Massachusetts

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:

A bit of an update out of Massachusetts; the article is another rundown of the MA Mess, but there's actually small enrollment update included as well: Exchange QHPs have gone up from 12,965 on 3/01 to 15,140 as of "this week" (I'll call it Wednesday the 19th).

As of this week, only 740 Massachusetts residents have been able to enroll in newly subsidized plans under the act, Health Connector Authority spokesman Jason Lefferts said.

He said 14,400 people were able to enroll in unsubsidized plans on the private market by using the connector's website. Their success rate is tied to not needing to go through the income eligibility process, Lefferts said.

However, here's the actual good news: It turns out that Massachusetts only includes paid enrollees in their reports. From a CNBC article a week ago:

OK, the cutesy title is kind of a misnomer; my two previous entries didn't use that title originally...but they should have, and do now.

March 31st is supposed to be the final day to enroll in QHPs via the exchanges...but it's looking more and more as though that won't quite be the case in not two, not three...but possibly up to seven states now, including a couple whose websites have been working smooth as silk??

On March 7th I pointed out that due to Massachusetts having some 154,000 people stuck in health insurance limbo, they've been granted some sort of temporary extension, twice...out to as far as June 30th in some cases...

A couple of weeks ago I pointed out that at least two states, Massachusetts and Oregon, may end up extending their enrollment period beyond the official March 31st "deadline" due to their exchange websites still being partially or completely hosed.

In Massachusetts' case, there's about 219,000 people currently stuck in coverage limbo; the HHS Dept. has granted an extension of some sort to as far out as June 30th to get these people squared away, although I'm pretty sure the extension only applies to those folks, not anyone who's just trying to enroll now...but that's still a hell of a lot of people.

Thanks to contributor deaconblues for sending me this story out of Massachusetts, which puts a bit of a downer spin on the otherwise fantastic one-two punch of hitting 1M QHPs in CA and 5M nationally. The short version? MA fired CGI, won't hit their own twice-extended deadline, and has tens of thousands of people stuck in a weird healthcare coverage holding pattern for...no one seems to know exactly how long:

Massachusetts has chosen to toss out CGICorp., the architect of the troubled Health Connector website, amid an ObamaCare enrollment crisis that threatens to spill into 2015....

UPDATE: On the down side, I was off by 4% this time around.

On the up side, I UNDERESTIMATED:

Actual Feb. enrollments: 942,833, for a total of 4,242,325 thru 3/01/14.

Sarah Kliff at Vox just announced that the February HHS report is expected to be released today at around 4:00pm. A few items in anticipation of that:

  • As I've noted several times, I'm projecting the report to total around 902,000 exchange-based private QHP enrollments for the month of February (technically 2/02 - 3/01)
  • If accurate, this would bring the cumulative total of exchange-based private QHP enrollments to 4.202 million (from 10/1/13 - 3/01/14)
  • From the data I have, the average daily enrollment rate in February was almost identical to that of January, which had about 1.146 million QHP enrollments. HOWEVER, the January report included five weeks of data (12/28 - 2/01), while the February report will only include four weeks (2/02 - 3/01). Therefore, even at the same daily average, it'll be about 20% lower no matter what.
  • Don't be surprised if Peter Lee of CoveredCA decides to steal some thunder by announcing that California has enrolled 1,000,000 QHPs all by itself either today or tomorrow. However, that would include the past 10 days, while the HHS number will only run thru 3/01.
  • If you want to get REALLY specific, call it 902,800 and 4,202,292.
  • I've been dead-on target 6 times in a row without hyping up my projections beforehand. This time I am hyping myself up beforehand, so I'll probably be way off...but as long as I've UNDERestimated the tally, I'll be perfectly fine with that...
  • The report will be released in about 5 minutes, but my kid gets home from school in about 10, so it'll be a good 20 minutes before I can really post anything. Feel free to follow Sarah Kliff of Vox in the meantime!

Last month there was news out of Massachusetts of some sort of extension being granted to "bring the state’s health care system in line" with ACA regulations. At the time I didn't pay much attention to it, thinking that it only related to administrative procedures or somesuch.

However, it turns out that there's actually 154,000 people who are currently enrolled in a sort of healthcare batter's box, being placed on hold until MA's screwed-up exchange is able to absorb them into the system via proper ACA-compliant QHPs (or Medicaid/CHIP...not sure about that yet):

Unable to immediately enroll applicants in new, private plans under the Affordable Care Act, state officials extended existing state coverage for about 124,000 individuals, and granted temporary state coverage to about 30,000 new applicants. Those individuals were supposed to move onto new plans by March. 31; the federal waiver gives officials another three months to do that.

So why am I bringing this up today, 3 weeks after that story broke? Because a contributor called my attention to this story out of Oregon:

Massachusett's ACA exchange website is still undergoing massive technical problems, but there's been significant progress made in processing a mountain of paper applications. The immediate impact isn't that significant (11,000 total enrollments = only 2,861 more than the Feb. 1st tally), but the article suggests that another 50,000 applications should be getting pushed through the system any day now... 

Officials running the state’s troubled health insurance marketplace reported progress on Friday toward addressing its most immediate problem -- a massive backlog in processing applications...

As a result, people were urged to file paper applications instead, both to replace expiring policies and to enroll for the first time. The nearest-term problem has been simply processing 72,000 applications, many of which come from uninsured residents....

Overall, a spokesman for the marketplace said that there have been about 11,000 people who have newly enrolled successfully for coverage since October, almost all in unsubsidized coverage.

As contributor deaconblues put it, "First mention I've heard of 30K new people being enrolled into Medicaid (in addition to the 130K transitioned from the CommonwealthCare plans)."

Before delving into the website issues, Patrick said Massachusetts still has the highest coverage rate in the nation at 97 percent and faced unique challenges to implementing the ACA because of past health reform efforts. He noted that on Jan. 1 130,000 subscribers to coverage through the Connector were successfully transitioned to new plans under the expansion of MassHealth and 30,000 new adults and children were enrolled in the Medicaid program.

For Massachusetts Health Connector’s Board of Directors, which is meeting today, the key question is: How bad do things have to be – and for how long – before the consequence is a brutal decision?

We know that MITRE, a private contractor, was hired to do a technical review of the flawed website of the Massachusetts state insurance exchange. MITRE is the same company that pointed out certain vulnerabilities in HealthCare.gov that have later been fixed.

CGI, which has been responsible for development, failed to deliver a working website. Worse than that: after three months, there is still no indication that CGI has the competency required to fix the website.

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