When Massachusetts passed its landmark health coverage law under Gov. Mitt Romney in 2006, no one claimed the state would get to zero, as in 0 percent of residents who are uninsured. But numbers out today suggest Massachusetts is very close.
Between December 2013 and March of this year, when the federal government was urging people to enroll, the number of Massachusetts residents signed up for health coverage increased by more than 215,000. If that number holds, the percentage of Massachusetts residents who do not have coverage has dropped to less than 1 percent.
According to the Kaiser Family Foundation, Massachusetts only had around 242,000 uninsured residents out of 6.65 million total as of last September (about 3.6%), just before the ACA exchanges launched. So on the one hand, Massachusetts already had the lowest uninsured rate in the country due, of course, to RomneyCare, the precursor of Obamacare (no matter how much Mitt wants to deny it now, Lord knows why...)
OK, Massachusetts' exchange is still seriously screwed up, and their reporting methodology is equally confusing, but it appears to be, as contributor deaconblues notes:
QHP: 32,706 unsubsidized + 773 subsidized = 33,479 (up from 31,695 as of 4/19)
Medicaid: 195,955 (expansion plus churn)
Limbo Status: 93,778 + 10,382 + 201,113 = 305,273
SHOP: 4,982? (1,869 members in Business Express and 3,113 members in QHP)
Really not sure how to handle the SHOP numbers, and that "Limbo Status" number keeps growing (it was 270K last I checked). Come June 30, I have no idea what those 300,000 people are going to do...
OK, not exactly the most stunning headline in the world (although this does appear to be shocking news to a certain anti-ACA political party), but still kind of cool to have some solid numbers on just how many lives could be saved with universal coverage:
Results: Reform in Massachusetts was associated with a significant decrease in all-cause mortality compared with the control group (−2.9%; P = 0.003, or an absolute decrease of 8.2 deaths per 100 000 adults). Deaths from causes amenable to health care also significantly decreased (−4.5%; P < 0.001). Changes were larger in counties with lower household incomes and higher prereform uninsured rates. Secondary analyses showed significant gains in coverage, access to care, and self-reported health. The number needed to treat was approximately 830 adults gaining health insurance to prevent 1 death per year.
Limitations: Nonrandomized design subject to unmeasured confounders. Massachusetts results may not generalize to other states.
Conclusion: Health reform in Massachusetts was associated with significant reductions in all-cause mortality and deaths from causes amenable to health care.
Not exactly surprising, but rather embarrassing for the state which spawned the ACA in the first place.
If the "off-the-shelf" replacement works, great. If not, and they follow Oregon into having HC.gov take over, that would mean a net change of...zero states, with MA and OR moving into the fold while New Mexico and Idaho break out on their own exchanges.
Massachusetts has scrapped its hopes for a totally customized state-based health exchange under the Affordable Care Act, and will instead purchase an “off-the-shelf” solution that can be installed by the fall with the possibility of joining the federal exchange if all else fails.
The state announced Monday that it would contract with Virginia-based hCentive for health insurance exchange software that has been used to power online marketplaces Kentucky, Colorado, New York and other states.
Health and IT officials will simultaneously work to ready the state and its insurers to join the federal health exchange in case the hCentive software solution cannot be implemented in time for the next insurance open enrollment period that begins in November.
The wording of the story makes it look like MA's exchange QHP total dropped by over 6K, but in fact they had only reported 12,965 to HHS as of March 1st, so this still represents a slight increase over the last number entered on 4/02 (29,720):
Unsubsidized enrollment in exchange plans fell to 29,775 April 8, from 36,060 Dec. 1, 2013, when the state had its own, homegrown exchange plan program in place. The exchange is planning to conduct a survey to learn why enrollment fell.
deaconblues, ever detail-oriented, also made sure to find the subsidized number of QHP enrollees as well: 769
As deaconblues reminds me, the 29K is in addition to the 720 subsidized enrollees that they've managed to get through their messed-up system.
Massachusetts will not meet its goal of moving more than 200,000 people into insurance plans that comply with the federal law by the end of June. It has managed to enroll about 29,000 residents in unsubsidized coverage, 138,000 in temporary coverage, and another 114,000 in extended coverage since the October launch of its new website, with a significant number applying on paper, said a Connector spokesman Thursday.
OK, in addition to the appx. 7.041 million enrollments on the Federal exchange (HC.gov), I've brought CO, CT, DC, HI, KY, MD, MN, NY, RI and WA completely up to date, with all QHP data through midnight on 3/31 (some of the Medicaid/CHIP data is still missing, but that's a lesser concern at the moment).
However, I'm still missing the following exchange QHP data:
California: 22 hours (that's right...the current tally runs thru 2am on 3/31)
Massachusetts: 3 days (current is thru 3/28)
Nevada: 2 days (current is thru 3/29)
Oregon: 3 days (current is thru 3/28)
Vermont: 1 day (current is thru 3/30)
I can't tell you how frustrating it is to be this close to full data while still missing it.
So, how much is actually missing? Well, if these states were running at their prior average March daily rate, it would be
CA: 11,754
MA: 512 x 3 = 1,536
NV: 427 x 2 = 854
OR: 502 x 3 = 1,506
VT: 775
Total: 16,425
However, this obviously doesn't apply since the final weekend and especially yesterday were insane.
A small update from Massachusetts...still not sure what the heck they're gonna do with a couple hundred thousand people who got caught in "limbo status" but that's for another day...
As of Friday, Connector spokesman Jason Lefferts said the site saw 26,793 people sign up with new federal Affordable Care Act-compliant plans since the Oct. 1, 2013 start date.
Residents seeking unsubsidized coverage had until Monday to buy insurance, but because of problems with the website, those having trouble applying now have until April 15 to apply.
As usual with Massachusetts, there's a lot of weird numbers flying around in this article (and therefore, no new hard enrollment numbers to add at the moment), but there's some other important stuff right in the lede:
BOSTON -- Massachusetts residents who have had difficulty signing up through the Health Connector for unsubsidized health insurance coverage will be given an extra two weeks to enroll under an extension plan to be presented Thursday, two days after President Barack Obama announced a similar reprieve for frustrated consumers on the national level.
...Residents who have had trouble completing enrollment to due technical problems with the website will be allowed to shop online for unsubsidized plans through April 15, with payment due April 23 for coverage starting on May 1.
OK, first, there's the standard "you get until 4/15 as long as you started by 3/31" bit which is all the rage (seriously, I think Connecticut is the only state not extending enrollment in one way or another at this point, while Rhode Island nor Hawaii are the only other states not to chime in one way or another...which is insane in the case of Hawaii).
Eureka! Finally, some serious progress on the Massachusetts Mess front. Apparently the backlog of manual payment enrollments is seeing serious progress as people mail in their checks. As a result, MA's 15,140 exchange QHPs as of 3/19 have shot up to 25K. And yes, these all appear to be QHPs, not Medicaid (under any of the dozen Medicaid categores that Massachusetts seems to have), as all of those numbers are far, far higher than 25K.
I should further note that MA only reports enrollments to HHS if the first premium is paid.
In one shot, Massachusetts has gone from running 30% behind their February QHP rate to of three times higher, and my overall 3/31 projection has moved up from 6.26 million to 6.30 million.
Lefferts said some 25,000 people have enrolled in Affordable Care Act plans, with the bulk of those being former Commonwealth Choice enrollees, along with a small number of subsidized individuals from Commonwealth Care and about 2,000 people for new dental coverage.
Eureka! Finally, some serious progress on the Massachusetts Mess front. Apparently the backlog of manual payment enrollments is seeing serious progress as people mail in their checks. As a result, MA's 15,140 exchange QHPs as of 3/19 have shot up to 25K. And yes, these all appear to be QHPs, not Medicaid (under any of the dozen Medicaid categores that Massachusetts seems to have), as all of those numbers are far, far higher than 25K.
