Nevada

Thanks to deaconblues for all three of these items:

Avalere Health, with whom I've both clashed and agreed with on ACA-enabled Medicaid enrollments in the past, is projecting as high as a net gain of 4.3M Medicaid enrollees through the end of March:

700K to 1.3M Additional Medicaid Enrollees through March, If Current Trends Continue.

However, March and April figures could bring more dramatic increases if outreach and enrollment efforts targeting the end of exchange open enrollment translate into new Medicaid enrollees. Specifically, if Medicaid sign-ups follow a similar pattern as exchanges, new Medicaid enrollees could reach 4.3 million by the end of March. In addition, recent figures released by CMS do not account for individuals assessed eligible for Medicaid through HealthCare.gov who have yet to be determined eligible by states.

Why the heck Nevada couldn't have posted the 3/31 total instead of tacking on 4/1, I have no idea, but what the hell; it's starting to look like I'll have to wait for the HHS report in order to get the precise monthly figure anyway (assuming they don't move the 30th & 31st over to April's report, that is...)

Update as of 4/1: 41,823 Nevadans confirm Qualified Health Plan Selections through http://t.co/k2YKIcssBl. 25,899 paid to date.

— Nevada Health Link (@NVHealthLink) April 3, 2014

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.

Nevada doesn't want to be left out of the craziness...OK, not exactly a major update but every one of those numbers is a human being (and one step closer to 7M)...about 4,500 more (although most of the new ones aren't paid yet...imagine that! They enrolled 2 days ago and still haven't paid? The horror!)

Update as of 3/29: A busy weekend for enrollment, 40,498 consumers confirmed Qualified Health Plan selections, 24,062 have paid. #GetCovered

— Nevada Health Link (@NVHealthLink) March 31, 2014

We are seeing record traffic counts at the call center and http://t.co/k2YKIcssBl. Many Nevadans are rushing to beat the deadline.

— Nevada Health Link (@NVHealthLink) March 31, 2014

A 1,000 increase in the number of paid exchange QHPs since 3/22:

Since Nevada Health Link opened, the state's exchange for insurance, there have been many problems in finishing the enrollment process.

More than 24,000 Nevadans have enrolled and paid, far lower than the projected estimates.

Meanwhile, Xerox (which botched the Nevada exchange just as Oracle botched Oregon's) thinks they'll be able to "convert" 57,000 of the partially-completed enrollments into full enrollees during the extension period (which actually runs all the way out until May 30th in Nevada's case...):

Xerox officials told the board that they’ve identified about 77,000 people they’ll target during special enrollment, which runs through May 30. Consumers eligible to sign up then include people who have selected an exchange plan but not paid for it, as well as people who qualified through the exchange for a federal premium subsidy but who have not bought a plan.

Company officials said they believe they could convert about 57,000 of the 77,000 targeted consumers into actual enrollees.

No exact numbers, but the previous update as of 3/15 was 22,533 paid / 10,520 unpaid (33,053 total), so this looks right. NV's March pace is still running around 45% above February's daily average.

As of March 22, more than 35,000 people have signed up for a health insurance plan. Approximately 23,000 of them have already started making payments on their health care coverage.

OK, this is a tiny number but every data point helps...in an article about the final crunch-time outreach efforts is this bit about the Nevada Health CO-OP's success:

The CO-OP sells plans both on and off of the exchange, but the “vast majority” of consumers who ask about plans are subsidy-eligible and buying on the exchange, Egan said. The CO-OP has actually sold more plans through the exchange than any other insurer: It’s responsible for 37 percent of plans sold, beating out industry titans UnitedHealthcare and Anthem, the state’s two biggest insurers. The CO-OP had sold about 9,500 plans on the exchange and just under 1,000 off of it as of Tuesday.

I'm gonna call "just under 1,000" 990 (shrug).

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...

On top of today's Big News out of California (1M) and the HHS (5M) comes a smaller, but just as significant update from Nevada. They're up from 20,930 paid / 9,085 unpaid (30,015 total) to 22,533 paid / 10,520 unpaid (33,053 total), a total increase of 3,038 (although the Paid rate in NV is down slightly, from 70% to 68%...although again, none of the new enrollees start coverage until April).

The significance is this: The first week of March, Nevada was averaging 211 QHPs/day, virtually identical to February's 212/day. However, with this addition, their daily average has shot up to 323/day, a 52% increase. Even more impressive, if you only include the 2nd week of the month, that's 3,038/7 = 434/day, or more than twice the daily average. The Surge is definitely here, folks.

Update as of 3/15: 33,053 consumers have confirmed Qualified Health Plan selections through Nevada Health Link, 22,533 have paid.

— Nevada Health Link (@NVHealthLink) March 17, 2014

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!

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