning January 1, as long as they complete the application and get us all the relevant information by midnight this Friday, December 19.
How Brownback Is Relying On O-Care To Close Kansas' Huge Budget Hole
Kansas Gov. Sam Brownback (R) is calling all hands on deck to fix his state's huge self-imposed budget crisis, which nearly cost him re-election this year, and the staunch conservative is now receiving an assist from an unlikely source: Obamacare.
The state's well-documented budget troubles came after Brownback's dramatic reductions in taxes since taking office in 2011. With its revenue drying up and cash reserves depleted, Kansas is staring at a $280 million hole in its $6.4 billion FY 2015 budget, which ends in June.
Brownback offered his proposal for closing that hole last week, a mixture of spending cuts and transferring funds from other parts of the budget to fill it. And second biggest of those transfers is $55 million in revenue from a Medicaid drug rebate program that was bolstered under the Affordable Care Act.
The short version then is this: Obamacare is helping Kansas address its fiscal crisis -- even if Brownback's administration seems loath to admit it.
It'll still have to get through the GOP-controlled state legislature, of course, but it looks like you can scratch Tennessee off the "Expansion Refusenik" list. I presume this'll be a "Private Option" program similar to the one in Arkansas:
In a major policy move, Gov. Bill Haslam has announced the new Insure Tennessee plan, a two-year pilot program to provide health care coverage to tens of thousands of Tennesseans who currently don't have access to health insurance or have limited options.
The plan would be leveraged with federal dollars, said Haslam, who has been working on a Medicaid expansion plan that could gain approval from both federal officials and the Republican-dominated General Assembly.
I spent a few minutes this morning poking around all 15 ACA exchange websites (HC.gov plus the 14 state-run websites). Obviously I didn't go through and actually create an account or enroll/renew in any of them (although my wife and I did renew our own coverage via HC.gov on Saturday, and everything went fine). However, I at least visited all of the sites and clicked through as far as I could go without actually setting any accounts up.
For the most part, everything went smoothly. Yes, some of the sites have more confusing layouts/navigation than others, but my main concern was whether they load at all, how quickly pages load, whether any glitches or broken links pop up and so on.
Midnight Monday, Pacific time, is the deadline for new customers to pick a health plan that will take effect Jan. 1, and for current enrollees to make changes that could reduce premium increases ahead of the new year.
HealthCare.gov and state insurance websites are preparing for heavy online traffic before the deadline, which gives consumers in the East three hours into Tuesday to enroll.
Thanks to contributor farmbellpsu for the heads' up.
Also, 21 year olds (in all states, not just Alaska) should pay special attention:
Doing nothing appears to be a particularly bad idea for people who turned 21 this year, according to the Center on Budget and Policy Priorities, a Washington group that advocates for low-income people.
As the article notes, just because someone applies for Medicaid doesn't mean that they'll be approved (or some in the household might while others aren't). Still, assuming that, say, 95% are approved and enrolled, and assuming 1.8x people per household on average (the Census Bureau says it's more like 2.5x), that should still be a good 125K Pennsylvania residents added to the tally in the first 2 weeks...or over 20% of the total eligible in the state:
Two weeks after enrollment began, the state has received tens of thousands of applications for health care coverage by way of the “Healthy PA” program, which offers subsidized, Medicaid-like insurance through private carriers to low-income Pennsylvanians.
As of the end of the day Wednesday, the state had received applications from nearly 44,000 households, according to the Department of Human Services. It also has received an additional 30,000 household applications referrals through the federal health care marketplace.
That doesn’t necessarily mean all those applicants will be eligible to receive coverage, though likely many of them will be, said Kait Gillis, a DHS spokeswoman.
Anyone who follows this site and The Graph regularly knows that I'm expecting a massive spike in enrollments this weekend and tomorrow (Monday)...possibly as many as an incredible 1.4 million nationally in just a 3 day period (370K yesterday, 380K today and potentially as many as an astonishing 650,000 tomorrow alone.
HOWEVER, even assuming that that many people try to log in and renew their current policy or switch to a different one (which I strongly advise), there's one snag: Sheer server capacity.
To the best of my knowledge, the highest load ever placed on HealthCare.Gov was on March 31st last spring, when upwards of 250,000 or so enrollments were processed in a single 24-hour period (for the record, the next 4 busiest dates at HC.gov included March 25 - 30th, April 1st, and December 23rd and 24th, which all make perfect sense).
Assuming around 75% of enrollments on any given day are added via the federal exchange, 650K total would mean around 480K via HC.gov...or nearly twice as many as the busiest day the site has ever experienced.
TALLAHASSEE — Last year, legislators allocated $900,000 to help Floridians find affordable health care through a new state-backed website.
At the same time, they refused to expand Medicaid or work with the federal government to offer subsidized insurance plans.
Six months after the launch of the state's effort, called Florida Health Choices (floridahealthchoices.net), just 30 people have signed up. Another seven plans were canceled either because consumers changed their minds or didn't pay for services.
Back on October 1st, Your Health Idaho posted the following blog entry launching their "window shopping" tool for 2015 private policies, which also included very specific deadlines for both selecting a plan as well as paying the first premium for January 1st coverage:
BOISE, Idaho – As the December 23 deadline for health coverage to begin on January 1 is days away, Your Health Idaho and insurance companies selling plans on Your Health Idaho are taking several steps to provide consumers with a smooth transition to coverage.
