Vermont has been pretty much on radio silence for the past two years. They issued fairly regular enrollment data reports in 2014 and 2015, but last year there was nary a peep; the only mid-season enrollment report with Vermont data was the official one released by CMS in early January.
I was, therefore, pretty happy to see a link to their "2018 Open Enrollment Update" posted earlier this afternoon.
Unfortunately...
Open Enrollment Countdown: Just 15 Days Left to Sign up for 2018 Health Coverage
Customer Support Center to Open Next Two Saturdays (9am-1pm)
Nothing official yet, but New York-based Politico healthcare reporter Dan Goldberg just tweeted this out:
@charles_gaba new ny numbers out. 46,000 new enrollees. 13 percent ahead of last year’s pace. 31,500 in essential plan. Numbers through end of November
Unfortunately, a lot of the state-based exchanges have an annoying habit of not posting renewal numbers until after the enrollment period is over (including the biggest one, California), but this is still helpful. Also handy to have the early BHP enrollment numbers.
A couple of weeks ago, a joint letter was sent to all four Congressional leaders from AHIP (America's Health Insurance Plans), the BlueCross BlueShield Association, the American Academy of Family Physicians, the AMA, the American Hospital Association and the Federation of American Hospitalsm warning them, in no uncertain terms, of what the consequences of repealing the individual mandate would be:
We join together to urge Congress to maintain the individual mandate. There will be serious consequences if Congress simply repeals the mandate while leaving the insurance reforms in place: millions more will be uninsured or face higher premiums, challenging their ability to access the care they need. Let’s work together on solutions that deliver the access, care, and coverage that the American people deserve.
Thank you for your letter regarding funding for the Navigator program. I appreciate hearing from you on this issue. The Patient Protection and Affordable Care Act requires each Health Insurance Exchange (whether Federally-facilitated or state-based) to have a Navigator program to, among other things, help facilitate enrollment of individuals in qualified health plans (QHPs) through the Exchange.
The Washington Health Benefit Exchange today announced that nearly 18,000 new customers have used Washington Healthplanfinder to select 2018 health coverage through the first four weeks of open enrollment. The number of new customers who have signed up since Nov. 1 represents a 43 percent increase over the same period last year.
In addition to the 4,500 new sign-ups received on average each week, Washington Healthplanfinder has experienced an 18 percent increase in visits to the website, with more than 423,000 visitors reviewing their coverage options on www.wahealthplanfinder.org.
Additional data revealing increased consumer interest during open enrollment:
Collins' bill with Nelson would set aside $4.5 billion over two years to help states establish reinsurance programs. Reinsurance directly compensates insurance carriers for their most expensive customers.
To the best of my knowledge, that's...pretty much all it does: $2.25 billion per year for two years, and then...that's it. If there's more to the bill than that, I'll revise this post, but in the meantime, that seems to be the whole bill.
All eyes are on the Godawful Tax Scam Bill this week, which once again lies mostly in the hands of a handful of Republican Senators including the usual suspects like John McCain, Lisa Murkwoski and Susan Collins.
McCain's biggest beef this year has been about "following regular order"; it's the reason he shot down the GOP's #BCRAP bill last summer. Of coruse, current tax bill most certainly isn't following regular order either. Will he stick to his guns on the issue or cave under pressure this time? Who knows?
In week four of Open Enrollment for 2018, 504,181 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday.
It's finally here, and just in the nick of time for the U.S. Senate's big vote on whether to scrap the Individual Mandate or not.
In around 15 minutes, I guarantee that you’ll understand how the ACA’s 3-legged stool works and why the Individual Mandate, while being about as popular as a root canal, still serves an important function. Don’t forget the popcorn!
(Oh, and if you'd like to help support my work, please feel free to do so via either my Patreon or GoFundMe accounts, thanks!)
Given the whole Silver Load/Silver Switcharoo craziness, I was mildly surprised to see that the ratio between Bronze, Silver and Gold have barely changed year over year, and in fact Silver has inched upward by a few points...until I remembered that Colorado is among the few states which went with the "broad load" model, spreading the additional CSR cost across all metal levels both on and off the exchange. This makes the similar metal level spread more understandable, but it also makes the 25% enrollment increase even more surprising, since subsidized enrollees will pay pretty much the same (no more or less) than this year, but unsubsidized enrollees are seeing their rates shoot up no matter where they go. As you can see below, the average premiums for unsubsidized enrollees ("NFA" = "Non-Financial Assistance) is 36.6% higher this year than last.
(St. Paul, MN) -- More than 100-thousand Minnesota residents have enrolled in the state's MNSure health insurance purchasing exchange. And about 50-thousand families are expected to get average tax credits of 72-hundred dollars to help pay for their coverage. Credits are higher in southeast and southwest areas. MNSure C-E-O Allison O'Toole says they can make the difference between "unhealthy and healthy" for thousands of people -- and yet, she says too many residents are not taking advantage. The open enrollment for MNSure runs through January 14th -- and O'Toole says that for at least a couple years, the tax credits will remain in place regardless of what happens to Obamacare in Congress.
That's the enitre article...it's dated yesterday (11/24), so I'm assuming the 100K figure was as of Thursday evening (Thanksgiving, Nov. 23rd).
The Centers for Medicare & Medicaid Services’ Center for Consumer Information and Insurance Oversight (CCIIO), part of the Department of Health & Human Services (DHHS), provides national leadership in setting and enforcing standards for health insurance that promote fair and reasonable practices to ensure that affordable, quality health coverage is available to all Americans. The center also provides consumers with comprehensive information on coverage options currently available so they may make informed choices on the best health insurance for their family.
...but among other things, they're the folks who actually implement the ACA, including, among other things, HealthCare.Gov (I'm not sure if it's the same team that operates HC.gov or not...probably a lot of overlap between the two?).
Consumer Information and Insurance Oversight
Ensuring the Affordable Care Act Serves the American People
On the one hand, I nailed the Week Three HC.gov number almost perfectly (I projected 2.3 million, the actual number is 2,277,079). Yay, me! Only off by 1%! On the other hand, I seriously underestimated the first two weeks, so I'm not patting myself on the back too much. It's an insane year with too many unknowns for me to do much more than throw darts at the board. Still, I'll take credit where I can.
In addition, CMS has also started breaking the numbers out by state, which helps analysts look for trends and cause/effect relationships, so let's jump in!
I used to track the monthly Medicaid/CHIP enrollment reports issued by CMS, watching as the numbersrosedramatically thanks to ACA Medicaid expansion.
I pretty much stopped doing that about a year ago, however, since the expansion numbers have mostly petered out. ACA Medicaid expansion actually has continued to climb a bit more since January, and is likely somewhere around 16 million people as of now, but it's also been partly cancelled out by a slight drop in standard Medicaid enrollment as the economy has continued to improve in general. In short, there's little reason to keep writing the same update every month.
As part of their Godawful "tax reform" bill, Congressional Republicans have decided to toss repealing of the ACA's individual mandate penalty into the mix, partly because they've always hated it but mainly because doing so would allegedly save the federal government $338 billion over the next decade...which in theory would be enough to keep the total increase in the federal deficit bythe tax bill below the $1.5 TRILLION mark (yes, you read that correctly: $1.5 TRILLION, with a "T").
Press release from the Massachusetts Health Connector...
BOSTON – November 20, 2017 – With a stable system and user process complemented by a proactive outreach and education effort, the Massachusetts Health Connector has seen members and new applicants more active in the first two weeks of Open Enrollment compared to last year.
Through Nov. 15, plans selected and enrollments are more than 40 percent higher than last year at the same time, new program determinations for Health Connector are up nearly 70 percent, and plans selected and enrollments by new members are up more than 15 percent.
“It is encouraging to see people hearing our message to shop for new coverage, and taking early advantage of Open Enrollment and finding the plan that best fits their needs for the new year,” said Louis Gutierrez, the Executive Director of the Massachusetts Health Connector. “We hope all of our current members take time to review their coverage for next year, and people who don’t currently have health insurance sign up so they have the health and financial security that comes with having coverage next year.”
Not much of an update, but good to see a hard number officially posted at AccessHealthCT (I assume they'll be updating this regularly from the looks of it):
Total Enrollments (active renewal, passive renewal, new): 130,556 (up 3% vs. last year)
Active Enrollments (renewals + new): 29,478 (up 98% over last year)
New Enrollments: 10,900 (up 10% over last year)
Applications: 275,790 (up 13% over last year)
Mobile App Visitors: 74,744 (up 110% over last year)
OK, the MD exchange breaks out their numbers slightly differently than I do, but they've provided the numbers necessary to reformat. Like a few other states, they're "front-loading" their auto-renewals, giving the following:
18,578 Active Renewals
101,078 Auto-Renewals
10,900 NEW Enrollees
130,556 TOTAL Enrollments
For clarification: When the MD exchange says that 130,556 is "3% higher than last year", they're talking about at this point in time. Subtract 3% and you get roughly 126.7K as of 11/17/16. Maryland's total enrollment by the end of the 2017 Open Enrollment Period was 157,832.
Insurers That Filed Wrong Rates Told By CMS They Can't Sell Plans Through Mid-November
An issuer whose final CMS-approved rates don’t account for the loss of cost-sharing reduction payments is being told by the agency that they won’t be able to sell plans until healthcare.gov data is refreshed– even though this would mean the carriers are even more crunched for time to sell their plans during the shortened open enrollment period.
Repeal Of The Health Insurance Mandate Won't Save As Much As Expected, Says Report
CENTENNIAL (S&P Global Ratings) Nov. 16, 2017--As the tax-reform debate heats up, the U.S. Senate tax bill may include a provision to repeal the individual mandate penalty. Repealing the penalty associated with the individual mandate will increase the uninsured rate. Subsequently, it will reduce government expenditure because there will be less federal funding needed for health insurance costs. However, the change won't be as financially meaningful as some expect, said a report released by S&P Global Ratings today titled, "U.S. Tax Reform: Repeal Of The Health Insurance Mandate Will Save Less Than Expected, And Will Not Support The Current Insurance Market."
A few days ago I noted that I had seriously misunderstood the Congressional Budget Office's individual market premium projections in the event the ACA's individual mandate is repealed: Yes, it'd be ugly, but not nearly as bad as I thought, although they still expect up to 13 million people to lose coverage as a result.
Yesterday, the Center for American Progress did an analysis which broke out those 13 million by state...along with the impact on individual market premiums and the 25 billion in immediate Medicare cuts which the GOP's tax bill would implement.
While I have my own doubts about some of the CBO's assumptions, there can be no doubt that premiums would increase substantailly, millions of people would end up without healthcare coverage, and the $25 billion in Medicare cuts do appear to be locked in if the GOP's bill were to become law:
I know there’s a lot going on in The Graph (see below), so lemme break it down:
The pale blue lines show the enrollment trend for the 2016 ACA Open Enrollment Period via the 38 HealthCare.Gov states (the lower line) and all 50 states + DC (the higher line). This was the all-time record for the ACA: 9.7 million via HC.gov, 12.7 million nationally.
The pale red lines show the enrollment trend for the 2017 Open Enrollment Period via 39 HC.gov states & all 50 +DC (Kentucky moved from their own exchange to the federal exchange last year). This was down a bit from 2016: 9.2 million / 12.2 million.
The dotted black lines are my “official” projections for the 2018 Open Enrollment Period: 7.5 million and 10.0 million respectively, both way down from both of the prior years.
The filled-in green/blue sections are the actual, confirmed 2018 enrollment numbers to date. Note that there are still enrollments missing: HC.gov only runs through 11/11, while other states range from no data at all all the way through 11/15. I’ve confirmed 1.71M to date, but suspect the total is actually closer to 3.0 million as of today.
The little blue dots are my current projections through this Saturday the 18th: 2.3M and 4.0M respectively.
DENVER — Between Nov.1 and Nov. 15, more than 22,000 Coloradans selected health coverage for 2018 through the state health insurance Marketplace, according to new data released today by Connect for Health Colorado®.
“I am glad to see the number of initial sign-ups during the first two weeks of Open Enrollment,” said Connect for Health Colorado® CEO Kevin Patterson. “There has been some confusion about healthcare coverage this year. I want everyone to know that the financial help to buy health insurance is still available for next year. I urge everybody buying their own health insurance to take a minute on our site, ConnectforhealthCO.com, to check to see if they qualify and then review their options and complete their enrollment before the last-minute rush.”
More than 48,000 new consumers selected a plan during the first two weeks of open enrollment, which is slightly ahead of last year’s pace.
New subsidized enrollees are using increased tax credit money to purchase coverage that is more comprehensive.
The majority of consumers signing up will be able to pay lower prices in 2018 than they would have for the same plans last year.
SACRAMENTO, Calif. — Covered California issued its first enrollment snapshot for the first two weeks of the current open-enrollment period. From Nov. 1 through Nov. 14, more than 48,000 new consumers signed up for coverage through Covered California, which is slightly ahead of last year’s pace when more than 39,000 consumers selected a plan during the first two weeks of November 2016.
Now that we have a couple of weeks worth of hard enrollment data under our belt, it's time to start trying to break the numbers out by state and category (that is, Active Renewals, Auto-Renewals and most importantly new Enrollees). This is trickier than it sounds for several reasons:
HealthCare.Gov hasn't started breaking out their numbers across the 39 states which utilize their platform yet. For them, I had to base my estimates on what portion of the 39-state total each state had in the first 12 days last year (via CMS's Public Use File). I'm assuming the ratios within HC.gov are roughly the same this year.
Five of the state-based exchanges haven't released any enrollment data yet (CO, DC, ID, NY and VT)
The other seven state-based exchanges have released some hard data, but none of their thru-dates match up with the federal exchange (11/11).
Even then, some state exchanges have only released the number of new enrollees, not renewals (CA, WA and--I think--MD), while others have already baked in passive/auto-renewals (MN, RI), which means their renewal numbers may actually decrease over time as some who were auto-renewed already change their minds.
In addition, in those states which included auto-renewals (MN, RI), I don't know the breakout between active and passive renewal, so I had to take a guess.
With all that in mind, here's where things stand to the best of my calculations. Again, while the subsets within each category are estimates, the totals include confirmed QHP selections only. I suspect the actual total to date is well over 3 million as of 11/15/17:
More than 91,000 Minnesotans have Enrolled in Private Health Plans through MNsure for 2018
November 15, 2017
ST. PAUL, Minn.—Today, MNsure announced 91,623 Minnesotans have enrolled in private health plan coverage for 2018 through MNsure.
The numbers reported include new consumers, renewing consumers who have come back and shopped for a new plan for 2018, and renewing consumers who are continuing their previous plan for 2018.
"Our first two weeks have gone very smoothly," said CEO Allison O'Toole. "MNsure's enrollment is looking strong out of the gate. This year, we renewed twice as many people into coverage than last year, and we're also seeing a steady stream of new consumers."
As I've been saying for months now, trying to predict not just the final number but the pattern of enrollments in ACA exchange policies for the 2018 Open Enrollment Period is a fool's errand given all the batcrap insanity surrounding the ACA this go around; this would be the case even without the actual enrollment period being slashed in half.
I want to focus on one portion of their analysis which I appear to have seriously misinterpreted: The projected impact on unsubsidized individual market premiums over time.
Average premiums in the nongroup market would increase by about 10 percent in most years of the decade (with no changes in the ages of people purchasing insurance accounted for) relative to CBO’s baseline projections.
Those effects would occur mainly because healthier people would be less likely to obtain insurance and because, especially in the nongroup market, the resulting increases in premiums would cause more people to not purchase insurance.
He was an incredibly kind and generous man who was a wonderful partner for my mother for over 23 years after my dad died, and I'll miss him terribly, but he lived a full and varied life to a ripe old age, and passed peacefully in his sleep in his own home, near loving family members. You can't ask for a better way to bow out.
When he became legally blind in his later years, Oscar was partnered up with a Leader Dog for the Blind named Mello, a beautiful golden retriever, who he grew to love more than anything on this earth.
Needless to say, this is going to be a busy week for me, so I'll probably be posting less frequently than usual for a few days.
If anyone would like to help honor Oscar's memory, I'd like to suggest a contribution to either of the following organizations:
Things were looking pretty dicey for two of Montana's three insurance carriers participating on the individual market the past few days. One of the three, Blue Cross Blue Shield, saw the writing on the wall regarding Cost Sharing Reductions (CSR) likely being cut off and filed a hefty 23% rate hike request with the state insurance department. The other two, however (PacificSource and the Montana Health Co-Op, one of a handful of ACA-created cooperatives stll around), assumed that the CSR payments would still be around next year and only filed single-digit rate increases.
I'm not going to speculate as to the reasons why they both did so when it was patently obvious that having the CSRs cut off was a distinct possibility, although I seem to recall the CEO of the Montana Co-Op said something about their hands being tied since CSR reimbursement payments are legally required, after all. Basically, it sounds like he was genuinely trying to avoid passing on any more additional costs to their enrollees than they had to.
HealthSherpa is a California-based technology company focused on connecting individuals with health coverage. The site was initially developed as an alternative to research plans from Healthcare.gov, and now provides individual health, dental and vision benefits to both part-time employees and retirees. As of February 2017, over 800,000 people have been enrolled in individual health coverage through HealthSherpa.
First, I want to clarify that I'm not shilling for HealthSherpa here. They aren't paying me for this post. I have no idea whether their customer service is awesome or sucks or anything like that.
Having said that, they are a pretty good resource for getting a feel for what the big picture situation is regarding open enrollment trends each year, and they have provided me with some internal data which they've OK'd me to share publicly.
It's important to note that all of the data here refers to exchange-based enrollments only. They reiterated to me that their individual market enrollments are on-exchange only:
With the 2018 Open Enrollment Period coming up just 5 days from now, it's time to put this to bed: After 6 months of painstaking research and analysis, I've compiled a comprehensive analysis of the weighted average rate changes for unsubsidized ACA-compliant individual market policies in 2018, including both the on- and off-exchange markets. It's already been confirmed by a different analysis by healthcare consulting firm Avalere Health, which used a completely different methodology to arrive at the exact same conclusion: The national average increase is between 29-30%, ranging from as low as a 22% average premium drop in Alaska (thanks to their successful reinsurance program) to as high as a painful 58% increase in Virginia.
However, what you're looking at is, in fact, a visual breakout of the state-by-state proportions of total Qualified Health Plan selections on the ACA exchange throughout the 2017 Open Enrollment Period, which ran from Nov. 1, 2016 - Jan. 31, 2017. The data comes from the official Public Use Files from the Centers for Medicare and Medicaid. As you can see, most states follow a fairly obvious trend because 39 of them are run through the federal exchange at HealthCare.Gov.
Since all 39 are administered, entered into the system and reported the same way, the only variances between them are their relative population size: Large states are thicker, small states are thinner throughout the entire enrollment period as you'd expect.
UPDATE: To clarify, just like with Covered California's "6,000 on day one" notice, Washington State's 4,550 new enrollees in 8 days don't include renewals/re-enrollments of current enrollees. Last year WA had 10,265 QHP selections total in the first 5 days and 21,665 in the first 12, so assuming a similar number of renewals each year, their total 8-day tally this year is likely around 13,000 + 4,550 = 17,500)
Every year, I painstakingly patch together Open Enrollment Period data from both the weekly (or bi-weekly, last year) snapshot reports for HealthCare.Gov as well as the dozen or so state-based exchanges to compile The Graph. Usually it's kind of bumpy and scattershot because the numbers for some of the state exchanges are released at (and through) seemingly random times. This means that the curve of the graph is usually a bit bumpy and skewed as I try my best to catch up.
Then, at some point the following year, CMS always compiles the data and posts it to a Public Use File (PUF) in a much more comprehensive, organized fashion. I knew this, and have used the PUF for prior years many times to analyze different demographics (income, age, metal level, financial aid, etc).
HOWEVER, what I didn't realize until tonight is that the same PUF also breaks out the enrollments by week in a nice, even fashion. This allowed me to more accurately recompile the enrollment graphs for both 2016 and 2017 at both the federal (HC.gov) and national (HC.gov + SBMs) level.
Weekly Enrollment Snapshot: Week One: Week 1, Nov 1-4, 2017
In week one of Open Enrollment for 2018, 601,462 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. Consequently, week one was only four days long this year - from Wednesday to Saturday.
Every week during Open Enrollment, the Centers for Medicare and Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchanges, the State Partnership Exchanges, and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.
The Results of CBO and JCT’s Analysis CBO and JCT estimate that repealing that mandate starting in 2019—and making no other changes to current law—would have the following effects:
ALBANY, NY (November 8, 2017) – NY State of Health, the state’s official health plan Marketplace, today announced a new partnership with ride sharing companies Lyft and Uber. Through the partnership, Lyft and Uber will reach more than 200,000 drivers throughout New York State urging them to visit the Marketplace to shop for and enroll in quality, affordable health insurance. NY State of Health will work directly with Lyft and Uber to promote coverage options and enrollment opportunities for drivers through an email campaign, In-App notifications and in-person education on coverage options.
...Statewide, in fact, growth is up 100 percent since last year, according to Betsy Plunkett, a deputy director for the Maryland Health Benefit Exchange. First-time enrollment is up 15 percent, with changes to existing plans up 270 percent. Overall, 10,420 people enrolled in the first week compared to 5,212 in 2016, she said.
In Rhode Island, enrollment this year is five times higher in the first week than it was last year, said Zach Sherman, the director of HealthSource R.I. An early outreach campaign by the state seems to have paid off with more than 500 people enrolling, compared to 109 people in the first week last year.
I've received a hard number direct from the exchange: It's actually 604 new enrollees through 11/07, versus 126 new enrollees in the first 7 days last year.
Several regular commenters here at ACA Signups have been wondering why the Congressional Budget Office keeps using March 2016 as the "baseline" for projecting the net impact on healthcare coverage numbers under the GOP's Trumpcare bills (the House's AHCA and the Senate's BCRAP), as opposed to the more recent January 2017 baseline. After all, according to the March 2016 baseline, the CBO was projecting that under the ACA, the total individual market would have 25 million people as of 2026 (18 million on the exchanges plus another 7 million off-exchange), whereas under the January 2017 baseline, their projections are for the individual market to only be 20 million as of 2027 (13 million on the exchanges plus 7 million off-exchange). Taken at face value, this would seem to suggest a 5 million enrollee discrepancy. This drumbeat has been taken up more recently by GOP Senators, particularly Wisconsin Senator Ron Johnson.
"We realize it's a shorter period so we have to get people in the door quicker," said Andrew Ratner, chief marketing officer for Maryland Health Benefit Exchange, which runs the marketplace.
Sign-ups have been brisk so far, with more than 5,000 people picking plans in the first two days, nearly twice as many as last year. The Maryland Health Connection website, which usually closes at 11 p.m., had to stay open an hour later on Wednesday because 300 people were still online. Maryland currently has about 120,000 Obamacare enrollees.
That same day in Connecticut [Wednesday, Nov. 1st], 1,596 residents enrolled in qualified health plans on the state exchange while another 2,293 people either completed Medicaid applications or determined that they were eligible for that program. Access Health CT CEO Jim Wadleigh said in a statement that the state’s call center and website experienced a 15 percent increase in volume compared to opening day last year.
Not much to add here; last year the first enrollment number I had for Connecticut didn't show up until halfway through November (about 16,000 selections in 15 days), but that doesn't give me much to compare with for the first day only. Still, the 15% traffic increase is a good thing.
Press release from MNsure, Minnesota's ACA exchange:
MNsure update on first week of open enrollment
ST. PAUL—MNsure CEO, Allison O’Toole, issued the following statement recapping the first full week of open enrollment:
“The first seven days of this year’s open enrollment period have gone smoothly. We are off to a strong start and doing a steady business of enrolling Minnesotans in health care coverage. Market disruptions last year— including a large jump in premiums, a major carrier pulling out of the market, the first year of enrollment caps as well as other factors—drove large numbers of consumers to our doors in the first few days of last year’s enrollment period. This year, we are seeing a much steadier flow of traffic to the website that is more in line with what we would expect. Call wait times have been consistently low throughout this first week.”
This year, MNsure renewed more people into coverage than ever before. Open enrollment figures will be released next Wednesday at MNsure’s public board meeting.
(sigh) OK, I wasn't planning on doing week-by-week estimates/projections given how batcrap insane this Open Enrollment Period is (not just in terms of the sabotage efforts and repeal lunacy, but also due to the time window being slashed in half for most states). In the end, however, my inner data geek got the better of me, so here we are.
Today is November 7th. The 2018 Open Enrollment Period's first week ends at midnight tonight. Here's what we know so far:
Unlike most states, the Massachuetts exchange also handles premium billing/payments themselves, so they have a more elaborate enrollment reporting system. However, I've confirmed the following breakout:
628: Current enrollees, plans selected
3,860: Current enrollees, plans selected/paid
445: Returning* enrollees, plans selected
215: Returning enrollees, plans selected/paid
1,375: New enrollees, plans selected
472: New enrollees, plans selected/paid
Total: 6,995 total plans selected, of which 4,547 are fully enrolled (i.e., 1st premium paid).
*"Returning enrollees" means someone who's already in the MA exchange system because they were previously enrolled in an exchange policy in the past but isn't currently enrolled in one. For instance, they might have been enrolled from 2015-2016, but then left the exchange for 2017 and is returning for 2018.
For awhile now I've been noting that making predictions about how many people will actually enroll in ACA exchange plans for 2018 is extremely difficult to do for a variety of reasons. On the one hand, Donald Trump has been desperately trying to sabotage the law any way he can, including everything from slashing outreach funding by 90% and cutting the enrollment period in half to cutting off Cost Sharing Reduction reimbursement payments...while at the same time Congressional Republicans have been desperately trying to repeal the law outright. All of this has caused a tremendous amount of confusion, as well as causing average unsubsidized premiums to shoot up around 30% on average nationally.
As both the largest-population state in the country and the largest state-based exchange under the ACA, Covered California provides an important guideline for me when it comes to attempting to track national enrollment data. They hold over 12% of the total U.S. population and enrolled 12.7% of all ACA exchange enrollments for 2017, coming in second only to Florida's 14.4%.
Today I confirmed that on Day One of the 2018 Open Enrollment Period, CoveredCA signed up 5,979 people...around 25% more than they did on Nov. 1st last year.
According to our CSR Load Load spreadsheet, Hawaii is supposed to be one of the 20-odd states using the full "Silver Switcharoo" strategy. It also has a single Rating Area, and only has two carriers (Kaiser and HMSA) participating in the individual market (on or off-exchange) anyway, making it a pretty easy state to run a full apples-to-apples year over year comparison.
Kaiser is offering a total of 11 plans on the ACA exchange (3 Bronze, 3 Silver, 3 Gold and 2 Platinum), while HMSA lists 10 (2 Bronze, 3 Silver, 3 Gold and 2 Platinum). I couldn't run a perfect comparison to 2017 since each carrier changed a couple of their offerings, but it's pretty darned close.
Maine voters on Tuesday decided to expand Medicaid to cover more low-income adults, becoming the first state to do so through a referendum.
Support for the ballot measure was up by more than 18 points with 64 percent of precincts reporting about 10 p.m. when it was called by NBC affiliate WCSH and The Associated Press.
The results in Maine, one of 19 states that rejected Medicaid expansion under the Affordable Care Act, comes as other Republican-led states like Utah and Idaho eye similar ballot measures.
Advocates of Medicaid expansion in Maine successfully petitioned the state to include a question on this year’s ballot following several failed legislative efforts to expand the program.
Over 32,000 unique visitors and 886,000 page views
At peak we had 3,534 concurrent users when on 11/1 last year our peak was of 2,699 concurrent users
2,108 QHP plans selected by customers who either did not have a 2018 enrollment or switched away from the plan they were auto-enrolled into
Over 800 new downloads of the WAHBE mobile app
No significant system issue was encountered
In addition, unlike the federal exchange and most state exchanges, instead of waiting until after the initial wave of erollments are out of the way, Washington auto-renews existing enrollees right up front, but then changes their policies as people log in and switch to a different policy (or cancels the renewals if people don't pay up or inform them that they're not renewing):
Even before President Donald Trump announced plans last week to nix Obamacare subsidies, the Illinois Department of Insurance raced over the summer to get insurers on board with a strategy to minimize the financial pain of such a move.
...Trump on Oct. 12 ordered the federal government to stop paying the cost-sharing subsidies provided to insurers to defray the cost of covering low-income people. But the Rauner administration has found a way to make the federal government pick up the tab anyway.
Believe it or not, the original core focus of ACASignups.net was...wait for it...to track how many people are Signing Up for the ACA. Hard to believe, I realize.
Enrollments in health insurance through the state’s health exchange was robust on the first day of open enrollment Wednesday, with more people signing up for insurance than last year, officials said Thursday.
Advocates and others had expressed concern that consumers would be confused by political wrangling and policy changes to the Affordable Care Act from the administration of Pres. Donald Trump that led to last-minute rate increases and a severe decrease in marketing dollars for the program.
But exchange officials reported that enrollments under the law, known as Obamacare, were up 70 percent to more than 1,800 compared with 1,055 on the first day a year ago. About 150,000 people signed up for private insurance on the exchange in the state last year and more enrolled directly through insurers.
Until today, I operated under the assumption that my home state of Michigan was among the 18 states which took the "Silver Load" approach to dealing with the Cost Sharing Reduction (CSR) cut-off by the Trump administration. Reviewing the SERFF rate filings of the various carriers participating in the individual market, it looked like most of them were loading the CSR cost onto both on and off-exchange Silver plans. I didn't check every single carrier, but that seemed to be the trend, so I filed the state under "Silver Load".
I'm signing up for a plan off the exchange with Priority Health in Michigan. ON-Exchange, the plan is $365 a month, but off exchange (directly from their website), the price is $300 per month. I don't qualify for a subsidy, but it's still cheaper than my 2017 plan with BCBSM. That was the Multi-State Plan in Region 7 with Dental and Vision.
Hey there, I called again and I was able to talk to a more knowledgeable agent who found out what the issue was and was able to enroll me in a plan!
Apparently, the Marketplace renewed automatically my application based on my 2016 income, which was enough to receive a tax credit in 2017, but is no longer enough to receive one in 2018.
Luckily, my income has increased since then, so I reported the change and was able to get a credit applied to the premiums
Still need to send copy of my green card for verification, but I can use the tax credit immediately
So I'm not sure why the person I talked to earlier today told me the rules had changed
Sorry for the confusion
OOF. OK, this pretty much torpedoes the entire basis of this blog entry. I'm going to leave it up in the interest of letting documented immigrants know that they ARE eligible to enroll AND for tax credits, but it sounds like the original concern may be unwarranted after all.
To summarize (again), this is where someone whose household income is too high for them to qualify for ACA tax credits (400% of the Federal Poverty Line) chooses an ACA-compliant off-exchange Silver plan instead, which is either identical or nearly identical to the same on-exchange policy in every way except that the additional CSR load hasn't been tacked onto it.
Here's a perfect example found by Louise Norris...ironically, this is via Priority Health here in Michigan, which (until today) I thought was a "Silver Load" state, not "Silver Switcharoo". I'll have to do some more research to be sure, but it sounds like at least one MI carrier (Priority) is going full Switch:
