Massachusetts: ACA-enabled Medicaid 300K, 1K SHOP

Contributor deaconblues brings a very nice find. Massachusetts continues to be one hell of a mess, but this latest official briefing helps bring some clarity to the situation, while raising some more questions. Rather than restate it all myself, here's deaconblues summary, and the chart in question:

• The QHP numbers have been updated since this briefing.
• There are 64K in new Medicaid (MassHealth).
• There were 107K in transfers from Commonwealth Care to Medicaid (was previously reported as 130K).

• The comments under the Commonwealth Care transition to Medicaid says "became part of the ~300,000 members newly enrolled in Medicaid as a result of expansion". Seems like an unambiguous statement. If you back out the 107K in transfers, that means an additional 193K of new expansion enrollees. This would not include the 84K in temporary transitional medicaid (these aren't expansion related). The 64K MassHealth number includes quite a bit of previously eligible, maybe some churn ... I don't know if this should just be absorbed into the 193K (to be conservative) or partially included. To put things in perspective, there were only about 240K of uninsured in Mass in the first place, and only 90K of them were Medicaid-eligible, so the 193K number puzzles me - but the wording is quite clear.

• The Limbo Status numbers are:
  • Commonwealth Care: 103,801 +
  • Commonwealth Choice: 29,010 +
  • Transitional Coverage: 84,000 +
  • Medical Security Plan: 10,550
  • Total: 227,361

The Medical Security Plan is/was a Mass plan to help people on unemployment benefits to get insurance. It's being absorbed into the ACA. The comments say "now in Commonwealth Care", but they are separate numbers, and part of the 410K total 3/14 enrollment.

Also of note:

Page 11 of the briefing also says the Small Business Platform has 1,056 enrollees. I didn't even know Mass had a working SHOP program.

Page 10 shows the Fast Track program sent out 22K invoices on 3/8. As of 3/13, 720 people had enrolled (the number we currently show). If the number sounds low, that's only 5 days for the invoices to be delivered, a check sent, the check received by the insurance provider, then notification provided to the Health Connector. The next update should show more representative numbers.

The end result of all of this is that MA's Medicaid total changes from 151K total (130K Bulk Transfers, 15K est. Strict Expansion, 6K est. Woodworkers) to 300K total (107K Bulk Transfers, 64K MassHealth, 129K Other New Medicaid). I'm assuming that the 64K is Woodworkers and the 129K are Expansion for the moment, but could be wrong about this.

On the private QHP side, I'm going ahead and adding the 1,056 enrollees to SHOP, but I'm ignoring the 227K "Limbo Status" for now, as I explained last night; I added them to the graph/spreadsheet briefly but have backed them out again for now. In fact, the SHOP number refers to 1,056 members, which may mean "employees", which means I should probably multily this by my standard 1.8x for "households" to include family members...but given how confusing MA is, I'm holding off on that; it'd only be about 800 more people anyway.

What a mess.