Yup, my wife and I went ahead and manually renewed our own private healthcare policy via HC.gov this morning here in the Wolverine State. We had already used the window shopping/browsing feature ("See Plans & Prices") and determined thatin our case, sticking with the same plan through the same company made the most sense for us.
Now, here's where things get interesting: For 2014 we qualified for a small tax credit. For 2015, while our projected taxable income is expected to be pretty much identical to what we had projected a year earlier, our tax credit went up by $61 per month.
The policy itself also did go up by $93/month, but due to our tax credit also increasing, our net cost ends up being just $32/month more. Don't get me wrong, I'm not thrilled about having to pay $384/year more on top of what's already a pretty steep rate, but the point is that for some people, their tax credits are increasing next year (ie, meaning a lower net premium increase than the official rate increase would indicate).
Special thanks to Nick Budnick for providing a direct link to Oregon's ACA exchange enrollment update page, which, as a bonus, also tracks off-exchange QHPs as well (which I really wish every state would include as a separate line item):
The Insurance Division will collect enrollment information from carriers each week throughout 2015 open enrollment. Updated numbers will be posted each week on this web page.
Members enrolled, Nov. 15-Dec. 7 On Healthcare.gov 26,933
Outside of Healthcare.gov 17,923
Total 44,856
About the data: Enrolled means a person has selected a plan. Consumers must pay the first month's premium for their coverage to become effective. These numbers do not identify whether the first month's premium has been paid. These numbers do not include Oregonians enrolled in the Oregon Health Plan (Medicaid).
These preliminary numbers are subject to change week to week based on people changing or canceling plans or having a change in status such as a new job or marriage.
Things weren't looking great eight months ago for Dr. Peter Beilenson and Evergreen Health Co-op, the insurance company he created from scratch.
The brand-new insurance company had been counting on Maryland's health exchange to bring in its first members. But the online marketplace was a nightmare for people trying to sign up. With higher prices and less name recognition than competitors like CareFirst BlueCross BlueShield, Evergreen ended the exchange's open enrollment period with just 400 members.
...Fast-forward to today and business is looking up for Evergreen. The companyshifted focus to small business groupsonce it realized it couldn't rely on the exchange alone. Evergreen lowered its premium prices for 2015 individual plans and is locking in the rates on both its individual and small group plans for two years. About 800 people have signed up for Evergreen health plans through the exchange since it opened in mid-November.
Two of the most heavily Republican states, Utah and Wyoming, appear to be moving closer to an expansion of Medicaid under the Affordable Care Act. Other GOP-dominated states, like Indiana and Tennessee, are also looking more closely at it, despite the hostility of their party’s leaders toward Obamacare.
...Gov. Matt Mead of Wyoming, where Republicans hold 78 of 90 seats in the legislature, acknowledged his opposition to Obamacare but said the statehad to be realistic by embracing Medicaid expansion in one form or another. “I don’t think we can say to those people in Wyoming who are working [and] who cannot get insurance that we’re not going to do anything,” he said.
...While the odds for expansion in Wyoming remain uncertain, Utah seems likely to move in the coming months. There, Gov. Gary Herbert made the case on moral grounds — as a duty to help people he described as “our neighbors, our friends and our family members.”
This is an excellent overview of how healthcare pundits, politicos, reporters and industry folks are keeping a very close eye on the ACA exchanges this weekend, as the December 15th deadline for January coverage approaches (well, for most states, that is; 6 states now have deadlines later than the 15th). It's well worth a read, as it goes into the whole "manual renewal" vs. "autorenewal" issue and a whole mess of other stuff.
However, towards the end are two additional data points:
CMS officials, including Marketplace CEO Kevin Counihan have been reassuring about auto-enrollment, said Martin Hickey, CEO of New Mexico’s co-op health plan. “It’s a stressor, but I haven’t seen him biting his fingernails,” Hickey said of Counihan. “But you never know.” His own health plan has had 3,ooo people sign up as of Dec. 10 through HealthCare.gov and the pace is picking up.
The latest official report from the MD exchange...
Enrollment Report (Thru Dec. 11, 2014)
More than 80,000 Marylanders have enrolled in advance of Dec. 18 deadline for full 2015 health coverage
Overview
As of Dec. 11, a total of 80,354 Marylanders have enrolled in quality, affordable health coverage for calendar year 2015 since the 90-day open enrollment period began Nov. 15.
This includes 45,014 individuals enrolled in private Qualified Health Plans and 35,340 individuals enrolled in Medicaid. Marylanders must enroll or renew their plans by Dec. 18 for insurance that starts New Year’s Day and, if they qualify, to receive an Advanced Premium Tax Credit (APTC) beginning then. Open enrollment for 2015 ends Feb. 15.
Again, for comparison: Last year, Maryland scored a grand total of 67,757 QHP enrollments through the April 19th open enrollment cut-off (6 1/2 months).
This year, they've already reached 2/3 of that in under 4 weeks.
