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2018 MIDTERM ELECTION

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A nice little final-day wrap-up report out of Alaska: 13K on the exchange and another 2,700 off-exchange QHPs. Premera is part of BCBSA, so I can't double-count their off-exchange number, but Moda Health isn't:

About 13,000 Alaskans signed up for health insurance on healthcare.gov during the open enrollment period that closed March 31st. The two insurers offering plans on the exchange in Alaska shared their enrollment figures today with APRN. Moda Health says it has about 7700 healthcare.gov enrollees in Alaska and the company is still processing some additional sign ups.

Premera Alaska enrolled 5300 people on the exchange. Before the troubled launch of healthcare.gov, the company had hoped for more customers. But Premera spokesperson Melanie Coon is satisfied with the numbers:

“I think we readjusted our expectations. We’re very pleased with how enrollment went, based on the slow start to the exchange and… the last minute changes that were made where people could extend.”

An hour or so ago, the Republican Staff of the Committee on Energy & Commerce Republican, chaired by Republican Representative Fred Upton, issued a press release which claims that:

April 15, 2014, only 67 percent of individuals and families that had selected a health plan in the federally facilitated marketplace had paid their first month’s premium and therefore completed the enrollment process. 

OK, let's unpeel this onion slowly, shall we?

First of all, the press release makes it very clear that the enrollment data which they're talking about includes all enrollments on the Federal exchange through April 15. Note the following wording (emphasis mine):

Rhode Island's ACA Medicaid expansion was at around 65K a couple of weeks ago, so this is a nice small bump:

Through April 19, 70,243 people had signed up for Medicaid under the Affordable Care Act rollout, according to state figures, with federal dollars paying for about two-thirds of those people and state and federal dollars roughly splitting the cost for the other third, because they were already eligible before Obamacare entered the picture.

There may be a few thousand more enrollments to come from Nevada, Colorado and so forth, but today, April 30, is about as definitive a date as we're gonna get for the wrap-up of the first Open Enrollment period under the Patient Protection and Affordable Care Act of 2010, otherwise known as the ACA or Obamacare.

With that in mind, the time has come for me to officially declare my intentions for this website going forward.

My Medicaid spreadsheet currently estimates Illinois at roughly 200K "strict expansion" and another 115K "woodworkers". This article suggests that the woodworker number may be too high, but the "strict expansion" number may be dramatically low:

For the first time, low-income adults without children are eligible for government health coverage.

 In Illinois, officials expect that'll mean 350,000 new people in Medicaid. And that's not all.

 Julie Hamos, director of the Department of Health Care and Family Services, says the news reports and advertising and community outreach around the Obamacare deadline led to a separate spike.

 "We have 80,000 more than the usual enrollment of people who already were eligible, they just didn't sign up. But because of that activity in the communities, now they're signing up."

One More final update from Minnesota...

Enrollment update, as of end of day on Tuesday, April 29:

  • 206,157 Total Enrollments
  • 112,834 Medical Assistance
  • 50,549 QHP
  • 42,774 Minnesota Care

 

SHOP: 731 * 1.8 = 1,316

The first article is mainly a breakdown of off-exchange QHP enrollments across various Blue Cross companies; normally this would be something of a jackpot for me, but since the BCBSA had already stated that they had over 1.7 million off-exchange enrollments not including March or April, these numbers don't really help out much. What I really need at this point are state-by-state off-exchange QHP numbers (ideally through at least the end of March), and I don't see those coming anytime soon.

HOWEVER, the article does also give an updated overview of where the "But how many have PAID???" situation stands...or at least, where it stood as of February 1st:

According to the Blue Cross and Blue Shield Association, between 80% and 85% of people who signed up for a Blues plan through a public exchange are paying their premiums. The percentage is based on a survey of member Blues plans as of Feb. 1. But individual Blues plans say that number is higher.

Hawaii's original CMS target was a piddly 9,000 exchange QHPs...believe it or not, they may just barely squeak over that line after all (although my own target for HI was 11,000, which they're almost certainly not gonna pull off...)

Total through April 26, 2014:

31,310 Applications completed in the Individual Marketplace
8,742 Individuals and families enrolled in the Individual Marketplace
576 Employers applied to SHOP Marketplace
628 Employees and dependents enrolled via SHOP Marketplace

Yes, yes, I know...the "official" open enrollment period "ended" on March 31st, and the "official" extension period ended on April 15th. However, there were a few exceptions to even that, including:

  • The 36 states run by HC.gov: If you submitted a paper application by 4/07, you have until today to complete your enrollment
  • Hawaii, DC and Oregon pushed out their official extension date until today
  • Other states such as CA, CO, CT, KY, MD, MA, MN, NY, RI, VT and WA have already shut down open enrollment, either on 3/31, 4/15 or 4/22

To my knowledge, after midnight tonight, that leaves only three states with any sort of options left:

  • Nevada has bumped their "started by 3/31" enrollment extension out until May 30.
  • Colorado is allowing people up until May 31st to complete their enrollments, but only if they applied for Medicaid but had their eligibility denied.
  • Massachusetts still has something like 270,000 people stuck in "Limbo Status" who may (?) have until June 30th to have their situations sorted out...not exactly sure what's going on with that, however.

Aside from that, the following exceptions hold true for every state:

Wow! I just updated this yesterday, but that number was from last week...(again, 36.3K of these were bulk-transfers already accounted for):

Healthy Michigan Plan Enrollment Statistics

Total Healthy Michigan Plan Beneficiaries: 158,654

*Statistics as of April 28, 2014 
*Updated every Monday at 3 p.m.

guest post by Esther Ferington

Recently, I've been puzzling over a question: what is all this "deadline creep" really telling us? Not just about the considerable burden it's placed on Charles Gaba in continuing this website, which is obviously no joke—but also about what's happening as the ACA rolls out. We've been watching deadline creep for at least a month now. And I think it's kind of a big deal.

Holy Cats. For a solidly Republican state which didn't expand Medicaid, Idaho has actually kicked some serious ass when it comes to ACA enrollments (then again, they're also one of only two states--New Mexico is the other one--which are planning on moving from HC.gov to their own state-run exchange next year, so perhaps it's not as surprising as all that). In any event, bravo to Idaho!

Dowd says the Congressional Budget Office wanted to have 40,000 Idahoans sign up through the exchange during the first six-month open-enrollment period. Your Health Idaho exceeded that target by more than 36,000 people.

...She doesn’t know how many of the 76,061 sign ups actually paid for their policies. She also doesn’t know how many of Idaho’s roughly 300,000 uninsured people signed up for a plan. She says finding out how many uninsured people sign up for coverage is a priority for Idaho and will be a question on the state’s portal during the next sign up period.

In addition to several states bumping their enrollment deadlines out until 4/30, and Nevada going even further by bumping theirs out to the end of May, Native Americans / SHOP / Medicaid not having any enrollment deadline at all and of course the "Qualifying Life Events" factor (marriages, divorces, births, adoptions, etc), it turns out there's Yet Another Group which has been given an extention by when they have to enroll in a QHP or Medicaid plan: Those in the ACA's temporary "High-Risk Pool", who were originally supposed to have enrolled by the end of 2013, then the end of April; they've now been given until the end of June to do so:

On Thursday, the Obama administration announced another special enrollment period to extend enrollment in the Affordable Care Act's insurance exchanges, this time for people enrolled in the Pre-Existing Condition Insurance Plan, The Hill's "Healthwatch" reports (Viebeck, "Healthwatch," The Hill, 4/24).

I know, I really shouldn't give an outfit like this the time of day much less any more exposure than they already have, but I can't help myself. There's an anti-ACA blog called "Uncover Obamacare" (not to be confused with "UnskewObamacare.com") which has "dug up" what they seem to feel is a real "James O'Keefe"-style "hidden camera" moment in the bowels of the Connect for Health Colorado administrative office:

Patty Fontneau, the Colorado Healthcare Exchange CEO, spoke at a hearing of a Colorado Legislative Review Committee yesterday, discussing the critical need to get young people to sign up for their state ObamaCare exchange. This is a problem that the White House and other states are facing as well. To make the math work for ObamaCare, young healthy people have to sign up to help pay for the old sick people. That’s been a tough challenge so far.

But don’t worry, Ms. Fontneau has a plan! A creepy, creepy plan: “The Three Ps.” Those three Ps are peer pressure, parental pressure and increased penalties. Because, that sounds like a good idea.

Remember all the fuss and bother that the GOP made about how no one would sign up for healthcare under the ACA for various reasons, ranging from the technical problems with the HC.gov website to the law making it "too easy" to get out of doing so (while simultaneously screaming about the mandate itself being "unconstitutional" even though the Supreme Court ruled that it isn't)?

Well, the former has obviously not been an issue from the enrollment side for months (at least on the Federal side).

As for the latter, guess what?

The government left the door wide open for millions of Americans to be excused from the Affordable Care Act’s requirement that most people must carry health insurance or pay a fine, but so far relatively few have asked for such a pardon.

About 77,000 families and individuals have requested exemptions from the health-care law’s so-called individual mandate, according to internal government documents obtained by The Washington Post. As of April 20, officials had approved tens of thousands of exemption requests and rejected none.

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