I don't write about Idaho much, which is a bit surprising when you think about it because it's kind of a unique state when it comes to the ACA exchanges. Most states never set up their own exchange platform. A dozen or so set them up and are still using them. Two states (Massachusetts and Maryland) scrapped their original, failed platforms and completely overhauled them. Three states started out with their own platform but gave up when they failed, moving home to the mothership (HealthCare.Gov). One state, New Mexico, was supposed to move off of HC.gov after the first couple of years, but changed their mind and is still hosted by the federal platform. Oh, and there's also Kentucky, which is scheduled to scrap their perfectly-functioning tech platform for absolutely no good reason other than the petty whim of their new Governor, Matt Bevin.
Last year, MNsure, Minnesota's technically (and actuarially) troubled ACA exchange enrolled "several hundred" people in Qualified Health Plans (QHPs) in the first day, and exactly 6,864 people in the first 17 days...which breaks out to an average of 404 per day for the first couple of weeks.
With improvements at the call center and on the website, MNsure has enrolled a record number of Minnesotans in coverage, O’Toole said.
“We’ve helped more Minnesotans than we have in any two day period in our history,” she said. “We’ve now enrolled more than 10,000 Minnesotans. That’s a benchmark that we didn’t hit until after Thanksgiving last year.”
Last week, ahead of the launch of the 2017 Open Enrollment Period, I took a look at what's new over at HealthCare.Gov this year. For the most part I was pretty impressed; they've made it more mobile-friendly, added refinements and changed the plan filtering interface so that it's consistent across both desktop, laptop and mobile devices.
The actual enrollment process itself also appears to be running smooth as silk; here's a comment from just this morning:
However, there are still a few user interface glitches which need to be addressed, at least on the "Window Shopping" tool. Here's two of them (three, really, although two are the same problem for different functions):
Modern Healthcare has an OE4 Launch roundup of sorts; most of the data is stuff I've already written about, and there isn't much in the way of hard enrollment data, but in general it sounds like things are off to a pretty promising start. First they note the 150,000 submitted applications on Tuesday which I wrote about earlier today; after that:
Open enrollment so far “has been going really well,” said Ambar Calvillo, national director of field and partner engagement at Enroll America, a D.C.-based not-for-profit group that helps people sign up for coverage. Calvillo said the group, which works with enrollment assistors across the nation, hasn't seen any major obstacles. Before open enrollment, exchange shoppers scheduled more than 5,400 appointments for in-person enrollment assistance through Enroll America's Get Covered Connector tool, up 80% over last year.
...State-run exchanges in California, Colorado, Idaho and Massachusetts reported no problems on the first day of enrollment.
Every year I keep trying to stress the importance of EVERYONE who's considering enrolling in an individual/family healthcare policy making sure to shop around on either HealthCare.Gov or your local state exchange website to see what the situation is each and every year.
I'm not just talking about people who are currently uninsured; I'm also talking about those already enrolled. I'm talking about those who plan on keeping the same policy. I'm talking about those who enrolled in an off-exchange plan because they think they don't qualify for subsidies (or they assume the subsidy would be nominal at best).
As I noted this morning, I'm expecting roughly 87,000 people to either enroll or renew their healthcare policies nationally via the assorted ACA exchanges (either HealthCare.Gov or one of the state-based exchange sites like Covered California, New York State of Health and so on) in the first 24 hours of the 2017 Open Enrollment period...which is to say, by midnight tonight.
I mention this because just moments ago in my post about Minnesota's exchange website and phone lines being attacked, I closed by light-heartedly noting that a straight national extrapolation of MNsure's enrollment figures from their first 2 hours of operation would suggest over 180,000 people enrolling nationally in just a few hours. I then brushed off that possibility as being extremely unlikely; my official projection has total 2017 exchange enrollments hitting around 785,000 the first week.
Remember three years ago when HealthCare.Gov launched with all sorts of horrible technical problems, and many people were speculating that at least some of the tech issues may have been the result of deliberate, malicious attacks (hacking, DDoS attacks, etc) by those opposed to either President Obama, the ACA or both?
Well, that turned out to be mostly hooey; while I'm sure there were some attempts at messing with the system, the technical problems were for the most part good old fashioned unintentional screw-ups by either the vendors, the HHS management or a combination of both. The Obama administration quickly brought in the Code Red crash team to fix the problems, and for the most part the federal exchange started working pretty well. Further improvements the past few years have completely transformed it into a pretty quick, easy, seamless experience for most people, to the point that it's now literally operating 100,000 times better than when the website first launched.
There you have it: The states which are 100% on board with the ACA exchange provisions (running their own full state-based marketplace, expanding medicaid and sticking to the original cut-off date for "transitional" policies) average around 18%. If you remove Minnesota from the equation, it's just 15.2%.
Those which implemented only one or two of the above provisions come in at around 26%. In a possibly coincidental quirk, all five fo the "halfway" state exchange states (Hawaii, Oregon, Nevada, Kentucky and New Mexico) just happen to also fall into this category as well, which is completely appropriate.
Finally, states which are fighting the ACA kicking and screaming (no Medicaid expansion, no state exchange and allowing transitional plan extensions as long as possible) are averaging around 30%.