Hmmmmm...MA has switched their weekly reports from Mondays to Fridays, which is fine...except that until now the weekly versions also included actual hard "QHP plans selected" data.
This one...doesn't. It includes all the other weekly stuff but not the actual plans selected (aka "total enrollments" by my lingo). As a result, I'll still have to do an estimate based on the Eligibility Determinations...which in this case is a total of 83,988.
Assuming that the % of QHP determinations which have already led to actual plan selections is up to around 60% per day by now (up from around 52% a week or so ago), that should mean roughly 44,800 QHP selections to date. To be cautious, however, i'll knock it down to an even 44K for now.
And, again, Medicaid (MassHealth) enrollments are already up to 72,175 people.
Unfortunately no breakout between the two yet...hopefully soon...I also don't know what date that number runs through, nor do I know if the QHP tally includes new enrollments only (a la California & Connecticut) or if it also includes renewals as well.
Also, we now have our first official Deadline Extension due to the massive snowstorm in Buffalo/etc recently:
@charles_gaba State also says deadline to enroll for jan. extended to Dec. 20 b/c of "extreme weather"
CEO Mario Schlosser is happy to finally be able to sell. The company started this year’s enrollment period with 17,000 members and grew to “way more than that” in the first week, he says. That represents around $85 million in annual revenue from health insurance premiums, which he says equals “a few hundred million dollars in actual health care spend.”
Oscar’s member count sounds small compared to what people have come to expect for Web startups, where anything shy of 10 million users is a flop. But 17,000 members handily beats the company’s initial goal of 7,500, Schlosser says. Oscar now claims 10% market share for the health care exchange in New York, its home market. Two weeks ago, Oscar began selling in New Jersey. The company has plans to expand into California and Texas in late 2015.
OK, I've been considering this for a few days now, but I wanted to wait for the actual 3rd week HC.gov snapshot to come in before committing to it.
Until now, I've kept my 2015 Open Enrollment Period projections pretty solid: 7.0 million by Dec. 15th; 8.0 million by Jan. 15th and 12.0 million by February 15th.
Of that 12.0 million total, I figured that around 88% will (eventually) pay for at least their first month's premium, or around 10.6 million.
With the deadline approaching for individuals to renew healthcare plans purchased on HealthCare.gov, Aetna has begun to see a surge in customers for 2015, the insurer's new president said on Thursday during a meeting with analysts and investors.
HealthCare.gov has a Dec. 15 deadline for individuals to renew their 2014 plans or select new ones before it will automatically re-enroll them for next year. Enrollment for individual plans is open until Feb. 15, which were created under the 2010 Affordable Care Act, often called Obamacare.
Karen Rohan, whose appointment was announced earlier this month, said that the company expects a surge in enrollment over the next few days and that it was "starting to see" that already. Aetna sells these plans in 17 states.
Hmmm...on the surface these numbers seem fairly clear: 8,058 QHPs, 20,942 Medicaid. However, the wording of the article, combined with the fact that 8K in 26 days is only 310/day so far (versus 2014's 396/day average) makes me suspect that this only refers to new enrollments and doesn't include renewals of existing enrollees. In addition, the previous data release by AccessHealthCT clarified that it only included new enrollments.
So far, in the ongoing round of open enrollment that began Nov. 15, some 8,058 Connecticut residents have enrolled in plans offered by private insurers and 20,942 have enrolled in Medicaid plans, Madrak said. That’s more than the first year at around this time. However, the numbers last year were reversed and some 14,365 residents enrolled with one of the private insurance carriers and 9,075 had enrolled in Medicaid through the close of business Dec. 4, 2013
If this only includes new enrollees, then the odds are that the total number is actually at least double that (16K+) and likely more like 20K+.
BOOM, there it is: Washington State has been pretty quiet on the update front, due, no doubt, to having to clean up a rather embarrassing screw-up on the part of their IT systems integrator a week or so ago when over 6,000 account enrollments/payments were accidentally cancelled.
However, I'm very happy to report that not only do they appear to have resolved most of this issue (2/3 of the accounts have been restored so far), but they've released detailed, up-to-date data...and it's pretty damned impressive so far:
Updated enrollment totals are included below:
Qualified Health Plans - New: 10,082
Qualified Health Plan Renewals: 45,843
Total: 55,925
Washington Healthplanfinder Business
Accounts Created: 1,550
Total Completed Applications – Link Sent to Employees: 73
Total Enrollments – Employee Plan Selection Complete: 3
*Note: These numbers reflect QHP enrollments through Dec. 10 and Medicaid Enrollments through Dec. 4.
They also reported on the Medicaid (Apple Health) situation:
Until now, I've relied on states like Maryland, Massachusetts and Vermont, which have given out frequent 2015 enrollment updates, to point out how impressive the enrollment stats have been this time around; Maryland and Vermont are currently running at nearly 5x their 2014 pace, while Massachusetts is adding people at an astonishing 10x their 2014 rate.
However, these are pretty misleading, because all 3 of those states had such Godawful websites last year that it didn't take much to outperform this year.
Instead, consider states whose exchanges were already doing pretty well out of the gate last year, such as Colorado:
On the surface, this looks pretty good, but nothing jaw-dropping. 24,811 in 27 days is 919/day, or about a 50% improvement over 2014's 627/day.
However, break it out between the first 16 days and the next 11 and it's a different story:
The Maryland exchange just tweeted out a rough total enrollment number: 76K. It isn't broken out between commercial policies and Medicaid, but based on the trend until now it looks like it should be roughly a 56/44 split, or around 43,000 QHPs & 33,000 Medicaid/CHIP enrollees:
Beneficiaries with Healthy Michigan Plan Coverage: 474,372
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)
*Statistics as of December 8, 2014
*Updated every Monday at 3 p.m.
Now, obviously that 477K eligibility figure could be off (I had previously heard estimates as high as 500,000).
This is a nice article giving a status report on how things are going in Nevada (which, along with Oregon, scrapped their own ACA exchange last year and moved over to Healthcare.Gov). It includes a straightforward enrollment number: "more than 10,000" right in the title.
However, the wording of the article makes it unclear as to whether that number includes unsubsidized QHP enrollments or just the 85% or so who qualify for tax credits:
Compared to last year’s rollout, Nevada Health Link is showing stronger numbers so far in this year’s open enrollment.
More than 10,000 Nevadans have enrolled for subsidized health care plans through the state insurance program.
The enrollment numbers are good news and show signs of improvements at Health Link, Nevada’s online health care market.
At this time last year, only 6,000 people had signed up. It was Health Link’s first year online.
The comparison number below (6,000 last year) make it sound like 10K includes everyone, but the "subsidized" caveat makes it sound like it doesn't, in which case the total number should be roughly 11,700 or so.
I'll go with the lower 10K number for now, however.
When you visit the link, it goes to a video interview with the executive director of the HI exchange, who states, when asked "do we know how many signups there've been so far?" that "it's about 12,000; we were at 250 this time last year, so we've made a lot of progress."
Now, hold the phone a minute. According to the Kaiser Family Foundation, Hawaii only has around 53,000 residents total who are even eligible to enroll via the ACA exchange to begin with.
Wow...HUGE data dump today! First California (well...half of it, anyway); then HC.gov (37 states); now, of course, Massachusetts' daily snapshot.
Another 4,725 QHP determinations. Assuming 60% of those have selected plans already, that should bring the total to around 42,100 to date...or 33% higher than MA's total 2014 enrollment tally.
Meanwhile, they've also hit 68.1K Medicaid enrollees.
OK, this definitely makes me feel better about the confusing CoveredCA data release less than an hour ago, in which the data was so spotty it made figuring out how close I was next to impossible.
So, let's think about this. "Almost 1 million" suggests at least 900,000 people to me, and the "more" part makes it clear that he's referring to new enrollments, NOT renewals of existing ones.
The most recent official data point given was HHS's announcement of 765,135 plan selections as of 11/28 via HealthCare.Gov. They also announced that 48% of those were new enrollees, or around 367,000 people in the first 2 weeks of open enrollment.
Just moments ago, CoveredCA head Peter Lee held a conference call in which he issued the first full 2015 open enrollment period data (until now, the only number released was 11,357 QHPs in the first 4 days...except that only included new enrollees, not renewals).
As I noted yesterday, I estimated appx. 397K QHPs through Monday (12/08). I'm also guessing it'll be about a 55/45 split between renewals of existing enrollees & new additions.
The actual number of NEW QHP enrollments turns out to be: From 11/15 - 12/03: 130K determined elgiible, of whom 48,950 have selected plans...
Hmmm. Well, now...on the surface, this makes it look like I was way off, overestimating by a whopping 8-fold factor.
HOWEVER, there are two rather important (and unexpected) points which make that comparison impossible:
Ah, here we go...the 2nd official update from Kynect (Kentucky's Obamacare exchange, for certain U.S. Senators who can't seem to admit that little detail).
15,140 QHPs in 24 days is around 631 per day...or about a 50% higher daily average so far than they had in 2014 (and that included the December and March Surges).
Meanwhile, they've also added an additional 10,017 people to Medicaid. They don't specify whether all of those are brand new (the vast majority of KY's Medicaid-eligible folks should already be enrolled by now) or if some of them are renewals by existing enrollees, however:
I don't know exactly how many individual people a "household" represents, but I've typically used a 1.8x multiplier to be very cautious (the Census Bureau uses 2.63x).
That suggests the actual number of PA expansion enrollees is more like 49,000 people in just the first week, which would be a fantastic start.
The Corbett administration reached an agreement with the federal government this year to launch the Healthy PA program in lieu expanding Medicaid. Open enrollment in the program has started and coverage will take effect Jan. 1. However Governor-elect Tom Wolf says he will scrap Healthy PA and opt in to Medicaid expansion.
The impending switch apparently has confused many low-income Pennsylvanians, and some are sitting on the sidelines rather than signing up for coverage.
“The most important things is for people to enroll and to get their names on the list,” said State Rep. Vincent Hughes (D- Philadelphia). “If they are not on the list then they won’t get the coverage."
Despite the confusion, more than 27,000 households applied for coverage in the first week of enrollment, which began Dec. 1.
I've received official confirmation that CoveredCA will give their first official 2015 Open Enrollment Period data report tomorrow (Wednesday) morning.
I'm gonna take a stab at their number:
IF I'm correct that Healthcare.Gov hit 1.35 million QHP selections as of 12/05, and
IF I'm further correct that Healthcare.Gov is consistently making up appx. 75% of the national total at any given time, and
IF I'm further correct that the total QHP selections as of 12/08 hit around 2.21 million, and
IF I'm also correct that CoveredCA is making up appx. 18% of the national total, THEN...
...CoveredCA's total through 12/08/14 should be around 397,000 QHP selections.
Again, I don't have the hard QHP selection numbers for the past 5 days, but assuming 60% of the QHP determinations have also selected a plan, the total should be roughly 39,300 as of last night.
In addition, Massachusetts' MassHealth (Medicaid) enrollments have reached 64,155 with immediate effect:
Massachusetts is now on track to enroll a minimum of 154,000 people...and that's not including the mid-December/mid-February surges which are sure to come.
One of the big media stories this morning ( a positive one for once, which has been all too rare of late) was President Obama filling in for Stephen Colbert's "The Word" segment (rebranded "The Decree" for one night only). In it, Obama made a hilariously self-depcrecating pitch to young people ("folks" as he loves to put it) to enroll in Obamacare, in the same vein as his "Between Two Ferns" segment last spring:
Yes, it's awesome; there were a few bits which literally made me laugh out loud. However, there was also one very important data point thrown in--and I guarantee you that it wasn't included lightly. Did you catch it? It comes in at exactly the 3:00 minute mark:
"Nearly 7 million people signed up last year, and almost 1 million more have signed up in just the past few weeks."
Pennsylvania is about to suffer from whiplash with their version of Medicaid expansion; outgoing GOP Governor Tom Corbett set it up as an Arkansas-style "private option" program, but incoming Democratic Governor Tom Wolf plans on switching everything back over to "standard" Medicaid expansion after he takes office, so things could get a bit confusing for awhile.
Gillis said people have reached the call center, but calls were taking longer than expected, with some taking two hours or more.
Meanwhile, she said the online enrollment process is working well. She said the state received 11,500 applications during the first two days of enrollment. There is no enrollment deadline, but people who want coverage on the first day it's available, Jan. 1, must enroll by Dec. 15, Gillis said.
I'm filing this entry away in order to smack every damned one of these states--including the ones with Democratically-controlled governments--over the head with it 7 months from now when the Supreme Court is expected to rule on the King/Halbig case.
They're playing Russian Roulette with the lives--literally--of millions of people, sitting on their asses on the assumption that a) the SCOTUS will shoot down the King plaintiffs or b) if they do rule for the plaintiffs, they can slap something together with duct tape & chicken wire at that time.
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.
Hmmm...for some reason, the MA Health Connector chose to give a daily report today instead of the weekly report which they've been doing on Mondays.
On the one hand, this is OK because it still includes the daily breakdown of QHP determinations. On the other hand, the weekly reports gave the hard QHP selection numbers, which aren't included here.
I'm going to assume that the ratio of actual selections has moved up to around 60% over the weekend (from the 48-50% it was at earlier) as we move towards the January cut-off point. If so, that means that QHP selections in Massachusetts should now be well above the 2014 total (31,695) and should be somewhere around 36,400 as of last night:
Meanwhile, Medicaid (MassHealth) enrollments have broken the 60K mark; I've been informed that these are effective immediately.
I've projected that total QHP enrollments nationally hit around 1.57 million as of Friday (12/05) night (of which about 1.18 million should have been via HC.gov).
As of last night (Sunday the 7th), the totals should be roughly 1.74 million nationally (1.30 million HC.gov). Until now, enrollments nationally should have been averaging roughly 75-80K/day (except for a lull on Thanksgiving, of course).
As you can see on The Graph, however, I now expect things to start ramping up dramatically: Likely 200K/day for 9 days straight, hitting around 3.4 million manual enrollments via either renewals, re-enrollments or brand-new enrollments through the 14th.
Then, on December 15th, I'm expecting something like 3.5 million current enrollees to be auto-renewed all in one shot, plus another 200-300K manual enrollments that day alone, which should push the total well over the 7 million mark.
Last year, the Kaiser Family Foundation ran an in-depth report which broke out a rough estimate of how many people in each state fell into various ACA categories (Medicaid expansion, eligible for QHP tax credits, not eligible due to being an undocumented immigrant, "Medicaid Gap" and so on). Based on that report, it looked like the total number of currently (at that time) uninsured people eligible for Medicaid--whether via expansion or "woodworker" status--was around 14 million, plus another 4.8 million who fell into the Medicaid Gap for non-expansion states.
New Hampshire's ACA Medicaid expansion program got a late start, not kicking off until July 1st of this year. That makes the fact that they've already reached 50% of their total potential enrollment all the more impressive:
State officials had expected 30,000 to 40,000 of the estimated 50,000 eligible adults would sign up in the first year either through the state's managed care program for Medicaid or a program that subsidizes existing employer coverage. As of mid-week, just fewer than 25,300 had signed up.
OK, the headline and lede paragraph are pretty lame since they make it sound like Oregon's OE2 enrollment is down 90% from last year. This is pretty stupid, of course, since it only covers the first 2 weeks of a 93-day enrollment period, and since there will obviously be a huge spike in enrollments late next week and then again in mid-February.
Still, this is the first hard 2015 enrollment data I've seen for Oregon, and it's especially interesting given a) Oregon's disastrous 2014 exchange experience and b) the subsequent move to Healthcare.Gov this time around (I have yet to see a similar story about Nevada, but will be on the lookout for it):
Cover Oregon officials say just 7,200 Oregonians had selected a private health insurance plan through the federal portal by the end of November.
The article also gives a current update on the 2014 off-season/attrition situation:
About 77,000 Oregonians were enrolled through Cover Oregon in 2014. A total of 105,000 actually enrolled but some dropped off due to cancellations and terminations.
As a bonus, this is also pretty much the first hard off-exchange data I have this year:
Another day, another 2,300 (estimated) QHP selections for Massachusetts. Assuming I'm right about that number (or even close to it), that means their total should now sit at around 31,750.
As I noted yesterday, Massachusetts has already reached their 2014 Open Enrollment Period total...in just 20 days.
At the current pace, MA is now on track to hit a bare minimum of 148K QHPs, without taking into account the double-surges around 12/23 and 2/15 to come.
Maryland just released their second official 2015 Open Enrollment report, and the numbers continue to impress:
As of Dec. 4, a total of 51,796 Marylanders have enrolled in quality, affordable health coverage for calendar year 2015 since the 90 day open enrollment period began Nov. 15. This includes 29,543 individuals enrolled in private Qualified Health Plans and 22,253 individuals enrolled in Medicaid.
From Nov. 15 to Dec. 4, 62,713 consumer accounts were created; 66,752 calls were made to the Consumer Support Center and 339,578 individuals visited the MarylandHealthConnection.gov website.
Marylanders must enroll or renew their plans by Dec. 18 for insurance that starts New Year’s Day. Open enrollment for 2015 ends Feb. 15.
For comparison, during the 2014 OE period, MD enrolled 67,757 people. They're already at 43.6% of that in just 20 days this time around.
Even I was surprised when I read that Minnesota's ACA exchange, MNsure, was projecting to more than double their 2015 enrollment figure. Yes, other states like Massachusetts are expected to increase their numbers severalfold, but it always seemed like a stretch for Minnesota, especially with their largest 2014 participant, PreferredOne, dropping out this year. They hit around 50K last year and were originally projecting to hit over 100K this time around.
Sure enough, they've decided to walk that number back a bit, down to 67K...which would be an increase of only 38% over the
48,495 they enrolled during the first open enrollment period:
MNsure on Wednesday said it was cutting by about one-third the number of people it expects will enroll in private health plans through the exchange for 2015.
That means MNsure will also see a drop in revenue, although officials say they expect to end the fiscal year next June with no red ink.
State officials say they don't yet know how enrollment is going this year in Delaware's health insurance exchange.
The Delaware Health Care Commission received an update Thursday on the second year of implementation of the Affordable Care Act.
But state health and social services officials say won't be able report any enrollment numbers until they get them from the federal government. They say they hope to see the first monthly federal report around later this month.
I did receive these oddly-worded tidbits via Twitter:
More than 23,612 Delawareans have enrolled in a #ACA plan since October 2013#netDE
For each of the first two weeks, HC.gov has reported that the total QHP enrollments to data are split roughly evenly between new enrollees and renewals, which I find rather interesting; I was figuring that the early days would skew more heavily towards renewals, perhaps by a 2:1 or 3:1 ratio.
Part of this could simply be different states cancelling each other out--after all, all enrollees in both Nevada and Oregon, which were shifted over to HC.gov this year, are being categorized as "new" since the enrollees had to start over again; between the two states, that's up to around 110,000 current enrollees who would be listed as "new" even if they were re-enrolling...so it's possible that there are other states with a higher "renewal" ratio which is cancelling those two out.
Oh for the love of...I spent a solid year screaming at HealthCare.Gov to start releasing their data on a regular basis; they finally did so, and now Covered California has decided to go radio silent instead. This is, quite simply, unacceptable.
In California, however, officials at Covered California, the Obamacare exchange here,haven't provided updates since Nov. 20, when they released data for the first four days of the new open enrollment session.
Covered California released those preliminary figures Nov. 20, when Executive Director Peter Lee revealed that 11,357 people signed up for private health plan coverage between the Nov. 15 beginning of this year's open enrollment period and Nov. 18.
...Since Nov. 20, there have been no new updates, and officials don't expect to announce new figures until mid- to late December, at the earliest, and possibly not until January.
I actually feel rather stupid about not looking into this earlier, but now's as good a time as any: In my latest post over at healthinsurance.org, I go over the various deadlines for both enrolling and making initial premium payments for January 1st, 2015 exchange policy coverage (and how this factor might impact my QHP projections). Take a look!
OK, this particular experiment is specifically for HealthCare.Gov QHP enrollments only, not the national total including the state exchanges. I'm trying to see just how much of a correlation there is between the Massachusetts exchange (the only state providing daily enrollment updates) and HealthCare.Gov. Obviously there are a lot of differences between the two beyond scale, but so far they've tracked pretty closely on a number of criteria, so I want to see if that holds true on actual enrollments as well.
So, this is actually a twofold projection:
On Monday, I suspect the MA Health Connector will announce roughly 33,300 QHP selections as of the end of Friday, December 5th.
Then, on Wednesday, I'm going to assume that HHS will announce roughly 465,000 additional QHP selections in the 3rd week, for a total of around 1.23 million QHPs via HC.gov thorugh Friday, December 5th.
Should be interesting to see how far off I am on this...
The Daily Caller might be interested in the fact that while yes, the 2nd week numbers did drop substantially in both Massachusetts as well as HC.gov, as I expected, they've bounced right back up again in the third week (in MA, at least). In fact, if you look carefully you'll note that determinations are increasing a bit each day so far:
Anyway, using my 48.5% rule, I estimate that Massachusetts is up to roughly 28,200 QHP plan selections to date...or nearly 89% of their 2014 total. They seem to be averaging around 2,200 QHP selections per day.
That's right: It's conceivable that MA could hit their 2014 total (31,695 as of April 19th) by the end of business tomorrow. Assuming the "selected plans" percentage has gone higher than 48.5% this week, it's even conceivable that they'll hit it today.
Meanwhile, Medicaid enrollments are about to break the 50,000 mark as well.
NOTE: I've decided to make "Short Cuts" the standard name for ACA-related stories which are interesting but which I just don't have time to do full write-ups on. I've also given up on trying to cram the headlines of each story into the blog entry title.
ObamaCare outreach campaigns across the country are diving deeper into the hard-to-reach uninsured populations such as rural areas with hopes of driving up enrollment in its second year, several state directors said Wednesday.
“We have a much better sense because of data from the federal government on where are the uninsured,” Ryan Barker, vice president of health policy for the Missouri Foundation for Health, said in a conference call hosted by Families USA.
The Michigan Primary Care Association said it is trying to “fill the gaps” of health insurance coverage by relocating a majority of its staff to rural, less-populated areas.
I was feeling kind of sour after writing my previous post about Sen. Tom Harkin's unhelpful comments today, so thanks to contributor "Dee" for cheering me up with this bit of idiocy from the Daily Caller from a woman named Sarah Hurtubise:
Obamacare Sign-Ups Stall In Week Two
The number of Americans signing up for Obamacare coverage on HealthCare.gov slowed significantly in the second week of the open enrollment season for the health-care law.
Just over 303,000 people chose plans on HealthCare.gov between Nov. 22 and Nov. 28, down from 462,125 who selected insurance coverage on the federal website during its first week, the Department of Health and Human Services announced Wednesday.
...The number of total applications submitted dropped by half in comparison to the first week. While over one million applications were submitted during the first week, that total fell to just 520,427 in the next seven days.
Today, he's followed up by IA Sen. Tom Harkin, who has the following incredibly insightful wisdom to spread to Democrats throughout the land:
“We had the votes in ’09. We had a huge majority in the House, we had 60 votes in the Senate," Harkin told The Hill, saying that the first Congress of President Barack Obama's administration should have passed “single-payer right from the get go or at least put a public option (which) would have simplified a lot.”
Huh. OK, I wasn't expecting MNsure's update until Friday this week (they put it out on Wednesday last week due to Thanksgiving), but fair enough:
Latest Enrollment Numbers
December 3, 2014
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 8,874
MinnesotaCare 2,954 Qualified Health Plan (QHP) 7,106
TOTAL 18,934
MNsure is running around 54% higher than their 2014 daily average so far, FWIW.
Massachusetts continues to steam ahead: Assuming at least 48.5% of QHP determinations have already selected policies, they should be at roughly 26,000 QHPs through last night, plus another 45,687 added to Medicaid.
If so, MA has reached 82% of their 2014 total in 18 days, and is on their way to a bare minimum of 134K even without the double-surges around 12/23 and 2/15.
Again, I'm expecting as many as 300K Bay Staters before the dust settles in February.
Over the summer, five different respected national healthcare studies agreed that the overall uninsured rate had plummeted by at least 25% from last fall through the end of June, 2014. The methodology varied a bit from one to another; some included all adults, others only included those under 65. Some included children under 18, others didn't. Some used the September 2013 as the starting point, others started with December 2013. Even with all of these variables, though, the consensus was a 25% reduction, from roughly 42.3 million down to around 31.3 million, give or take.
Today, one of the five, the Urban Institute, released an updated study which includes the third quarter of 2014, and as expected, the trend has continued:
On the one hand, moving from 2,000 in the first 3 days to a minimum of 6,000 (likely more like 10K, since the 6K refers only to "accounts" not "people") in the first 17 days is a perfectly reasonable point for Washington to be at right now.
Today, the Exchange identified an error affecting 6,000 customer accounts enrolled in Qualified Health Plans. Early analysis indicates that our system integrator, Deloitte, ran an automated enrollment cancellation process in error. The affected accounts, which are a portion of the total number of customers who are enrolled in coverage starting on Jan. 1, 2015, experienced an erroneous cancellation of both their enrollment and payment for 2015 coverage.
Oops.
Well, on the plus side, the rest of the PR makes it clear that a) they're on top of it, b) it's gonna get resolved ASAP and c) it looks like this screw-up was Deloitte's fault, not the actual exchange itself (they call them out by name, which is noteworthy).
Colorado's first official enrollment report is simple, to the point, and includes not only new Medicaid/CHIP data after all (I was concerned that they'd stopped doing so, but apparently not), but also includes a handy 2015 vs. 2014 comparison chart, the SHOP number and even the number of QHP enrollees receiving tax credits/cost sharing!
In fact, the only gripes I have here are the lack of a new vs. renewal breakout (which it looked like they were going to include at first). They also don't include Medicaid/CHIP for 2014, but I already know that number went up 310K so far this year.
Regarding the King v Burwell ACA case which is headed to the Supreme Court soon (with a ruling likely sometime next summer, after the 2nd Open Enrollment Period is long behind us), Mitch McConnell had this to say this morning (h/t to Greg Sargent of the Washington Post for the story):
The moment, which was flagged by a Democrat, comes in an interview that McConnell gave to the Wall Street Journal’s Gerald Seib this morning (see second video). Seib notes that some Republicans have advocated for repeal, and asks: “How do you approach the Affordable Care Act now?” McConnell answers (emphasis added):
“It bears the president’s name. The chances of his signing a full repeal are pretty limited. There are parts of it that are extremely toxic with the American people. The elimination of the 40 hour work week. The individual mandate. The medical device tax. The health insurance tax. I think you could anticipate those kinds of things being voted on in the Senate. Such votes have not been allowed in the past.
Based on yesterday's Massachusetts update, I'm knocking my "% selected of total determinations" down from an even 50% to 48.5% on any given day. Even so, 48.5% of 48,902 QHP determinations still means roughly 23,700, up nearly 2K on Monday.
As MA's 2014 OE total was only 31,695, this means the state is alread up to 75% of their 2014 total in the first 17 days of the 2015 period.
Put another way, at their current rate, MA is on track to enroll a minimum of 130,000 people for 2015...and that would be even without a December 15 or February 15 surge.
Meanwhile, MassHealth (Medicaid) enrollment continues to steam ahead, now standing at 41,762 people.
You need a subscription to read the full article, but this is a Good Thing. One of the big concerns with the 2015 Open Enrollment period has been whether the ACA exchanges are set up to let insurance companies know (quickly) when a current enrollee switches from them to someone else, to avoid double-billing. On the down side, this really should have been in place before OE2 started a couple of weeks back. On the plus side, it sounds like they're on top of it now, anyway, and they do still have a few weeks before the first premiums are due from either the old or new insurer anyway...
CMS TO Create 'Enrollee Switched List' For Federal Exchange Issuers
CMS announced in guidance Monday (Dec.3) that it will create an “Enrollee Switched List” that allows issuers participating in federally facilitated exchanges to identify enrollees who actively re-enrolled in coverage with another issuer.
If you take a look at The Graph this evening, you'll notice two small additions: First, now that the confirmed QHP selections are large enough to actually be visible, I've added them as a permanent feature (it'll be jaggy due to the staggered data release schedule of the various exchanges, especially HC.gov). Second, just for the hell of it, I've decided to add a rough projection for the point I expect total QHPs to hit the 2 million point: December 8th.
That would leave just 1 week to add a whopping 5 million people if my "7M by the 15th" projection is to also prove accurate. For comparison, last spring around 2 million people enrolled in the last 16 days of March (plus another 940K during the 15 day April "overtime" period), so it may sound insane to think that 5 million can be enrolled in just 1 week...and if it wasn't for the "autorenewal" factor, I'd agree.
However, I'm operating on the assumption that roughly 4 million current enrollees (in the 45 states which are set up for autorenewals) will simply do nothing whatsoever and automatically get renewed all in one shot on the 15th.
Today I've been informed that the renewal number reached 4,415 as of 11/23, plus another 3,588 new applications. It was also specified that an "application" represents a household, not the total number of covered lives for whatever policy is eventually enrolled in.
Assuming an average of 1.8 people per household, and further assuming that roughly 50% of those who apply had also already selected a plan as of the date in question (this has been a consistent rule of thumb based on the Massachusetts data to date), that suggests that those applications represent roughly 6,400 actual people, and roughly 3,200 of them should have already selected their plans. Knocking 100 off in the interest of caution gives roughly 3,100 new enrollments on top of the 4,415 confirmed renewals, or around 7,500 total enrollments as of the 23rd.
When I last estimated QHP enrollments for Massachusetts, I assumed roughly 50% of QHP determinations had been selected and thus figured they were up to roughly 19,200 as of the 27th. Today they posted their 2nd official weekly report, and it looks like I overshot a bit (the actual number through the 28th was 18,646). The good news is that the weekly report also includes three more days (through last night). When you tack on the weekend, the grand total now sits at 21,740. Divide that into the 44,446 QHP determinations and the ratio has dropped slightly, to 48.9%.
Still an impressive showing through the holiday weekend. For the record, MA has reached about 68% of their 2014 open enrollment total in just 15 days, and is on pace to reach at least 135K by 2/15 (though I still estimate they'll reach more than double that).
Meanwhile, Medicaid additions are now up to 38,283 to date:
