Connect for Health Colorado® Extends Enrollment Deadline in Response to Surge in Sign-ups
Posted on Tuesday, January 31, 2017
DENVER — Connect for Health Colorado® today announced it is giving consumers who attempt to enroll by the Jan. 31 deadline three more days to complete their enrollment.
Individuals who began the enrollment process by midnight Tuesday will have until 6 p.m. Friday, Feb. 3, to choose a health insurance plan that will be in effect March 1, 2017. Friday will be the last day to purchase coverage this year, except for customers who experience a qualifying life change event, such as marriage, divorce, having a child, losing your employer-sponsored insurance, or moving to Colorado.
I've received confirmation from CMS that this "in line by midnight" grace period ONLY applies to those who CALL THE FEDERAL EXCHANGE at 1-800-318-2596and LEAVE THEIR CONTACT INFORMATION.
In other words, it does NOT appear to apply to those who are using the website application/enrollment process only; you have to CALL HC.gov and leave your number to qualify.
Every Open Enrollment Period to date, most of the ACA exchanges have ended up offering some sort of deadline extension and/or "in line by midnight" overtime grace period to allow people who started the enrollment process by the deadline additional time to wrap up their paperwork and complete the process.
First Minnesota's ACA exchange, MNsure, announced an 8-Day "don't call it an extension!" Special Enrollment Period mainly targeted at providing a 25% premium discount for those who don't qualify for the normal federal APTC/CSR financial assistance.
Covered California Gives Consumers More Time to ‘Cross the Finish Line’ as It Prepares for Surge of Enrollment
Consumers must begin the application process by the end of Jan. 31 and complete their enrollment by the end of Feb. 4.
Thousands of Certified Insurance Agents and Community Enrollment Partners are ready to provide free and confidential in-person assistance.
SACRAMENTO, Calif. — Covered California announced it is giving consumers who attempt to enroll by the Jan. 31 deadline four more days to complete their enrollment.
I'm typing this at 9:40am on Tuesday, January 31st, 2017.
The 2017 Open Enrollment Period ends at Midnight tonight (I'm assuming that's Eastern time).
That means you still have just over 14 hours to enroll for a Qualified Health Plan for the rest of 2017. If you enroll today (and pay your first month's premium), your policy will go into effect starting March 1st, and as long as you keep paying your premiums, should remain in effect until December 31st.
Many people are understandably concerned or outright scared about what will happen to their coverage given the insanity swirling around the Trump Administration, the Republicans in the House and Senate actively taking steps to repeal the ACA and so forth.
Now, I've already said many times that 2018 coverage options are likely to be a complete disaster thanks to the massive uncertainty and sabotage being deliberately created by both Donald Trump and the GOP. For the current year, 2017, it's a different story.
The Washington Health Benefit Exchange is alerting customers that tomorrow, Jan. 31 is the deadline to sign up for 2017 health and dental coverage through Washington Healthplanfinder.
Individuals and families have until 11:59 p.m. tomorrow to select a plan that is good for the remainder of the year. Residents who fail to secure coverage by the deadline could be required to wait until the following year to sign up for health and dental coverage.
Last week, Congressional Republicans held a closed-door meeting to try and figure out how the hell they're going to replace the ACA (also known as "Obamacare" donchaknow?).
This may seem a little silly, but given the upcoming Open Enrollment deadline, the did-they-or-didn't-they confusion regarding the Trump administration's attempt to pull the final TV commercial/social media/phone/email notifications and the general insanity going on right now, I figured it might be helpful to provide direct links to the various ACA (Obamacare) websites for people to actually sign up for 2017 coverage.
Remember, regardless of how much the GOP-held Congress screws things up for 2018, signing up for a Qualified Health Policy (QHP) via one of these exchange websites by Tuesday, January 31st at Midnight should lock in both your policy and premium rate through the end of 2017.*
Last week I posted an exclusive story over at healthinsurance.org regarding attempts by the Minnesota Republican-held legislature to sneak in a nasty amendment which, had it passed and been signed into law, would have given insurance carriers the right to offer policies which cover, basically nothing whatsoever.
The story ended on a happy note a few days later, as the massive negative backlash caused the state GOP to yank the amendment from the bill in question just before it went to the final vote. Awesome!!
However, I never really explained exactly what bill the pulled amendment was attached to in the first place. I should have written up a full entry on this, but have been swamped all week due to the political insanity and rapidly-changing situation on everything, so here's the basics:
New Mexico is one of five states (also including Nevada, Oregon, Hawaii and Kentucky) which technically operate their own state-based ACA exchange, but utilize HealthCare.Gov as their website enrollment platform. As such, their enrollment numbers are usually only released along with the other three dozen states on the federal exchange.
However, once in awhile they post the enrollment numbers themselves; today is such a day:
@charles_gabaNMHIX: 52,006 total signups - almost as much as last year. Still anticipating a surge as NMHIX continues ads and outreach.
The breakout here is 36,579 renewals + 15,427 new enrollees, or a 70/30 split.
Last year, New Mexico's total came in at 54,865 QHP selections, so they've hit 95% of that so far.
My original target for New Mexico for this year was 60,000, though I've knocked this down to 57,000 more recently. They're at around 91% of that so far, with less than a week to go. They'll have to add another 5,000 people in the final surge, which seems unlikely, but who knows?
For weeks now I've been pointing out that just when the most recent round of unusually high (unsubsidized) rate hikes seemed to have reassured insurance carriers on the ACA exchanges that they were over the hump...just when things seemed to be settling down for next year's enrollment period...Donald Trump won the the election, triggering the Republican-held Congress to start tearing things apart left and right, throwing everything into chaos again.
On Tuesday I noted that all of this confusion and uncertainty caused by Trump/the GOP Congress has started giving heartburn to insurance executives. Again: In October, just before the election, Molina Healthcare was happy as a clam with their exchange business and projected "another solid year" ahead. And now???
The Trump administration apparently was unable to scrap all outreach efforts to enroll individuals in Obamacare, following widespread concern that its move Thursday to pull ads promoting enrollment could destabilize the insurance marketplace.
It may seem a little silly to keep posting these tiny individual-state updates with everything going on at the moment, but every enrollee counts. Access Health CT held their monthly board meeting yesterday and posted some noteworthy data/policy points.
The irony is that this is exactly how the ACA should be being handled by Congress and the President: By using actual hard data and logic, problem-solving, fixing what's broken and improving upon what isn't.
...none of which seems to mean a damned thing to Trump or the Trumpublican Party.
107,736 have enrolled in a QHP for 2017. That includes 12k new customers. #AHCTBoDMeeting
With the GOP Congress still obsessed with repealing the ACA and Donald Trump doing everything in his power to sabotage the law whether it gets repealed or not, the final 5 days of the 2017 Open Enrollment Period, which would normally see a spike in enrollments regardless, is going into a bit of a panic mode. Trump and his Republican cohorts are doing whatever he can to discourage people from enrolling before the deadline, while the insurance carriers, healthcare advocates and everyone else is doing whatever they can to encourage it.
New York State of Health, the NY ACA exchange, just announced that with the 1/31 final deadline rapidly approaching next Tuesday, they're extending their customer service hours on Saturday and Sunday.
The Trump administration has pulled the plug on all Obamacare outreach and advertising in the crucial final days of the 2017 enrollment season, according to sources at Health and Human Services and on Capitol Hill.
Even ads that had already been placed and paid for have been pulled, the sources told POLITICO.
...Individuals may still sign up for Obamacare plans until the Jan. 31 deadline — but the Trump administration isn't advertising that fact any longer.
It is also halting all media outreach designed to spur signups in the days leading up to the deadline. Emails are no longer being sent out to individuals who visited HealthCare.gov, the enrollment website, to encourage them to finish signing up. Those emails had proven highly successful in getting stragglers to complete enrollment before the deadline.
A few weeks ago, frustrated with the disturbingly large number of Trump supporters (and, let's face it, plenty of non-voters and even a few Hillary supporters) who still seemed to be unaware that "Obamacare" and "The Affordable Care Act" are the exact same thing, I whipped up a snarky and admittedly sarcastic infographic trying to clue them in.
A few days later, after calming down a bit, I reworked the infographic into a nonjudgmental, more informative version:
SEN. TOOMEY: “Now, one way to force it is to force insurance companies to provide health insurance coverage for someone as soon as they show up, regardless of what condition they have, which is kind of like asking the property casualty company to rebuild the house after it’s already burnt down.”
Now, aside from the obvious callousness of this statement, there's a couple of important problems with his comparison:
Politically, the big unknown is whether or not Paul Ryan and Mitch McConnell will get away with trying to pin the blame for this on the Democrats/the law itself. That's why they've been pushing the "Obamacare is already in a death spiral!" claim hard for the past few weeks, even though it quite simply isn't.
...So, if this does end up in a worst-case scenario, Trump's "stop enforcing the mandate altogether!" order here could end up causing that death spiral even if the GOP doesn't technically end up repealing anything legislatively. The carriers would start announcing that they're bailing next year as soon as this spring (remember, the first paperwork for 2018 exchange participation has to be filed in April or May), and McConnell/Ryan would simply say, "See?? We told you it was collapsing all by itself! We didn't touch nuthin'!!"
As has been obvious for some time now, the early projections by the Congressional Budget Office back in the pre-exchange days of 2010 - 2013, which foresaw ACA exchange enrollment heading into the 20-million-plus range by this point, obviously not only never came to pass, but are unlikely to do so anytime in the near future under the current legal/healthcare policy structure. There are several reasons for this ranging from legitimate problems with the structure of the ACA itself to Republican obstruction, but the two most obvious errors the CBO made in their projections were:
The last time Covered California released enrollment data, they gave a hard number for new enrollees (258,158) but left the number of people renewing their policies a bit vague ("approximately 1.3 million"). I later learned that the actual number of renewals had been rounded up, so I'm assuming it's actually around 1.27 million; this gives a total of 1.53 million QHP selections as of January 3rd.
Today, CoveredCA issued another update, touting a new enrollee survey which concludes that in California, at least, people don't seem to be shying away from enrolling in spite of the ugly ACA repeal rhetoric coming out of Washington, DC:
Covered California Enrollment Continues at Strong Pace; New Research Suggests ACA News Coverage Is Not Deterring Consumers
In Arkansas, 70,404 people enroll in private exchange policies as of the end of January. I estimate around 50,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 331,000 enrolled in Arkansas' "Private Option" ACA Medicaid expansion program for a total of 380,000 residents kicked to the curb.
As for the individual market, my standard methodology applies:
Plug in the 2/01/16 QHP selections by county (hard numbers via CMS)
Adjust for 1/31/17 QHP selections based on hard CMS data.
Knock 10% off those numbers to account for those who never end up paying their premiums
Multiply the projected effectuated enrollees as of March by the percent expected to receive APTC subsidies
Then knock another 10% off of that number to account for those only receiving nominal subsidies
Whatever's left after that are the number of people in each county who wouldn't be able to afford their policy without tax credits.
The Medicaid expansion data comes directly from state data.
Back on December 15th, I posted an entry entitled "I cannot guarantee accurate federal data after 1/20/17", in which I warned that given Trump's never-ending stream of bullshit and the fascistic overtones of the impending Trump Administration, the odds were pretty high that once they took over, all data from the federal government would likely become highly suspect. Cooking the books, doctoring the data, flat-out purging vast quantities of information...all of this was possible.
Federal Workers Told To Halt External Communication In First Week Under Trump Staff have been told to stop talking to Congress and the press.
WASHINGTON ― Multiple federal agencies have told their employees to cease communications with members of Congress and the press, sources have told The Huffington Post.
Oh. Well, I'm sure that was just a sheer coincidence, right? No doubt Aetna will clear this up with an unequivocal statement to put any speculation to...
From Peter Sullivan of The Hill:
Asked if the DOJ’s actions on the merger had any relation to Monday’s announcement, Aetna spokesman TJ Crawford did not directly say yes or no.
Economix is a graphic novel by Michael Goodwin, illustrated by Dan E. Burr, that explains the economy. More than a cartoon version of a textbook, Economix gives the whole story of the economy, from the rise of capitalism to Occupy Wall Street. Economix is published by Abrams Comic Arts.
Today he contacted me to inform me that he's using some of my data as part of his latest project: A bona fide 20-page comic book which explains, in laymans terms, the basics of the ACA, how Paul Ryan/Tom Price's replacement plan would work and why their replacement pretty much sucks eggs.
Here's a low-resolution version of the first page (which also just happens to be where he included my data) to give you a taste of what it's like. I'm absolutely floored and honored to play a small role in disseminating this information in such a user-friendly way:
I've recently updated the enrollment numbers out of Idaho, Connecticut and New York. None of them have moved the needle much, but the latest New York number did finally goad me into making a decision: Going forward, I'm going to start including Basic Health Plan enrollments in my Open Enrollment Period totals.
I'll still be separating them out, since the "official" number which is generally counted by everyone (including myself) only includes exchange-based Qualified Health Plans (QHPs)...but unlike standalone dental plans, BHPs are full medical insurance policies, enrolled in via the ACA exchanges, and while they may resemble Medicaid in some aspects, they aren't in either category or funding source. Furthermore, BHPs are also "cannibalizing" quite a few enrollees who would otherwise be enrolling in QHPs anyway, so it's important to recognize their impact on the numbers.
It's Back! Okay, folks, it's time to call your legislators, because the Drazkowski bill is back, and the GOP is giving it a full hearing TODAY!
This is the bill that would allow insurance companies to sell policies that do not cover chemotherapy, diabetes treatments, mental health services, maternity care, and many more benefits that are currently required to be covered by MN law.
The photo included is the Minnesota Statute 62Q, which is the statute that is being amended with this bill. These are the services that would be allowed to no longer be covered.
ACCESS HEALTH CT ENROLLS 106,891 CONSUMERS IN HEALTH INSURANCE
1,192 enrolled in dental care, 1,519 enrolled through the Small Business Program
HARTFORD, Conn. (January 20, 2017) – Today, Access Health CT (AHCT) CEO Jim Wadleigh announced that 106,891 individuals have enrolled in health insurance in 2017. In addition, 1,192 individuals enrolled in dental coverage and 1,519 enrolled via the Small Business Program.
“As we head towards the final days of Open Enrollment, which ends on January 31st, we want to remind Connecticut residents that Access Health CT offers many ways to get free help choosing a plan,” said AHCT CEO Jim Wadleigh. “We are also very happy to see people taking advantage of the dental coverage we offer.”
"The Democrats are the party that says government will make you smarter, taller, richer, and remove the crabgrass on your lawn. The Republicans are the party that says government doesn't work and then they get elected and prove it." --P.J. O'Rourke, Parliment of Whores
As I noted on Friday, Donald Trump's executive order essentially orders the incoming HHS Secretary (presumably Tom Price), along with other relevant agency heads, to do everything in their power to sabotage the ACA regardless of any repeal legislation (whether partial or total) on the part of Congress. Since the ACA grants the HHS Secretary pretty wide authority about how (and whether) to enforce various components of the law, this gives ample room for the Trump administration to make the individual mandate (among other ACA provisions) effectively meaningless.
Trump also issued a memo to all agencies requesting that they begin to "ease the burden of Obamacare as we transition from repeal to replace," Spicer said. He declined to provide specifics on what various agencies might do in response to the president's directive.
HOWEVER, David Anderson (formerly Richard Mayhew) notes that Section 2, which instructs the HHS Secretary to "waive, defer, grant exemptions from or delay" any "fiscal burdens" o sounds an awful lot like telling them to be absurdly lenient regarding granting "hardship exemptions" from the individual mandate:
@annaedney@ZTracer yes individual mandate exemptions will be passed out like pacifiers at a rave
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
Well, Republican U.S. Senator John Cornyn, the Majority Senate Whip (and therefore one of the biggest shots in the Senate) shot off quite a promise about the concerns regarding up to 32 million people potentially losing their healthcare coverage in the event the ACA is repealed:
One of the top concerns is what will happen to individuals who became eligible for Medicaid with its expansion under Obamacare. The Senate's No. 2 Republican, however, promised that no one who got coverage under Medicaid expansion will lose it.
When Conrnyn was asked if he was concerned about people who've benefited from Medicaid expansion losing coverage, he said it was a shared concern.
I've decided that for all future ACA enrollment data reports, I'm going to tack on "...on brink of possible ACA repeal" to the headline. Seems appropriate.
It's been quite awhile since I've written much of anything about the ACA's SHOP programs, which are the small business counterpart to the individual/family exchanges. The reason is pretty simple: SHOP enrollment is mostly a rounding error compared to either the ACA's Individual exchange enrollments or Medicaid expansion numbers.
SHOP enrollment (a mere 120K - 170K nationally, as far as I can tell) is even dwarfed by BHP program enrollment (around 700,000)...and that's only available in 2 states (Minnesota and New York). Heck, I don't even bother tracking them on my spreadsheets or graphs (I tried in 2014 but gave up on it the following year).
Record Number of Idahoans Select Insurance through Your Health Idaho
Lawmakers Get Update on State’s Health Insurance Exchange
BOISE, Idaho – Your Health Idaho (YHI) executive director Pat Kelly went before lawmakers on Wednesday to give them an update on the third year of operations for Idaho’s state-based health insurance exchange. YHI set new records for enrollment during 2016 and led state-based exchanges across the country in per capita enrollment.
“Lawmakers’ choice to keep the federal government out of Idaho’s health insurance decisions and to do things our way has benefited Idaho immensely,” said Kelly. “Your Health Idaho gives consumers options when it comes to selecting a health insurance plan and we keep more money in Idahoans’ pockets by having lower assessment fees than the federal government.”
In federally managed states, consumer fees are set at 3.5percent. In 2016, YHI’s board of directors set the state’s assessment fee at 1.99 percent. To date, lower health insurance assessment fees have saved Idahoans more than $15 million.
I, and many others, have suggested (sometimes jokingly, sometimes not) that Donald Trump and the GOP's "terrific!" replacement for the Affordable Care Act could very well be to simply rebrand it as "TrumpCare", declare victory and call it a day.
I was debating whether to hold off on doing so yet again until after January 31st, since that's the last day of the 2017 Open Enrollment Period...but upon further reflection, today is really more appropriate.
I've committed to keeping the site operating through at least April 30, 2017...which is also around the point that pretty much all of the final reports from HHS, CMS, ASPE and so forth documenting the OE4 numbers should have been released. I'm also assuming that we'll have some idea about just where the hell the ACA repeal/replacement direction is at that point...although who the hell knows?
Anyway, the answer to the question "Where do we go from here?" is, quite simply...beats the fuck out of me.
To everyone who has donated in the past...or submitted data, or offered suggestions, or reposted/retweeted links to the site over the past 3 1/2 years...thank you.
I'm not closing up shop or anything (yet)...but if anyone's in a position to pony up a few bucks to help keep the site going for as long as possible, this is as good a time as any to do so.
Not sure if the sender wants public credit or not, but a few Republican Goverors have some things to say about repealing the Affordable Care Act...especially Medicaid expansion:
Today, Republican Governors will meet with GOP Congressional leaders in DC to discuss – you guessed it –the Affordable Care Act. Medicaid expansion is a key factor in this discussion because, as Governors will tell you, Medicaid expansion is leading to lower uninsured rates, higher rates of care, and critical treatment for people fighting opioid use disorders. And if Republicans repeal the ACA without a replacement plan in the same bill, CBO would score a subsequent bill restoring Medicaid expansion funding as an almost $1 trillion spending increase over 10 years. Interestingly, a number of GOP Senators broke with their party on expansion related vote-a-rama measures last week, and Governors from both parties have spoken out about this issue, as well as about the dangers of repeal and delay.
ATTENDING TODAY’S MEETING WITH REPUBLICAN CONGRESSIONAL LEADERS:
OK, the guest host is actually Cliff Schecter, but I'll be a guest on the Leslie Marshall radio talk show this afternoon from 3:00 - 3:30pm EST today, talking ACA, repeal and so forth.
OK, given the impending End of the World As We Know it (and, on a smaller scale, the potential End of the Affordable Care Act), this is a pretty minor thing, but worth noting.
This afternoon I did a write-up about today's Week 10/11 HealthCare.Gov Snapshot Report, which showed nearly flat enrollment growth from 12/31 to 1/14...two solid weeks with barely 64,000 additional signups across 39 states. As I noted, this particular stretch of Open Enrollment was expected to be pretty quiet, but even so, the numbers were still far lower than I expected.
In the Weeks 8/9 Snapshot Report, HHS reported exactly 8,762,355 QHP selections as of New Year's Eve via HealthCare.Gov specifically (which only includes 39 states).
For weeks now, I (and many others) have been crunching the numbers and making projections to see just what the fallout would be on the individual market (and the total uninsured rate) if the GOP were to follow through with their promise to repeal the Affordable Care Act.
There's a lot of variables at play, and there's also no way of knowing what (if any) replacement plan they'd come up with instead, but there are two main scenarios to consider: First, what would things look like if the ACA were to be fully repealed (without a half-decent replacement ready to swoop in); second, what would happen if the ACA were to be partially repealed via the reconciliation process (ie, killing off the subsidies, individual/employer mandates, Medicaid expansion and so forth, but keeping the guaranteed issue, community rating and other regulatory provisions in place, which is what would happen if the Republicans were to continue on their present course).
With the Republicans scrambling to come up with a plan, any plan to replace the Affordable Care Act at the same time that they repeal it (as opposed to, you know, simply not repealing it, at least until they actually have a reasonable plan, which they could certainly do if they wished to), there was a huge amount of buzz generated Sunday night over this story from Robert Costa and Amy Goldstein of the Washington Post:
Trump vows ‘insurance for everybody’ in Obamacare replacement plan
President-elect Donald Trump said in a weekend interview that he is nearing completion of a plan to replace President Obama’s signature health-care law with the goal of “insurance for everybody,” while also vowing to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid.
Drug negotiations aside, the rest of the article is exactly what you'd expect:
No, I'm not accusing him of murdering anyone (well, unless his ACA replacement bill becomes law, that is), but it's starting to look like the Senate would have to be on drugs to confirm orthopedic-surgeon-turned-Congressman Tom Price as the new HHS Secretary:
Trump's Cabinet pick invested in company, then introduced a bill to help it
Rep. Tom Price last year purchased shares in a medical device manufacturer days before introducing legislation that would have directly benefited the company, raising new ethics concerns for President-elect Donald Trump's nominee for Health and Human Services secretary.
...Less than a week after the transaction, the Georgia Republican congressman introduced the HIP Act, legislation that would have delayed until 2018 a Center for Medicare and Medicaid Services regulation that industry analysts warned would significantly hurt Zimmer Biomet financially once fully implemented.
The real "final" deadline to sign up for 2017 healthcare coverage is Tuesday, January 31st. Anyone who signs up between the dates above and the 31st will be enrolled in a policy starting coverage on March 1st.
After that, under the ACA, the only ones who are supposed to be able to sign up for 2017 coverage are people who qualify for:
In Minnesota, assuming 116,000 people enroll in private exchange policies by the end of January, I estimate around 58,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 234,000 enrolled in the ACA Medicaid expansion programand around 62,000 covered by their Basic Health Plan (BHP) program (aka MinnesotaCare) for a total of 354,000 residents kicked to the curb.
As for the individual market, my standard methodology applies:
Last spring, during the primaries, there was a month or so where there was still a small but not unreasonable possibility that Ted Cruz could have ended up pullling the nomination out of the grasp of Trump's hands. During that time, there was a lot of discussion among progressives (and some intellectually honest #NeverTrump conservatives) as to which one would be worse from a progressive/Democratic/liberal point of view.
After all, the reasoning went, Trump supposedly held strongly liberal positions on many key issues up until like 5 minutes ago (he was pro-choice, etc). He's promised a gargantuan infrastructure spending program (roads, bridges, etc)! Hell, during the very first GOP primary, he came right out and said that he thinks Single Payer healthcare is awesome in other countries! He later stated that whatever he came up with would "cover everyone" with "the government paying for it all". How awesome is that for a progressive!!
However, there are some major problems with this...
In Kentucky, assuming 80,000 people enroll in private exchange policies by the end of January, I estimate around 43,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 443,000 enrolled in the ACA Medicaid expansion program, for a total of 487,000 residents kicked to the curb.
As for the individual market, my standard methodology applies:
Back in mid-December, just about all of the ACA exchanges bumped out their enrollment deadlines for January 1st coverage by a few days. I was mildly surprised because improvements in the bandwidth, coding, layout and support staffing have meant a smoother process towards the big last-minute surge. Still, I wasn't blown away by the development or anything, as mid-December has always seen a massive spike in enrollment.
New Yorkers Now Have Until January 18 to Enroll in or Renew Health Insurance Coverage Beginning February 1
Consumer Demand Remains High Prompting Deadline Extension
ALBANY, N.Y. (January 12, 2017) – NY State of Health, the state's official health plan Marketplace today announced that consumers now have three additional days to enroll in a health plan with coverage starting February 1. The deadline has been extended through 11:59 p.m., January 18. The previous deadline was January 15.
AHCT ANNOUNCES 105,313 CUSTOMERS ENROLLED IN 2017 HEALTH INSURANCE -
CALL CENTER HOURS FOR MARTIN LUTHER KING JR. HOLIDAY
Call Center will be open Sunday, January 15 instead of Monday, January 16 in honor of Martin Luther King Holiday
HARTFORD, Conn. (January 13, 2017) - Today, Access Health CT (AHCT) CEO Jim Wadleigh announced that 105,313 people are enrolled for 2017 coverage as of January 12th. In addition, Wadleigh announced that the AHCT Call Center will be open on Sunday, January 15th from 10:00 AM to 5:00 PM and closed on Monday, January 16th for the Martin Luther King Jr. holiday.
In Delaware, assuming 30,000 people enroll in private exchange policies by the end of January, I estimate around 20,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 10,000 enrolled in the ACA Medicaid expansion program (PPT), for a total of 30,000 residents kicked to the curb.
As for the individual market, my standard methodology applies:
In New Mexico, assuming 57,000 people enroll in private exchange policies by the end of January, I estimate around 25,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 260,000 enrolled in the ACA Medicaid expansion program, for a total of 285,000 residents kicked to the curb.
As for the individual market, my standard methodology applies:
In New Hampshire, assuming 58,000 people enroll in private exchange policies by the end of January, I estimate around 31,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 50,000 enrolled in the ACA Medicaid expansion program, for a total of 81,000 residents kicked to the curb.
As for the individual market, my standard methodology applies:
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
In Montana, assuming 59,000 people enroll in private exchange policies by the end of January, I estimate around 39,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 61,000 enrolled in the ACA Medicaid expansion program, for a total of 101,000 Montana residents kicked to the curb.
As for the individual market, my standard methodology applies:
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
Over at Business Insider, Bob Bryan has posted a writeup explaining where exactly things stand regarding the Republican Party's ongoing ACA repeal process. He's even included the handy checklist to the right.
The US House of Representatives on Friday struck the second blow in the repeal of the Affordable Care Act (ACA), better known as Obamacare.
The House passed a resolution Friday that will direct committees in the Senate to draft legislation that would repeal the ACA.
The resolution's passage followed a morning of spirited debate, including a colorful goat analogy from one Republican lawmaker. But both parties largely stuck to their talking points: Republicans highlighted increasing premiums and costs, while Democrats focused on expanded coverage to more than 20 million Americans.
UPDATE 4/6/17: It looks like the GOP is trying one more time to cram through their much-hated "American Health Care Act" (aka Trumpcare 2.0) bill. The twist this time is that in addition to allowing states to kill off Community Rating and Essential Health Benefits (with the key phrase being "kill"), they'd also make High Risk Pools part of the mix (HRPs were already allowed in the earlier version, but apparently they'd be specifically mandated this time around...I think).
Given this development, I'm re-pinning this entry to the front of the site again.
(Update: Thanks to Griffin Cupstid, MD for the link to the CNN transcript, which allowed me to make some minor wording edits below).
So, I watched the ACA-related segments of Republican House Speaker Paul Ryan's CNN Town Hall thing last night. He took several questions about the ACA (Obamacare, remember) and Medicare, but I'm just gonna focus on the first one here. The questioner was a self-described lifelong Republican who used to hate the idea of the ACA...right up until he was diagnosed with cancer and given just months weeks to live. Pre-ACA he would have been denied coverage for the pre-existing condition and would have died. He profusely praised the ACA and flat-out thanked President Obama for saving his life.The actual question was "why would Ryan repeal the ACA without a replacement in place."
QUESTION: I was a republican and I worked for the Reagan and Bush campaigns. Just like you, I was opposed to the Affordable Care Act. When it was passed, I told my wife we would close our business before I complied with this law. Then, at 49, I was given six weeks to live with a very curable type of cancer. We offered three times the cost of my treatments, which was rejected. They required an insurance card. Thanks to the Affordable Care Act, I'm standing here today alive.
Being both a small business person and someone with pre-existing conditions, I rely on the Affordable Care Act to be able to purchase my own insurance. Why would you repeal the Affordable Care Act without a replacement?
RYAN: Oh, we -- we wouldn't do that. We want to replace with something better. First of all, I'm glad you're standing here. I mean, really -- seriously.
QUESTION: Can I say one thing? I hate to interrupt you...I want to thank President Obama from the bottom of my heart, because I would be dead if it weren't for him.
Given the massive backlash/debate going on over the impending (supposed) repeal of the Affordable Care Act, there seems to be one particular fact which a huge number of Obamacare opponents (and even many supporters of the law) don't seem to be aware of.
One of the big talking points among ACA opponents is "Why should my hard-earned tax dollars go to subsidize someone else's lazy ass?"
Now, aside from the fact that a) "being self-employed" or b) "happening to have a job which doesn't offer health benefits" or c) "being married to/a child of either a) or b)" hardly makes one "lazy", there's something which these folks should know:
nearly everyone's healthcare coverage is heavily taxpayer subsidized.
Assuming 310,000 people enroll in private exchange policies by the end of January, I estimate around 207,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 532,000 enrolled in the ACA Medicaid expansion program, for a total of 739,000 New Jersey residents kicked to the curb.
Thanks to Louise Norris for providing this report which breaks out the Medicaid expansion numbers by county. It's worth noting that like New York, New Jersey will also see more people lose Medicaid coverage post-ACA repeal than technically signed up "because" of the law because they, too, had previously partly expanded Medicaid via a pre-ACA waiver which has since expired. Unlike New York, however, in New Jersey's case I had already baked the larger number into my estimates anyway, so it hasn't changed anything.
As for the individual market, my standard methodology applies:
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
A few days ago I noted that MNsure, Minnesota's ACA exchange, has skyrocketed from last place to first in terms of achieving my personal OE4 enrollment targets, having enrolled 103,578 people in Qualified Health Plans (QHPs), plus another 19,960 in MinnesotaCare (MN's BHP program) and 65,164 in Medicaid.
Yestrerday they updated their numbers once again:
That's a further increase of 3,009 Minnesotans in QHPs in the past week or so. MN has already blown past my original projection (86K) and has reached 92% of my revised target (116K).
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
A few days ago I had the honor of joining healthcare reporter Jonathan Cohn and healthcare patient advocate Amy Lynn Smith as a guest on The Sit & Spin Room, a podcast presented by Michigan's best political website, Eclectablog, featuring hosts Chris Savage and the mysterious @LOLGOP.
Cohn is the guest for the first half-hour, while Smith and I join in for the remaining hour of the show.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
This isn't a particularly dramatic update given that CMS released their "mid-season" report yesterday, which already updated Washington's tally from 180K thru 12/20 to 194K as of 12/24...but an update's an update:
The Washington Health Benefit Exchange today announced that more than 200,000 customers have selected 2017 health and dental coverage through Washington Healthplanfinder since the open enrollment period began on Nov. 1 – an increase of almost 14 percent over the same point last year.
Hmmmm...the numbers look good, but that "...and dental" caveat is a bit troubling. I've asked for clarification; it's possible that the "dental" reference simply refers to the fact that some Qualified Health Plans also include dental coverage, as opposed to referring to standalone dental plans, which shouldn't be counted as QHPs.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
Assuming 37,000 people enroll in private exchange policies by the end of January, I estimate around 25,500 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 169,000 enrolled in the ACA Medicaid expansion program, for a total of over 195,000 West Virginians kicked to the curb.
As for the individual market, my standard methodology applies:
OK, with this morning's CMS/ASPE "mid-season report" being released, I figured this would be a good time to take a look at where things stand on both a state-by-state and national level. All of the state enrollment numbers should be accurate with the possible exception of California; there's a potential discrepancy of around 93,000 enrollees which I'm still trying to clarify. The tables/graph below all assume that those disputed 93K are supposed to be included.
Here's my original projections for each state, sorted in order based on what percent of my personal target each state has reached. As you can see, Minnesota, Hawaii, Massachusetts and South Dakota have already broken 100%, with Utah, Vermont, Oklahoma, Wyoming, Colorado, Oregon and (possibly) California all over the 90% mark. Any state over 90% at this point should hit my targets by the end of January.
For the past couple of weeks I've been compiling the county-level data across various states for just how many people are at risk of losing healthcare coverage if the Republican Party actually does follow through with repealing the Affordable Care Act. The main numbers are the subsidized QHP enrollees and the Medicaid Expansion enrollees.
What people really want, though, given the politics of the situation, are these numbers by Congressional District. Unfortunately, I can't provide that, which is why I'm going with County level data for now.
As I've noted before, until today, there was one state which I had no OE4 data for whatsoever: Vermont (which is ironic given their historic support of healthcare reform, including Sen. Bernie Sanders). This blank has been filled in by today's supplemental CMS/ASPE report: 29,021 QHP selections as of 12/24, which is actually quite a bit higher than I expected for the state (my target for VT is only 30,000 total through 1/31).
As regular readers know, I've always made sure to report the number of people who enroll in the ACA's Basic Health Plan (BHP) programs in Minnesota (since 2014) and New York (since 2016). The HHS Dept. didn't really highlight BHP numbers in 2014 or 2015 because they weren't even a rounding error nationally (they had 43,000 enrolled in BHPs via MNsure in April 2014, for instance). In addition, the BHP program in Minnesota was really just a retooling/expansion of an existing program anyway. As a result, it was treated as more of a footnote in the national reports. Interestingly, the number of MN residents enrolling in BHPs through MNsure this year is quite a bit lower (20,000), although state-wide the number is much higher (around 62,000 as of this week). Basically, 1/3 of MinnesotaCare enrollees are doing so via the ACA exchange, the rest via traditional state agencies/processes.
Don't get excited yet. This isn't remotely settled yet, and even if the GOP backs off now, there's no reason to think they won't be back in full force a few months down the road.
GOP Senators Propose Delay On O'Care Repeal To Work Out Replacement
After publicly airing some of their grievances with the GOP's current strategy of repealing Obamacare without a replacement plan, a handful of Republican senators put their concerns in legislative writing. Five senators on Monday evening introduced a measure that would delay the next steps on repealing the Affordable Care Act by more than a month. The senators, in their statements accompanying the provision, said the delay would buy Congress more time to work out of the the details of a replacement.
Assuming 265,000 people enroll in exchange policies by the end of January, I estimate around 175,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 692,000 enrolled in the ACA Medicaid expansion program, for a total of over 865,000 Ohioans kicked to the curb.
As for the individual market, my standard methodology applies:
Minnesota is a different story. They started out Open Enrollment with a bang, racking up enrollees at up to 12x last year's pace...but that was mainly due to their unique "enrollment cap" policy this year. Once the caps were filled and current enrollees were all squared away, new enrollments appear to have dropped off dramatically. They're now dead last percent-of-target wise (again, I can't include NY or VT here since neither has enough data available).
It feels a little odd to be alternating estimates about how many people could lose their coverage in each state with the number signing up for it at the same time, but that's where we are: Remember, there's still 6 more days for people to enroll for 2017 coverage starting in February, and 16 days after that to sign up for coverage starting in March.
Connect for Health Colorado Reports Increase in Healthcare Plan Selections for 2017 Coverage
DENVER — More than 158,000 Coloradans selected healthcare coverage for 2017 through the state health insurance Marketplace through Sunday, January 8, a rate 18 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
The typical agreement a QHP issuer enters into if selling on the FFM requires them to keep the policy in force for the entire calendar year. [This exit clause] gives them option to term the policy abruptly if the Courts rule, or a Trump administration decides, that it won't pay CSR offset payments to carriers. Because this won't hit the Supreme Court until late 17 or early 18, I think this is as much about assuaging carriers fears of a Trump admin trying to destroy the marketplaces as anything else.
Illinois is pretty straightforward. Assuming 400,000 people enroll in exchange policies by the end of January (a modest 3% increase over last year), I estimate around 275,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus the 643,000 enrolled in Medicaid expansion as of June 2016, for a total of just over 918,000 Illinoisians kicked to the curb.
As for the individual market, my standard methodology applies:
OK, it's really important to note that a) this is a very simplified rendering of the true situation and b) this only applies to two populations: The individual market (around 20 million people) and the medicaid expansion population (around 14 million, plus another 2.6 million being denied thanks to 19 states refusing to expand it). In other words, it has nothing to do with the large group market, small group market, Medicare, the VA/TriCare, federal/state/local public employees and so on. This chart only applies to around 37 million people in the U.S. Got it?
Having said that, what I've tried to do is to provide a visual representation of, among that population, who the ACA is working well for, who it isn't working so well for, and who can legitimately complain about feeling screwed by it:
Oops. Last week I reported that Access Health CT appeared to state that they had a total of 114,421 QHP selections during the current open enrollment period. The wording was slightly squirrelly ("currently active for 2016 and/or 2017"), especially since I also knew there were around 12,000 existing enrollees who still hadn't chosen a new policy...but an earlier update had given the number as "around 113,000" in a seemingly less-confusing way, so I assumed that all 114,421 applied to 2017.
22 Percent Increase Over Last Year • New Yorkers Show Demand for Quality, Affordable Healthcare
ALBANY, N.Y. (January 6, 2017) – NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.4 million people have enrolled in health insurance through December 24, 2016.
With almost a month to go until the end of the 2017 Open Enrollment period, participation in the NY State of Health Marketplace has already increased more than 22 percent since the last Open Enrollment period ended, January 31, 2016. Enrollment has increased in all 62 counties of the state. The overall share of New Yorkers now enrolled through the NY State of Health has reached nearly 18 percent of the state’s population.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
My standard methodology applies:
Plug in the 2/01/16 QHP selections by county (hard numbers via CMS)
Project QHP selections as of 1/31/17 based on statewide signup estimates
Knock 10% off those numbers to account for those who never end up paying their premiums
Multiply the projected effectuated enrollees as of March by the percent expected to receive APTC subsidies
Then knock another 10% off of that number to account for those only receiving nominal subsidies
Whatever's left after that are the number of people in each county who wouldn't be able to afford their policy without tax credits.
In the case of Georgia, assuming 567,000 people enroll in exchange policies by the end of January, I estimate around 396,000 of them would be forced off of their policy upon an immediate-effect full ACA repeal.
Last March I cobbled together this pie chart, which attempted to break out the health coverage status of every single person living in the United States (yes, including undocumented immigrants). It gained quite a bit of attention at the time from healthcare reporters, wonks and so forth. While my numbers may have been slightly fuzzy here and there, it received a general seal of approval from Larry Levitt of the Kaiser Family Foundation, who stated "Obviously some of the estimates are approximations, but I don't see any glaring problems."
OK. Today saw fresh enrollment updates from Rhode Island (nominal), Covered California (impressive) and, most significantly, HealthCare.Gov (which not only covers 39 states, but also finally includes auto-renewals). I now have auto-renewal for 48 states + DC included in the mix, and the numbers are current through 12/31/16 or later for 41 of them. I still have no data whatsoever from Vermont (ironic, given their history of progressive healthcare policy, Bernie Sanders, etc), and only very limited data out of New York (they mentioned 55,000 enrollments over a 3-day period just ahead of the December deadline, but nothing from before or after that).
As i noted last week, with all renewing enrollees accounted for, Rhode Island's ACA exchange is likely to come up short not only of my pre-election projection (40,000 enrollees), but will likely see a drop from last year's 34,670 QHP selections. They had only hit 29,312 QHPs as of Christmas Eve, and have only tacked on another 580 people since then:
INDIVIDUAL AND FAMILY ENROLLMENT • As of December 31, 2016
Hot on the heels of Covered California's update just moments ago, the HHS Dept. has posted their latest bi-weekly Snapshot report. While the extra 2 weeks of data is obvoiusly important, the key number I've been anxiously awaiting is the auto-renewal number, which is finally included in today's report:
Biweekly Enrollment Snapshot • WEEKS 8 AND 9, DEC 18 – DEC 31, 2016
8.8 million Americans have signed up for coverage through HealthCare.gov since Open Enrollment began on November 1st. This compares to about 8.6 million plan selections last year at this time, demonstrating Americans’ strong and growing demand for affordable, quality coverage. Total plan selections as of December 31st, which include auto reenrollments, consist of 2.2 million new consumers and 6.6 million returning consumers. Among returning consumers, two thirds, or 4.4 million, actively selected a plan, an increase from last year’s already high levels of consumer engagement.
Between the big December deadline (for January coverage) having passed and the holiday season, the actual OE4 enrollment data has been pretty sparse the past few weeks. A few minutes ago, however, Covered California broke the enrollment news drought (no pun intended) with a press release which, while not primarily focused on the actual enrollment data, nonetheless includes a solid update:
Covered California Brings Health Care Within Reach and Shows How Consumers Can Save by Shopping
Hat tip to Dan Goldberg for the heads up. (also thanks to Amy Shefrin)
Yesterday I crunched some numbers and estimated that, assuming a full ACA repeal w/immediate effect and no replacement, roughly 800,000 New Yorkers would almost certainly lose their healthcare coverage, including:
Over 2.7 Million New Yorkers Would Lose Coverage Estimated State Budget Impact of $3.7 Billion
Counties Across New York Would Lose Over $595 Million in Direct Spending
New York Residents Would Lose $250 Million in Health Care Savings Tax Credits
NOTE: I've asked Nicholas Bagley, law professor at the University of Michigan, to chime in to make sure I have everything below correct. I'll post an update if I have any of the details wrong.
UPDATE: OK, I've heard back from Bagley; he confirms that yes, I have it right:
"Yes [you have it correct]. Because of the Byrd rule, the big risk isn't legislative repeal...There are two real risks. First, that the individual mandate is repealed, destabilizing the DC exchange....Second, that Trump changes the OPM rule enabling the feds to cover the costs of congressional insurance."
This is section 1312(d)(3)(D) of the Affordable Care Act. The so-called “Grassley Amendment” says that members of Congress and their staff may only get their health insurance through the exchange or on the individual market. No Federal Employees Health Benefit Plan for them!
Republicans will first have to overcome a revolt from Senator Rand Paul on unrelated budget issues, with the Kentucky Republican saying Tuesday in an interview he would oppose the budget resolution because it adds significantly to the deficit.
"It never gets to balance. Not in 10 years, not in 100 years, not in 1,000," Paul said.
As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.
My standard methodology applies:
Plug in the 2/01/16 QHP selections by county (hard numbers via CMS)
Project QHP selections as of 1/31/17 based on statewide signup estimates
Knock 10% off those numbers to account for those who never end up paying their premiums
Multiply the projected effectuated enrollees as of March by the percent expected to receive APTC subsidies
Then knock another 10% off of that number to account for those only receiving nominal subsidies
Whatever's left after that are the number of people in each county who wouldn't be able to afford their policy without tax credits.
In the case of Florida, assuming they hit 1.825 million exchange enrollees this year, it comes to a whopping 1.35* million people.
Justin Kloski learned that he qualified for Medicaid under the worst of circumstances. The student and part-time lawn-company worker had lost 20 pounds, could not shake a nagging cough and was sleeping 14 hours a day when he decided to visit a clinic in Muncie, Ind., that provides free care for the poor and uninsured. A clinic employee invited Mr. Kloski, now 28, to apply for Medicaid.
A few days later, he took his new coverage to the emergency room at IU Health Ball Memorial Hospital in Muncie. A CT scan found a 15-centimeter tumor in his chest, so big it was pressing on his windpipe. In May 2015, he learned he had Hodgkin’s lymphoma, a form of cancer that is curable if caught early.
The Affordable Care Act, and Governor Pence’s decision to go against many other Republican governors and expand Medicaid under the law, may well have saved Mr. Kloski’s life.
A definitely-NOT-comprehensive selection of opinions regarding the Republican Party's imminent "Repeal & Delay" strategy for the Affordable Care Act:
What outside experts are saying about repeal and delay:
American Academy of Actuaries: “Repealing major provisions of the ACA would raise immediate concerns that individual market enrollment would decline, causing the risk pools to deteriorate and premiums to become less affordable. Even if the effective date of a repeal is delayed, the threat of a deterioration of the risk pool could lead additional insurers to reconsider their participation in the individual market.” [Letter to Congress, 12/7/16]
Nick Gerhart (Iowa Republican Insurance Commissioner): “If you're going to repeal this, I hope that there's a replacement stapled to that bill.” [NPR, 11/21/16]
New York is a little different: For one thing, they haven’t actually released any 2017 Open Enrollment data yet (other than a cryptic “55K enrolled over a 3-day period", which isn't very useful). They should be up to around 200K w/out auto-renewals by now. More significantly, they're one of only 2 states (Minnesota's the other) which features the ACA's Basic Health Plan. Unlike QHPs, which are divided into subsidized and unsubsidized enrollees, the BHP program is entirely dependent on ACA financing, so if the law is repealed, all BHP enrollees are kicked to the curb, just like Medicaid expansion enrollees would be.
OK, this appears to be quickly turning into my next project thing. The methodology here is pretty much the same as the other states; the only major difference is that while I do know the total Medicaid enrollment for each county (as of December 2016), I don't have that broken out between traditional and expanded Medicaid. Fortunately, I have a hard state-wide number for that: Around 398,000, or roughly 20.8% of the state-wide total. I've therefore multiplied each county number by 20.8% to get a rough estimate of the ACA expansion tally for each.
Like Texas, I'm also no longer expecting Arizona to beat last year's Open Enrollment total by much. Assuming 209K QHP selections, there should be around 125K indy market enrollees and 399K Medicaid expansion enrollees who'll be in a world of hurt post-repeal, or roughly 524,000 altogether.
(sigh) OK, after doing this for Michigan earlier today, I said that I wasn't gonna do this for every state, and I'm not...but the irony is that the 19 non-expansion states are actually easier to compile this data for than the expansion states...because you can't rip away healthcare from someone you never provided it to in the first place. Anyway, someone requested that I do a county-level estimate of how many people would likely lose their healthcare coverage in Texas under a full repeal of the Affordable Care Act, so here it is.
Regular readers (and Twitter followers) know that for the past month I've been heavily pushing my state-by-state analysis projecting how many people I expect to lose their healthcare coverage if/when the Republican-held Congress follows through on their promise to repeal the Affordable Care Act. As noted in that post and the various links within it, part of the projection is very specific and confirmed (ie, the exact number of Medicaid expansion enrollees), while the rest is more speculative. For one thing, I don't know exactly how many people will have enrolled in ACA exchange plans, because we're still in the middle of the open enrollment period; even then, the percentage of those enrollees who will be receiving APTC assistance is still unknown as well...and even then, not all of those folks will be receiving substantial subsidy assistance which would make or break their ability to keep their policy.
It's New Year's Day, so I figured I should indulge in a little year-end navel-gazing by looking back and seeing which posts generated the most traffic throughout the year. There's a good chance that this site won't survive the new year anyway, so what the heck.
Below is a daily traffic graph showing the days with the biggest traffic spikes, along with the specific stories driving those spikes. I hope you don't mind, but I'd rather not post the actual numbers involved publicly.
As you can see, in 2016, there were 5 stories in particular which captured tons of traffic:
Over at Business Insider, 
