Just 2 days ago I posted an analysis of the New York individual market rate increase requests for 2016. My takeaway was that the weighted average requested was 10.0%, with the usual caveats about rounding errors, estimates of the total individual market size and so forth. Plus, of course, these were just requested increases, not final ones.
NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICES ANNOUNCES 2016 HEALTH INSURANCE PREMIUM RATES, INCLUDING RATES FOR NY STATE OF HEALTH
Individual Rates for 2016 Remain Nearly 50% Lower than Before Establishment of New York’s Health Exchange
DFS Rate Reduction Actions Will Save Consumers More than $430 million
New Essential Plan Will Lower Premiums to $20 or Less and Provide Better Benefits for Lower-income New Yorkers
IMPORTANT:See this detailed explanation of how I've come up with the following estimated maximum weighted average rate increase request for Texas.
UPDATE 8/4/15: Revised table to display maximum, likely and minimum statewide average increase requests:
Assuming you've read through the explanation linked to above, here's my best estimate of the maximum possible rate increase requests for the Texas individual market:
When I was crunching the numbers to come up with my rough estimate of the weighted average rate increase requests for Florida yesterday, I had a revelation: While Healthcare.Gov's Rate Review database, frustratingly, only includes rate requests higher than 10% (thus ignoring dozens of requests of under 10%, or even rate reductions in some cases), it doesstill at least provide guidance as to what the maximum average could possibly be.
For instance, let's say that there's a state with 4 insurance carriers, each of which has exactly 10,000 enrollees. Two of them are asking for a 20% and 15% increase respectively. Since those are both above 10%, they'll both show up on the Rate Review site:
In addition to the normal off-season "Qualifying Life Events" which allow roughly 7,500 people to select a private policy nationally every day, it looks like up to 100K additional people might be added to either the QHP or Medicaid tally over the next month or so:
CMS will offer a special enrollment period to thousands of Healthcare.gov enrollees who were incorrectly told that they qualified for fewer subsidies than they should have received or none at all, due to a Social Security-related glitch in the eligibility system that inflated household income.
...Tricia Brooks, a senior fellow at Georgetown University's Center for Children and Families who frequently writes on the issue, estimates that the glitch affects around 40,000 households.
Not sure how this slipped by me earlier today...I've been so busy trying to figure out the 2016 rate increases for each state that I missed this report from HHS about the 2015 premium and competition changes at Healthcare.Gov (this doesn't include the state-based exchanges, but still covers 2/3 of the states and 3/4 of total private enrollments):
Competition and Choice in the Health Insurance Marketplace Lowered Premiums in 2015
The Health Insurance Marketplace established by the Affordable Care Act allows consumers to compare health insurance plans based on key factors, such as covered services, providers, and importantly, price. According to a report released today, choice and competition increased in the 2015 Marketplace and consumers benefitted as new issuers entered and price competition intensified. In 2015, 86 percent of Marketplace-eligible consumers could choose from at least three issuers, up from 70 percent in 2014.
The Rate Review database at Healthcare.Gov is a very useful tool for any insurance company requesting rate increases above 10%, but it's completely useless for requests below 10%. As such, I have hard data on the requested increases for about 600,000 Florida residents:
If Florida's entire ACA-compliant individual market was only 600K people, that would be the end of the story.
However, Florida actually has 16 different insurance companies selling individual policies...and the other 9 are all asking for lower than 10% hikes. After poking around the Florida Office of Insurance Regulation website as well as contacting the department directly, I've been able to pull together covered lives data for all 16, and requested rate change data for 3 more of them...2 of which are actually requesting rate decreases. When I add those 3 companies into the mix, the picture changes like so:
The Office of the Inspector General released a big report today which confirms what most healthcare/ACA observers have known for awhile now: The CO-OP organizations established by the ACA across 2 dozen states to help increase competition and keep the private, for-profit insurance companies (somewhat) honest...haven't been doing very well overall.
A judge has blasted a California software giant's claim that a cabal of campaign advisers are to blame for the decision to tank the state's $300 million Cover Oregon website project.
Oracle in February sued five campaign advisers and consultants to former Gov. John Kitzhaber, who resigned in February. Oracle argued the exchange was ready to roll out in February 2014, but said advisers led by Patricia McCaig pulled the plug on the project for political reasons.
On Monday, Multnomah Circuit Court Judge Henry Kantor issued a written opinion ripping Oracle's legal arguments using language that went far beyond his earlier e-mailed notice of the decision. He called Oracle's arguments "totally unsupported by the evidence provided."
Assuming my ballpark estimate of appx. 7,500Off-Season QHP Selections Per Day is accurate, the grand total nationally should be breaking the 13 million milestone right about...now-ish (or at least sometime this week).
I should note that thanks to this morning's New York update, the confirmed total has now officially broken the 12.1 million mark. The other 900,000 or so haven't been reported yet, and are mostly via Healthcare.Gov, of course.
Our growth continues to be balanced so far in 2015 as we added 571,000 Medicaid members, 331,000 national members, 51,000 individual members and 16,000 local group members. As a reminder, we closed on the Simply Healthcare acquisition in February of this year, which contributed 209,000 members. These results have been supported by strong operating cash flow of $2.8 billion year-to-date, which represents 1.6 times net income.
Humana Group is one of the largest health insurance companies in the country. As such, their enrollment data being made available is extremely helpful in seeing where things stand and how they've changed nationally.
Today, Bob Herman of Modern Healthcare provided me with a link to Humana's latest SEC filing. In addition to a whole mess of financial info which is of little interest to me, there's also all sorts of year-over-year data about their enrollment numbers...including a very handy section about their individual market, broken out by ACA exchange-based, Off Exchange and even their non-ACA compliant enrollments (ie, "grandfathered" and/or "transitional" enrollees).
Unfortunately, the data gets cut off as of 2/28/15, so this doesn't give any insight into the attrition rate since then (or a precise count of how many additional people enrolled during the #ACATaxTime special enrollment period which followed). However, it does give a lot of detailed analysis of the open enrollment period numbers, and does tack on an extra week's worth of private enrollments & 2 week's worth of CH+/Medicaid numbers (the official HHS report only ran through 2/21 for New York and the last press release with CH+/Medicaid numbers was as of 2/15).
As a result, the official numbers are slightly higher than what I had until now across the board:
A team of actuaries at the Minnesota Department of Commerce are currently scrutinizing the proposed rates that have been filed for 2016, and final rates will be announced on October 1. But for now, four MNsure’s individual market carriers have proposed the following rate changes for coverage effective January 1, 2016 (market share is as of the end of the 2015 open enrollment period):
UPDATE 8/27/15: I've been writing up a whole mess of *approved* state rate updates today; look for this entry to be updated on Friday.
Recently, Richard Simpkins (aka icowrich) gave me the idea to take the known state-wide 2016 rate increase requests and go a step further, by plugging the weighted average rate increases for each state into a spreadsheet and then running a weighted average based on each state's proportion of the total U.S. population, like so (scroll to bottom of this entry for links to analysis for each state):
Remember that University of Michigan study I posted about last week which claimed that in spite of all the predictions by ACA opponents that expanding Medicaid would make it impossible for enrollees to actually make a doctor's appointment, the opposite ended up being the case?
A new University of Michigan study shows that the availability of primary care appointments actually improved for people with Medicaid in the first months after the state launched the Healthy Michigan Plan, the state’s Medicaid expansion under the ACA. What’s more, it remained mostly unchanged for those with private insurance.
Well, apparently the Michigan results are not an outlier:
I very rarely write much about Medicare here, partly because I just don't have time to cover every aspect of the healthcare system, partly because Medicare is only impacted by the ACA indirectly for the most part. However, there's been two recent developments which are worth noting:
The slowing growth of healthcare costs has extended Medicare's projected lifespan 13 years beyond projections made in 2009, the last report issued before the passage of the Patient Protection and Affordable Care Act.
The Medicare Hospital Insurance Trust Fund will have "sufficient funds to cover its obligations until 2030," the Medicare Board of Trustees said Wednesday in its annual financial review of the $613 billion program.
Over 71.6 million individuals were enrolled in Medicaid and CHIP in May 2015. 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.
509,082 additional people were enrolled in May 2015 as compared to April 2015 in the 51 states that reported comparable May and April 2015 data.
Looking at the additional enrollment since October 2013 when the initial Marketplace open enrollment period began, among the 49 states reporting both May 2015 enrollment data and data from July-September of 2013, more than 12.8 million additional individuals are enrolled in Medicaid and CHIP as of May 2015, more than a 22 percent increase over the average monthly enrollment for July through September of 2013. (Connecticut and Maine are not included in this count.)
Most Mainers buying Affordable Care Act insurance will see modest increases in their premiums for 2016, below the national average and much lower than the double-digit increases projected in some cities by a recent study of initial rate filings.
About 80 percent of the 75,000 Mainers purchasing ACA marketplace insurance have a plan through Lewiston-based Community Health Options – formerly Maine Community Health Options. The ACA marketplace, operated on the Web as healthcare.gov, is where those without insurance – often part-time or self-employed workers – can obtain subsidized benefits.
FOR IMMEDIATE RELEASE Media Line: (916) 206-7777 July 27, 2015
COVERED CALIFORNIA HOLDS RATE INCREASES DOWN FOR SECOND CONSECUTIVE YEAR
Average Increase Is 4 Percent; Consumers Who Shop Can Lower Their Premium by an Average of 4.5 Percent
SACRAMENTO, Calif. — Covered California announced its rates for 2016 and unveiled which health insurance companies will be offering plans through the marketplace. The statewide weighted average increase will be 4 percent, which is lower than last year’s increase of 4.2 percent and represents a dramatic change from the trends that individuals faced in the years before the Patient Protection and Affordable Care Act.
When I last checked in on Pennsylvania's year-late-but-certainly-welcome addition to the ACA Medicaid expansion club, newly inaugurated Governor Tom Wolf was in the process of replacing his predecessor's poorly-conceived, overly-complicated "Conservative version" of the expansion program with "official" Medicaid expansion to up to 600,000 state residents. At the time (early May), they had hit roughly 250,000 people.
I'm happy to report that according to today's Pittsburgh Post-Gazette, the dust has settled on the transition, and enrollment has been on a tear, with the tally now standing at roughly 439,000 Pennsylvanians.
About 439,000 Pennsylvanians have enrolled in expanded Medicaid, which provides health insurance coverage to the poor and disabled, since the beginning of the year, according to figures released last week by the state’s Department of Human Services.
Criminal Inquiry Is Sought in Clinton Email Account
..and the wording of the passage was changed to this:
"...into whether sensitive government information was mishandled in connection with the personal email account Hillary Rodham Clinton used as secretary of state."
Japanese holdouts (残留日本兵 Zanryū nipponhei?, "remaining Japanese soldiers") or stragglers were Japanese soldiers in the Pacific Theatre who, after the August 1945 surrender of Japan ending World War II, either adamantly doubted the veracity of the formal surrender due to strong dogmatic or militaristic principles, or simply were not aware of it because communications had been cut off by the United States island hopping campaign.
They continued to fight the enemy forces, and later local police, for years after the war was over. Some Japanese holdouts volunteered during the First Indochina War and Indonesian War of Independence, to free Asian colonies from Western control despite these having once been colonial ambitions of Imperial Japan during World War II.
Over the past couple of months, the proposed 2016 individual & small business market premium rate filings have mostly been released. These are requests only, and have yet to be approved by state regulators in most states (Oregon and Kentucky are the only ones I know of which have actually approved theirs so far), but it at least gives us a general idea of where things are likely to stand next year.
News Alert – July 23, 2015
Individual/Consumer Markets
What to Expect for 2106 Open Enrollment Plans
On Monday, the Texas Department of Insurance gave Blue Cross and Blue Shield of Texas (BCBSTX) the clearance to announce a change in retail product offerings for 2016. We wanted to share this information with you first.
...There are some changes in the plans we intend to offer in 2016. Most significantly, we won’t be offering our Blue Choice PPO insurance plans for our under 65 block of business going forward.
We intend to offer other products, on and off the Marketplace. A new product has been filed that we believe will give you a flexible choice for your clients. We will be able to share information about that product if and when it is approved by the Centers for Medicare & Medicaid Services (CMS) closer to open enrollment.
...Currently, we have about 367,000 individual Texas members who will have their PPO plan discontinued in 2016. This number fluctuates monthly.
Hawaii Health Connector offers individual plans from two carriers: BCBS’s Hawaii Medical Service Association (HMSA), and Kaiser Permanente.
For 2016, HMSA has proposed a 45.5 percent rate increase for their individual HMO plan, and nearly a 50 percent rate hike for their individual PPO plan (49.1 percent overall). The carrier justified their rate hikes based on claims costs, explaining that while virtually everyone in Hawaii was already insured, the uninsured pool – many of whom purchased new ACA-compliant plans – had significant medical needs.
Ouch. Yup, that's a pretty ugly requested increase, no way around it.
The following day, Kaiser proposed an 8.7 percent rate increase for their individual market policies.
Once again, the Affordable Care Act (ACA) is proving its critics wrong. Opponents of the ACA, or Obamacare, have been falling all over themselves proclaiming that an influx of new patients will overburden the healthcare system, creating a dire doctor shortage.
At least in Michigan, that’s proven to be absolutely false.
A new University of Michigan study shows that the availability of primary care appointments actually improved for people with Medicaid in the first months after the state launched the Healthy Michigan Plan, the state’s Medicaid expansion under the ACA. What’s more, it remained mostly unchanged for those with private insurance.
At the end of May, I noted some very promising news out of the Nutmeg State: Out of the 111,268 people (109,839 during Open Enrollment + another 1,429 during the #ACATaxTime SEP) who had selected a private policy via AccessHealthCT as of last spring, around 93% were still enrolled in effectuated coverage, which is fantastic considering that last year, 12% of those who selected QHPs didn't pay in the first place, aside from any additional net attrition which happened after the first month.
Well, it's mid-July now, and the AccessHealthCT board just had their monthly meeting at which they gave a bunch of solid updates. Thanks to Arielle Levin Becker for most of the Tweetstorm:
There are a total of 608,231 processed applications. 96,966 CT residents are insured in a Qualified Health Plan (QHP). #AHCTBoDMeeting
I am not an insurance broker.
I am not an insurance agent.
I am not an ACA Navigator.
I am not an insurance company.
I am not a healthcare exchange or marketplace.
Most importantly (this one seems to be a common mistake):
I AM NOT THE HEALTH & HUMAN SERVICES DEPT. OF THE UNITED STATES.
Well, it looks like I need to add one more: I'm also NOT the Robert Wood Johnson Foundation:
I'm not trying to embarrass anyone; I've alerted the reporter to the error and they quickly made the correction, but just to be safe, going forward I've also gotten the OK to include an "Advertisement" tag to the RWJF banner ads as Esther F. suggested recently...
Long-time readers (and anyone from Maryland, I presume) know that the Old Line State (I have no idea whether that nickname is actually widely used?) was among those whose 2014 ACA exchange website turned out to be a huge technical mess. Oregon and Nevada received most of the headlines because they both ended up scrapping theirs completely and moving home to HealthCare.Gov this year (to be followed by Hawaii in 2016), but along with Massachusetts, Maryland went the "Try, Try Again" route.
This AP article provides snippets about a handful of states; it'd be nice if they just released the actual report so we could see the hard expansion numbers (as opposed to the total increase numbers, which are still obviously useful but don't distinguish between traditional Medicaid and ACA expansion enrollees):
In Kentucky, for example, enrollments during the 2014 fiscal year were more than double the number projected, with almost 311,000 newly eligible residents signing up. That's greater than what was initially predicted through 2021.
...At least 14 states have seen new enrollments exceed their original projections, causing at least seven to increase their cost estimates for 2017, according to an Associated Press analysis of state budget projections, Medicaid enrollments and cost details in the expansion states. A few states said they could not provide original projections.
Just 4 days ago (Friday), you'll recall that both Investor's Business Daily (and myself in my response to them) made a big deal out of a report from the Taxpayer Advocate dept. of the IRS which gave the initial estimates of how many households/people ended up paying the Individual Shared Responsibility Payment (aka the "individual mandate tax"), and just how much that ended up generating in tax revenue.
According to that report, about 6.6 million tax returns (this distinction is vitally important) ended up paying a total of roughly $1.254 billion, or $190 per return.
Before I get to the actual visualization itself, some important disclaimers/caveats:
Most of the numbers shown are rough estimates.
All estimates have been rounded off to the nearest 100,000, and in most cases to the nearest million.
There's a tremendous amount of churn in the U.S. insurance market; tens of thousands of people are shifting around from one form of coverage to another daily.
Some of the numbers shown were as of a given month, while others were quarterly or even yearly averages.
In some cases, the estimates shown are extrapolations from earlier hard numbers. (for example, "Medicare/Medicaid Dual Enrollment" went from 8.6 million to 10.2 million between 2006 - 2011; at that rate I estimated it at roughly 11 million in 2013 and 12 million as of this summer)
Some estimates are composites from several different reliable sources, including the U.S. Census Bureau, the Centers for Medicare & Medicaid, the Kaiser Family Foundation, Gallup, etc.
I originally attempted to keep everyone in a single column. Needless to say, with 320-odd million people involved, it proved impossible to make this fit on the screen, so I've moved Employer-Sponsored Insurance (which makes up nearly half the total) onto a second column. Even so, I'm pushing it.
As a result of all of the above (not to mention population growth), it's entirely possible--in fact, quite likely--that some of the estimates shown are off by a bit. Employer-Sponsored Insurance, Medicare and Medicaid, in particular, could be too high or low by up to 1-2 million people each given the large numbers involved.
With all of that out of the way, here's my best crack at trying to portray the current healthcare coverage status of every single person in the United States of America as of October 2013 (just prior to the launch of the ACA exchanges and Medicaid expansion program) and July 2015. Comments welcome. I've added some additional notes below the graphic.
Obamacare enrollees on average have one-third fewer choices when it comes to picking doctors and hospitals than those on regular commercial plans, a new study says.
But its authors claim that’s not necessarily a bad thing. And others in the health-care arena believe the findings are misleading and don’t tell the whole story.
The study from Washington, D.C.-based Avalere Health finds that those under Affordable Care Act plans have roughly 66% of the choices compared with those in commercial plans, and the number of options may vary depending on the type of physician needed.
Under Obamacare, enrollees have access to roughly 58% of the oncologists and cardiologists that commercial plan members have. The average goes up when it comes to hospitals, as those using the public exchanges have access to 76% of those care facilities.
Huh. This is kind of weird...two completely different stories, from two different reporters (although both are via the Associated Press) about the latest Medicaid expansion numbers from two of the largest states at opposite ends of the country: California and New York.
This wouldn't be surprising if there had been a major report/press release regarding Medicaid enrollment nationally broken out by state, of course, but as far as I know there hasn't been (the last report from CMS came out in early June, only runs through March and doesn't distinguish between "traditional" and "expanded" Medicaid anyway).
In any event, I'm happy to report that the numbers actually line up pretty closely with what I already had estimated for each state:
It's a quiet Sunday afternoon and everyone (including myself) is focused on Donald Trump's latest blatherings, so I figured I'd throw this in.
I think I read about this guy a couple of years ago, and remembered being impressed, but I didn't actually watch his TED Talk until today.
I'm eternally grateful that I did. He articulates every thought I've had swirling around in my head the past few years about capitalism and economics, but he does so in a far more coherent, comprehensive and logical manner than I could ever hope to. Plus, for me it's just theoretical; he speaks from deep knowledge.
Take 20 minutes out of your day and watch it all the way through without interruption.
Democrats were naturally declared the big winners of last month’s King v. Burwell Supreme Court decision. That ruling, after all, saved the party’s most significant legislative accomplishment in decades: The Affordable Care Act (ACA).
But Obamacare has not simply been an ideological victory for the Democratic Party. The percentage of Democrats with health insurance has increased dramatically since the ACA’s marketplace went online in October 2013, according to weekly surveys conducted by YouGov for the Economist. In fact, the display below suggests that Democrats’ uninsured rates have essentially been cut in half under Obamacare.
Breakthrough — Utah GOP leaders reach a deal on Medicaid expansion
Republican leaders have agreed to a broad, conceptual framework for expanding Medicaid to insure tens of thousands of low-income Utahns with a plan that would call on medical providers to pay for the new health coverage.
The so-called Gang of Six — Gov. Gary Herbert, Lt. Gov. Spencer Cox, Senate President Wayne Niederhauser, House Speaker Greg Hughes, House Majority Leader Jim Dunnigan and Sen. Brian Shiozawa — huddled this week constructing the skeleton of a new Medicaid plan to replace the governor's Healthy Utah and the House's Utah Cares proposals.
On Friday, they announced their agreement, saying it was sustainable and would protect other key areas of the budget.
Before I get into the meat of the headline, I just wanted to point something out (bear with me, there's a reason for this):
Exhibit A:
October, 2013: Several million people receive cancellation notices from their health insurance companies, stating that their current policies will be discontinued effective 12/31/13 because they don't meet the Affordable Care Act's minimum coverage requirements. Much outrage and gnashing of teeth follows because President Obama had repeatedly stated that "If you like your plan you can keep it" (which, as I noted over a year ago, was an absurd thing for him to promise without including any caveats since there's no way of guaranteeing that the company won't go out of business, leave the state or simply decide to discontinue that policy for their own reasons which may or may not have anything to do with ACA compliance).
November, 2013: In response to the "You Can Keep It" brouhaha, President Obama and the HHS Dept. announce a 1-year (later quietly extended to up to 3 years) "transitional" policy for non-compliant plans. Some states take them up on it; some don't.
July, 2015: Republicans and other ACA critics complain that allowing the "transitional" policy extension is partly to blame for significant rate hikes expected to show up in 2016.
CONCLUSION: Damned if you do, damned if you don't.
Over at Balloon Juice, Richard Mayhew has posted a great piece illustrating, once again, the importance of looking past the scary headlines to find out 1) what the true picture is (ie, taking all of the rate changes into account--not just the biggest ones--and weighting them by proportionate market share), and 2) what's going on with your situation, not someone else's:
As expected, the initial ask by insurers is being revised down. It is easier for insurers to get state regulators to agree to a lower number from the initial than to get the regulators to agree to a higher number than the initial ask. That allows regulators and their champions to point to a clear example of their effectiveness at protecting the public. This is a bit of a kabuki. In my state, when Mayhew Insurance and our competitors submit rates, there is a de facto implicit fudge factor built into the rates (usually as excess reserve accumulation) that everyone expects to be cut by the third round of review.
Louise Norris has done the heavy lifting for me regarding Rhode Island's 2016 rate change requests. Then again, there's only 3 companies operating on the exchange anyway (and I don't see any other companies operating off-exchange only, so I assume that's it for the state's individual market):
Of the three carriers that offer individual plans in HealthSource RI, only one –UnitedHealthcare of New England – shows up on the rate review tool that HHS is using to publish proposed rate hikes of ten percent or higher. United is requesting an average rate increase of about 11 percent for their Compass individual plans.
Blue Cross Blue Shield had also initially proposed weighted average rate hikes of 11 percent for their individual market plans in RI, but in early July, the carrier revised their projection to a weighted average rate increase of just 7 percent. The lower rate is partially due to the fact that in the FY 2016 budget (see below), the HealthSource RI premium fee is lower than initially proposed.
Alaska Governor Sidesteps GOP-Controlled Legislature, Expands Medicaid On His Own
Alaska will become the 30th state to accept Obamacare’s optional Medicaid expansion, after Gov. Bill Walker (I)announced on Thursday that he will use his executive power to bypass the GOP-controlled legislature and implement the policy on his own.
Walker — a former Republican who has since become an Independent — has been advocating for Medicaid expansion for over a year. Implementing this particular Obamacare provision, which was ruled optional by the Supreme Court in 2012, would extend health coverage to an estimated 40,000 low-income residents in his state. Polling has found that the majority of Alaska residents agree with Walker’s position.
This may not seem like a Big Deal to anyone but myself, but I've decided to bump up my estimate of the currently effectuated ACA exchange QHP tally from 10.3 million (which is what I've been estimating ever since the March HHS report came out) to 10.4 million, where I expect it to hover until right around the point that the 2016 Open Enrollment period kicks off in November.
I'm basing this modest increase on the latest enrollment data out of 4 states: Washington, Colorado, Maryland and Massachusetts, each of which is showing stronger retention numbers (or, in some cases, net increases) since March:
Whoa, Nelly! Ask and ye shall receive...I was just sent a copy of the June report from the Massachusetts Health Connector, and there's some fasinating healthcare data nerd stuff included.
I've pasted screen shots of every page of the report below (and there's a link to the PDF version at the bottom), but here's the main takeaways:
Effectuated QHPs have reached nearly 166,000...a whopping 40,520 higher than at the end of Open Enrollment!
While the national effectuation number is likely only 2% or so higher today than it was in March (likely 10.3 - 10.4 million vs. 10.2 million), in Massachusetts it's 32% higher. There's two main reasons for this, both connected to "ConnectorCare", which is unique to Massachusetts. ConnectorCare consists of the same low-end Qualified Health Plans that anyone can purchase (ie, they're still counted as QHPs in the national tally), except that in addition to the federal Advanced Premium Tax Credits (APTC), enrollees in ConnectorCare also receive additional state-based financial assistance, making them even more attractive to enrollees. In addition, however, unlike "normal" APTC or Full Price QHPs, which are limited to the official open enrollment period for most people, ConnectorCare enrollment, like Medicaid/CHIP, is open year round. That makes a dramatic difference, as you can see below; over 85% of the net QHP enrollment increase since March is thanks to ConnectorCare additions.
In addition, MA is the only state I know of which actively reports their attrition numbers--that is, so far this year they've had 13,635 people drop their QHP policies, meaning a total of 179,557 people have selected a plan and paid at least their first monthly premium.
Assuming a 90% payment rate (confirmed for Massachusetts back in April), this also suggests that the cumulative QHP selection total should be roughly 200,000 people to date, which is only significant to me and The Graph.
When you add the MA factor to the other state-level numbers I've received from Washington State, Colorado and Maryland, this is very strong evidence that the current effectuated number as of July nationally is more like 10.4 million vs. the 10.3 million I've been assuming.
But wait, there's more! Look below and you'll see a whole mess of pie charts, bar charts and line charts, breaking out everything from Metal Level selections and Market Share by Provider to SHOP enrollments (5,247 lives covered as of July 1st) and even Dental Plans!
Not sure how this one got by me, but the Maryland Health Benefit Exchange actually released some updated enrollment numbers over a week ago:
Nearly a half-million Marylanders — 493,346 — have enrolled in quality, affordable health coverage through Maryland Health Connection for 2015.
That includes 126,346 people enrolled in private Qualified Health Plans and 367,000 enrolled in Medicaid from Nov. 15, 2014 through July 5, 2015. About 92 percent of enrollees through the state’s health insurance marketplace are receiving some form of financial assistance.
Medicaid enrollments are year-round. And while open enrollment for private health insurance for 2015 coverage ended in February, people may still enroll if they have a qualified “life event.”
The "92% receiving financial assistance" bit is slightly misleading; that's true, but only because the Medicaid enrollees are lumped in. If you're talking about QHPs only, it's more like 69% (87.2K out of 126.3K). Whether that's a good or bad thing obviously depends on your POV.
The official tally of QHP selections nationally during the 2015 Open Enrollment Period (from 11/15/14 - 2/22/15) was 11,688,074 people.
The actual number of people still enrolled in effectuated plans (i.e., active) as of March 31, 2015, according to the HHS Dept., was 10,187,197 people. That's a net reduction of exactly 1,500,877.
On the surface, that may look bad, but bear in mind that with a 90% payment rate (which I suspect is actually pretty close to the non-ACA industry standard, and which is about 2 points better than last year), that means only about 10.5 million of the original enrollees would have been expected to actually be enrolled in March anyway. That leaves another 332,000 people who presumably paid up for January, February and/or March, but had dropped their policies by the end of March.
When you have diarrhea of the mouth and a "TEN BILLION DOLLAR" megaphone as Donald Trump does, sooner or later you're going to shoot your mouth off about every conceivable topic under the sun. I knew it was just a matter of time before he got to the Affordable Care Act, and while I didn't know exactly what he'd say, I knew that whatever it was, it'd be easily debunked.
Donald Trump, the celebrity businessman who has shaken up the Republican presidential race, has been attacking both Republicans and Democrats in his speeches and interviews. At one point in a July 11, 2015, speech in Phoenix, he took aim at the Affordable Care Act, President Barack Obama’s signature health care law.
He singled out the healthcare.gov website, which was unveiled in the fall of 2013 with a panoply of bugs and glitches, calling it "the $5 billion website for Obamacare, which never worked. Still doesn't work."
PolitiFact does a pretty good job of debunking both claims.
The obligatory update. Assuming around 7,500 off-season QHP selections per day nationally, the grand total should cross the 12.9 million milestone sometime this week if it hasn't already, and should pass the 13 million mark at the end of July.
This won't likely have any impact on the currently effectuated number of course, which is likely still hovering around the 10.3 million mark due to non-payments and normal attrition, although some limited evidence from Washington State and Colorado suggests that this might be a bit higher--perhaps 10.4 million or so.
Last week I noted that of the 33 million people still uninsured in the United States, around 6.5 million of them can't be covered via Affordable Care Act provisions because they're undocumented immigrants, who aren't legally allowed to #GetCovered via either the ACA exchanges (private coverage) or Medicaid expansion (public coverage). Another 3.7 million legal residents/citizens, of course, are caught in the Medicaid Gap. I also brought up the undocumented immigrant factor in a piece yesterday trying to break out the other portions of that 33 million total.
Anyway, in the comments, "dawgitall" asked a reasonable question: If there's around 11 million undocumented immigrants in the U.S. total (everyone seems to agree on that estimate), and 6.5 million of them aren't insured at all, what's the deal with the remaining 4.5 million?
Last week, after the latest quarterly Gallup survey came out stating that the uninsured rate among U.S. adults had dropped to just 11.4%, I did some number-crunching and pointed out that:
About 6.5 million of those 33 million are undocumented immigrants who are therefore not eligible for coverage via the ACA anyway
Another 3.7 million are folks caught in the "Medicaid Gap" in 21 Republican-controlled states...these are people who a) make less than 100% of the federal poverty line (making them ineligible for federal tax credits to purchase private policies) but b) aren't eligible for traditional Medicaid either, meaning they're basically screwed.
When you subtract those two populations, it leaves roughly 22.8 million people who are still uninsured. So, who are they?
Well, according to the Kaiser Family Foundation, as of 2014, there were roughly 13.8 million uninsured eligible for Medicaid (either traditional or via ACA expansion). Since then, thanks to several more states going through with expanding the program (Pennsylvania, Indiana and, any day now, Montana), this number has increased to around 14.3 million. According to the March Medicaid report released by CMS in June, there's been a net increase of 12.2 million Medicaid/CHIP enrollees since 2013 (I'm not including the 950K "bulk transferees" brought onto the program prior to October 2013, since most of those were already covered by some other state-run program).
As most people know, website owners have a variety of methods of tracking the metrics of who's visiting their site, including tools like Google Analytics and the like. Depending on which analytics solution you use, you can track not only how many people visit per hour/day/week/month, but their exact IP addresses, rough latitude/longitude, what type of operating system/web browser they use and even the resolution of the monitor they're viewing the site on.
You can also generally track how they found your site--that is, which link on which other website brought them to yours. For example, most visitors who don't load the site directly come from Twitter or via Facebook, as you'd expect, but other major traffic sources are links from the Washington Post, Slate, the MaddowBlog, Salon or other "official" news/opinion sites. Obviously whenever Paul Krugman gives me a shout-out at the NY Times, that causes a big spike. After that, it tends to be healthcare-specific sites such as healthinsurance.org, Modern Healthcare and so on, followed by other "unofficial" blogs such as Xpostfactoid, Lawyers, Guns & Money, Balloon Juice etc.
And then, every once in awhile, I'll receive traffic from...a different type of website.
Colorado is one of the few ACA exchanges issuing monthly reports during the off-season. Until now, these reports, while chock full of data, have made it rather confusing to separate out the key number which I'm looking for: The cumulative number of 2015 QHP selections and the currently effectuated QHPs, because of their tendency to mix SHOP and Dental policies into the mix.
Japanese holdouts (残留日本兵 Zanryū nipponhei?, "remaining Japanese soldiers") or stragglers were Japanese soldiers in the Pacific Theatre who, after the August 1945 surrender of Japan ending World War II, either adamantly doubted the veracity of the formal surrender due to strong dogmatic or militaristic principles, or simply were not aware of it because communications had been cut off by the United States island hopping campaign.
They continued to fight the enemy forces, and later local police, for years after the war was over. Some Japanese holdouts volunteered during the First Indochina War and Indonesian War of Independence, to free Asian colonies from Western control despite these having once been colonial ambitions of Imperial Japan during World War II.
Intelligence officer Hiroo Onoda, who was relieved of duty by his former commanding officer on Lubang Island in thePhilippines in March 1974, and Teruo Nakamura, who was stationed on Morotai Island in Indonesia and surrendered in December 1974, were the last confirmed holdouts, though rumors persisted of others.
Since the Supreme Court has ensured the viability the federally-facilitated exchanges, they could be the best option for other states with problematic marketplaces. “There is no new money now to build new infrastructure, and there are no grants available to fix these systems if they’re struggling,” said Heather Howard, the director of the Princeton University program that advises states on exchange building, told the Times. “So the only path forward may be to use HealthCare.gov.”
Did Obama Cover Up Real Reason for Obamacare Website Crash?
Nearly two years after its failed launch, there still remain more questions than answers, but perhaps the recent King v. Burwell case has subtly lifted the veil on the real reason for the crash.
Hmmmm..."subtly lifted the veil"? I'm intrigued! Do go on...
At the time of the HealthCare.gov crash, Obama’s media spin doctors insisted the site’s failure was caused by “extremely high” traffic, as Sebelius reiterated in an interview with CNN’s Sanjay Gupta. According to Sebelius, nearly 20 million people visited the site in just the first three weeks, a volume site designers simply weren’t prepared for.
Anyone over the age of 40 or so--regardless of their political stripes--should demand that, henceforth, July 12 be given the same Unofficial National Holiday status that, say, Star Wars Day has received.
A few weeks ago I reported that Indiana's implentation of the ACA's Medicaid expansion provision, which kicked off at the end of January, was already up to 237,000 enrollees.
Industry representatives say Indiana's expanded health care program for low-income residents has functioned smoothly in the months since it was implemented following federal approval.
The federal Centers for Medicare and Medicaid Services in January approved expanding the existing Healthy Indiana Plan into a larger program that Gov. Mike Pence has dubbed HIP 2.0. That program uses federal Medicaid funds under President Barack Obama's health care law to cover people with incomes under 138 percent of the federal poverty level.
State enrollment in HIP 2.0 has climbed to nearly 290,000 participants, with about 60 percent of those people under age 40, according to state figures presented Thursday during a public hearing in Indianapolis on the program.
For the first time, the Obama administration has deployed an important new power it has under the Affordable Care Act: proposing to pay doctors and hospitals based on the quality of care they provide, regardless of whether they want to be paid that way.
It rolled out two such programs this week. One would require all hospitals in 75 metropolitan areasto accept a flat fee for the costs associated with a hip or knee replacement — including the costs of surgery, medications, the joint implant and rehabilitation. And if the quality of the care is not judged to be good, Medicare will take back some of the money it paid. Another program would increase or decrease payments tohome health agencies in nine states, depending on how they perform on certain quality measurements.
This story is mainly included for reference if/when I'm able to do a market share/rate increase analysis of Illinois in the future:
Yesterday, after the big quarterly Gallup survey was released showing a total reduction in the uninsured among U.S. adults from 18% in October 2013 down to 11.4% in June 2015, I went ahead and whipped up a more detailed graph which 1) includes the full range starting from 0% (Gallup's official graph cuts off the first 10%, which gives a bit of a false impression of the true situation); 2) includes the 2 key dates: March 2010 (when the ACA was signed into law) and October 2013 (when the ACA exchanges/Medicaid expansion enrollments started); and 3) also includes 2 extremely important color-coded areas: The 3.7 million people caught in the "Medicaid Gap" in 21 Republican-controlled states, and the millions of uninsured, undocumented immigrants nationwide.
Just 3 days ago, I wrote about the changing 2016 rate increase request situation in Connecticut, where Arielle Levin Becker reported that 2 of the state insurance providers were lowering their requested rates ahead of the public regulatory hearings...even though the CT exchange, Access Health CT, is increasing their rates a bit to cover expenses. As a result, the overall weighted average increases being requested dropped a half a point, from 7.7% down to 7.2%, which is pretty darned good, all things considered.
The four companies selling individual health plans through Connecticut’s health insurance exchange have revised their proposals to raise rates in 2016, seeking lower increases than initially proposed.
Last week Oregon became the first state to actually approve their 2016 individual/family and small group market policy rate changes. Yesterday, Kentucky appears to have become the second:
Unfortunately, as you can see, while the average rate request for each company is listed, it isn't easy to find the actual enrollment/market share data for most of them, making it impossible to get a weighted average. In addition, there's an awful lot of "n/a / 0%" entries for some pretty big companies. Usually this means that they're new to the market, but I'm not sure that's the case here.
Anyway, assuming that I have the partial data above accurate, it looks like Kentucky's individual market changes will range from an 11% decrease (for WellCare Health Plans of Kentucky, Inc.) to a wince-inducing 25% increase (for the Kentucky Health CO-OP). I don't know how many are enrolled in WellCare right now, but the CO-OP has 53,000 customers, so expect some shuffling around...except, again, I have no idea what that's a 25.1% increase from.
Breaking: Birth Control Coverage Guaranteed for All — Despite Religious Exemptions
Now free coverage of all forms of birth control is guaranteed for all women, no matter where they work. The Obama administration on Friday issued a workaround to last year’s Hobby Lobby ruling, which gave companies religious exemptions on coverage for certain forms of birth control.
On top of this morning's excellent news from Gallup that the total number of uninsured U.S. adults dropped another 1.2 million people in the 2nd quarter of 2015 (0.5% of adults 18 & older = 0.5% out of appx. 245 million adults = around 1.2 million), the polling firm has released another data drop regarding approval/disapproval of the law, post-King v. Burwell:
On the surface, this isn't really that jaw-dropping; several other national polls have found similar trends, and the Kaiser Family Foundation's most recent survey actually has approval slightly outpacing disapproval. Still, it's always good to see confirmation from another respected source.
In addition, while the Kaiser survey included a fairly large "Don't know/Refused to answer" contingent, Gallup seems to be more forceful about getting leaners to commit: The latest survey only has 5% unlisted.
Furthermore, anyone who enrolled/enrolls between around February 23rd and March 15th (varies by state) will start coverage on April 1st...and then, on May 1st, the bulk of the #ACATaxTime Special Enrollment Period enrollees will be kicking into gear. Don't forget off-exchange enrollees, ongoing Medicaid expansion, etc...I wouldn't be at all surprised to see the national uninsured rate drop to below 12% by April.
The uninsured rate among U.S. adults declined to 11.9% for the first quarter of 2015 -- down one percentage point from the previous quarter and 5.2 points since the end of 2013, just before the Affordable Care Act went into effect. The uninsured rate is the lowest since Gallup and Healthways began tracking it in 2008.
Yesterday I noted that if the Republican Party really wants to damage the Affordable Care Act, they could do so quite easily...byhelping the Affordable Care Act:
Put another way: 11.7 million people selected QHPs during 2015 open enrollment, of which roughly 10.3 million are currently enrolled nationally. If every state had expanded Medicaid as of the beginning of this year, only around 9.5 million people would have selected QHPs and only around 8.4 million would still be enrolled in them today.
That's right: As Sprung put it last March, by refusing Medicaid expansion, red state governors and legislatures drove almost 2 million private plan enrollees to federal exchange.
UPDATE 7/13/15: OK, looks like they've posted a "teaser" of the interview this morning; it's set to air this evening at 6pm; as you can see, in the text version, at least, they did a good job of including several of the key points I brought up, especially the "shop around" factor:
This led to a bit of confusion about just who does and doesn't fall into the "Medicaid Gap"...that is, people who don't qualify for Medicaid, but also don't make enough money to qualify for federal tax credits to enroll in private policies via the ACA.
As I noted yesterday:
...in states which expanded Medicaid, households earning less than 138% of the Federal Poverty Level (FPL) are eligible for Medicaid; anyone from 138% - 400% are eligible for federal tax credits to enroll in private Qualified Health Plans (QHPs) via the ACA exchanges.
Remember that massive Excel HC.gov enrollment spreadsheet file released last week? The one which broke out 2015 QHP selections by county, age group, metal level, income range and so on? Well, for those who don't have Excel, they've set up a web-based version of each.
OK, this is rather embarrassing (from the Office of the Inspector General):
CMS's internal controls did not effectively ensure the accuracy of nearly $2.8 billion in aggregate financial assistance payments made to insurance companies under the Affordable Care Act during the first 4 months that these payments were made.
Last week another healthcare reporter and I (I think I do count as a "reporter" by now, yes?) were discussing the fact that some of the 10.3 million people currently enrolled in private policies via the ACA exchanges would be eligible for Medicaid instead, if their states would simply expand Medicaid via the ACA.
How is this? Well, in states which expanded Medicaid, households earning less than 138% of the Federal Poverty Level (FPL) are eligible for Medicaid; anyone from 138% - 400% are eligible for federal tax credits to enroll in private Qualified Health Plans (QHPs) via the ACA exchanges.
However, in states which didn't expand Medicaid, households earning 100% - 400% are eligible for those private QHP tax credits (anyone below 100% are flat-out screwed if they don't already qualify for "normal" Medicaid in their state).
In nearly every state, the official "enrollment number" used in the HHS Dept's ASPE reports has been the number of QHP selections completed...whether or not the enrollee actually pays their first monthly premium. Naturally, this led to a lot of fuss and bother about "How many have PAID???" last year (and this year as well, though to a lesser extent). In the end, the answer in 2014 turned out to be roughly 88%, with an additional 4% or so gradually dropping their policies over the course of the year and another 5% dropping theirs once the 2015 season opened up. In 2015, so far it looks like the 1st-month-paid percent is a bit higher, more like 90%.
Most news outlets mushed the two figures (non-payments and attrition) together, but I keep them separate, and Washington State is one reason why. Unlike most states, the Washington ACA exchange only reports their exchange policies after the first monthly premium has been paid. As a result, while their official numbers seemed a bit weak back in February (160,732 vs. their stated goal of 230,000), the silver lining is that it was also a "cleaner" figure; I didn't have to lop off 10% of the total, since WA "pre-purged" it for me.
Spotlight here is on Alabama in my continuing close look at how many low income ACA private plan buyers accessed Cost Sharing Reduction (CSR) subsidies by buying silver plans. (Yesterday, HHS released detailed county-level data about buyers of private plans on healthcare.gov, the federal exchange, enabling a close look at state stats.)
CSR is available to buyers with household incomes below 251% of the Federal Poverty Level (FPL), and strongest for buyers under 201% FPL. It is available only with silver plans, the second-cheapest of four metal levels available on ACA exchanges -- a fact that's less than obvious to the average shopper, Buyers under 201% FPL are leaving a really strong benefit on the table if they don't buy silver plans (see the note at bottom for more detail). I consider the percentage of buyers under 201% FPL who select silver an important measure of how well the exchange is functioning in a given state. (Those in the 201-250% FPL range are likelier to have good cause to forego the relatively negligible CSR provided at that level.)
Nearly 2 months ago, I posted about Connecticut's insurance policy rate change requests from the 9 companies which plan on offering individual healthcare policies either on or off the ACA exchange, Access Health CT. The takeaway at the time was that, when weighted for the relative market share of each company, it looked like a statewide average requested rate increase of 7.7%, which isn't bad at all given the massive hikes being tossed around in some other states:
None of these have actually been approved yet, mind you...and in fact, just today it was announced that the CT Insurance Dept. will be holding public hearings to discuss the rate requests by three of the companies above: Anthem, ConnectiCare and Golden Rule.
Even before that happens, however, there's been some shifting: The first two companies, Anthem and ConnectiCare, have put in revisions to their earlier requests:
Needless to say, being Breitbart, they lay on the "OMG!! SKY IS FALLING!! MASSIVE RATE HIKES!!" stuff pretty thick, and as I've noted repeatedly, in some cases that may very well be true. I didn't bother reading most of it since I already know what it says.
However, there's one rather curious passage which did catch my eye:
Regulators for Covered California, the largest Obamacare exchange with 1.4 million members, have been mum on just how big their premium rate increase will be. But with the exchange already expected to lose $78 billion in the state fiscal year that began July 1, there is no state money for extra subsidies.
As I noted at the end of April, after climbing at a furious pace every week for months on end, Michigan's implementation of the Affordable Care Act's Medicaid expansion provision (aka "Healthy Michigan") plateaued at around 600,000 enrollees back in February, and then bobbled around the 600K level for several weeks straight. As I noted at the time, I'm still checking this figure weekly, but it has never deviated far from that number--sometimes a bit higher, sometimes lower.
For 2015, Colorado HealthOP cut premiums aggressively, and ended up with the lowest-cost plans in eight of the state’s nine rating areas. Unsurprisingly, that resulted in the CO-OP garnering the highest market share in the exchange during the 2015 open enrollment period, with nearly 40% of exchange enrollees selecting Colorado HealthOP coverage (among our own clients, Colorado HealthOP was even more popular, including among those who selected off-exchange coverage).
...In 2015, Colorado HealthOP got almost 40% of the exchange’s market share, and Kaiser was a close second with 35%; the two non-profits accounted for three-quarters of all the private plan enrollees in Connect for Health Colorado this year.
The last official enrollment update for Rhode Island was 31,513 people as of 2/23/15, of which 30,001 had paid their first monthly premium at the time.
On the one hand, that makes it look like an amazing 95% payment rate; however, RI also "pre-purged" unpaid enrollments which missed the payment deadline prior to officially reporting them, so their payment rate actually ended up being more like 91% (ie, 30K out of around 33K total selections).
HealthSource RI has enrolled over 36,000 Rhode Islanders in 2015 healthcare coverage to date. Some Rhode Islanders may be eligible for a special enrollment period (outside of open enrollment) during which they can get coverage because of qualifying life-change events (such as a change in family status, loss of insurance, and certain hardships). More information about who qualifies for a special enrollment period is available at HealthSourceRI.com.
I've had no fewer than a dozen different people call my attention to a story in the New York Times last Friday by Robert Pear which lays out the dramatic 2016 rate increase requests from various insurance companies across multiple states:
Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more, saying their new customers under the Affordable Care Act turned out to be sicker than expected. Federal officials say they are determined to see that the requests are scaled back.
Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives.
(sigh) Just when you thought it was safe to go back in the risk pool...
Now that the dumbest lawsuit ever to make it to the United States Supreme Court has been kicked to the curb, you might think that it's smooth sailing for the Affordable Care Act, at least legislatively-speaking. You would, of course, be wrong:
The Obama administration and House Republicans are clashing over the healthcare law in court, with the Justice Department blasting a GOP lawsuit as "unprecedented."
House Republicans are suing President Obama over what they call executive overreach, saying Obama is unconstitutionally spending money on an ObamaCare program Congress declined to appropriate money for.
The Obama administration counters it does not need an appropriation because the funds were made permanent and mandatory by the Affordable Care Act. The funds in question are for “cost-sharing reductions” that help insurers lower out-of-pocket costs for low-income people.
As we head into the holiday weekend, and with King v. Burwell finally in the rearview mirror (thank God...and the Supreme Court), it's time once more to update The Graph.
As you can see, assuming appx. 7,500 QHP selections per day nationally during the off-season, the grand total for 2015 should be crossing the 12.8 million mark right about...NOW. (OK, give or take a week or so...it's possible that things slowed down considerably in the days leading up to the King v. Burwell decision due to all the uncertainty...on the other hand, there might have been a mini-surge this week as a bunch newly-married same-sex couples signed up. Who knows?
Back in April, the HHS Dept. provided a massive Excel file containing total 2015 QHP selections across the 37 states run through Healthcare.Gov, broken out by Zip Code.
By digging into the weeds and doing some serious data-crunching, you can get all sorts of interesting info. For instance, Families USA was able to figure out just how many people were at risk of losing their federal tax credits in each individual Congressional District in the 34 states which were at risk from King v. Burwell, and so forth.
As I noted last week, now that the King v. Burwell debacle is behind us, all options are on the table for the future of the 13 remaining "full" state-based exchanges (Hawaii is in the process of moving over to Healthcare.Gov for 2016, joining Oregon and Nevada). The two additional state exchanges most likely to make the move are Vermont (which is having both serious technical and funding issues) and Minnesota (where neither issue is quite as bad, but still troubling). The other 11 exchanges are in considerably better shape on the technical side, but the financing situation varies widely.
Fortunately, it looks like at least one state exchange has turned the corner, or at least is pretty confident that they're about to: The largest one in the country, Covered California. They just released a report at the Alliance for Health Reform forum; for the most part it's a general overview of CoveredCA's 2015 enrollment situation, rehashing data which was already known (1.3 million currently enrolled, etc.) However, there's a few noteworthy slides which fill out the picture more completely.
Long-time readers will remember that throughout the 2014 Open Enrollment period, there was much fuss and bother made by both the Obama administration, the HHS Dept., myself and some ACA detractors over the "sub26er" population: Young adults aged from 19-25 years old who are covered by their parents policies thanks to provisions in the Affordable Care Act requiring all new policies issued since 2010 to allow this.
During the fall of 2013, leading up to the ill-fated launch of the exchanges, the HHS Dept. kept throwing around a hard number to hype up the "sub26er" factor: 3.1 million, which actually came from this ASPE Issue Brief from back in June 2012:
There are 29.7 million adults in this age group, as of the most recent Census data (see Footnote 6). There was a 10.4% increase in insured young adults (64.4% to 74.8%) from Q3 2010 to Q4 2011 (Table 8). 10.4% of 29.7 million is 3.1 million young adults...
The Kaiser Family Foundation released another new, comprehensive national survey today about post-King v. Burwell awareness & opinion, as well as opinions on the ACA as a whole now that the KvB case is (finally) behind us. The poll was conducted after the decision, from 6/25 - 6/29 of over 1,200 adults across all 50 states; full methodology here.
Most of the results are interesting but not terribly surprising; while awareness of KvB rose after the SCOTUS decision, 61% of the public still didn't know much or anything about it, and the fact that 62% approved of the decision is pretty much what is pretty much in line with their earlier poll, where 63% of the public said that if the Supreme Court ruled for the plaintiffs, Congress should pass a simple law restoring tax credits to the 34 states in question. Basically, 62-63% just wanted this idiotic "problem" to be fixed one way or the other so we could move on to something else. As the Kaiser survey itself put it, after the decision "few expressed strong emotions" over it one way or the other; 66% were either "satisfied but meh" or "disappointed but meh" about the decision.
However, it's actually the very last question which caught my eye, and I was a bit surprised that Kaiser gave it so little attention.
With just over a day left before a government shutdown, the legislature passed a final budget on Monday evening. The Washington budget included $110 million in funding for the Washington Health Benefit Exchange. The funding level, and how it is allocated, is nearly identical to the House proposal released last week.
President Barack Obama will discuss his signature health care law Wednesday at Taylor Stratton Elementary School in Madison.
Although the closed event is at a school, Obama chose a city local leaders frequently tout as the health care capital of the country for his latest speech on the Affordable Care Act.
Also hot off the presses, Nick Budnick at the Oregonian reports that OR is the first state to approve final 2016 individual market policy rates. Since Oregon is not allowing "transitional" policies for 2016 (they gave a 1 year extension vs. the 2-3 that some states allowed), this should apply to all individual policies state-wide (as well as small group policies):
More than 220,000 Oregonians who buy their own health insurance will face higher premiums next year, and Portlanders could see some of the biggest hikes in the country.
State regulators have announced the 2016 rates for people who aren't covered by their employers or government programs.
The overall news is not good for consumers. Some insurers had asked the state to approve rates similar to last year's lowest. But many insurers lost money from unexpectedly high costs, so officials proposed raising many rates in preliminary decisions two weeks ago. The final decisions issued Wednesday resulted in a slightly better range of options for consumer.
New ObamaCare enrollees are healthier and spent less on drugs than enrollees last year, according to a new analysis.
The report from Express Scripts, the country’s largest pharmacy benefits manager, is a positive sign for the law, given the need to maintain a mix of healthy and sick enrollees to keep costs down.
Still, ObamaCare exchange enrollees tended to be sicker than those in other health plans. Costs were 16 percent higher per member per month compared to non-ObamaCare plans, the report finds, largely due to higher spending on costly drugs for complex conditions.
The encouraging sign for the law is that the number of new enrollees who used at least one prescription medication declined 18 percent in the first quarter of 2015. Costs were 36 percent lower per member per month compared to the first quarter of 2014.
Way back in January, when the King v. Burwell brouhaha was starting to heat up (yes, it had been a possibility since last summer, but the Supreme Court didn't actually agree to hear the case until the end of last year), I posted the following:
Yup. 5-6 million customers across 37 states will suddenly be unable to afford their shiny new policies, and at the same time will no longer be legally required to have them. Many of them will thus drop their coverage, meaning quite a few insurance companies would lose upwards of 70-80% of their customer base.
Furthermore, the other 20-30% would likely have a much higher percentage of people with truly serious medical issues, in turn causing the very "death spiral" of increasing premiums which ACA opponents claimed would happen if the law operated under the current situation (but which never happened).
In other words, the "death spiral" didn't happen the way they thought it would, so they're making damned sure that it DOES happen by tearing the law apart any way they can.
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.
