Charles Gaba's blog

2018 MIDTERM ELECTION

Time: D H M S

Vermont's method of enrolling people has always confused me.

There are 36,846 Vermonters who have enrolled in health coverage, 33,549 who were automatically transitioned to Medicaid and 30,000 to 40,000 in the small-group market who were enrolled directly by the insurance carriers participating in the exchange.

A second article, from the Burlington Free Press, confuses things because it says the 36.8K are households, representing 50.4K people:

a state official reported to lawmakers Tuesday that 36,846 households had signed up for 2014 plans....

Larson’s presentation Tuesday showed that 50,475 individuals applied for coverage using Vermont Health Connect between Oct. 1 and March 17. A significant number of these applicants, 20,312, found they qualified for Medicaid, which has expanded eligibility this year.

At long last, the 'Bagger Brigade seems to have discovered this website (I'm surprised it took them this long). I have a special welcome message just for them.

(I should note that "bagger" refers to any Nutbag, not just the Tea-bearing kind.)

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.

Now that we're hitting crunch time and I'm getting some national TV buzz (well, The Graph is, anyway), people have started asking me what the best comparison to use for The Surge should be. There are three examples which come to mind for obvious reasons...and while all three are indeed very similar to the current situation in many ways, they're also very different.


Massachusetts/Romneycare, 2006: The irony of having the very guy who ran against President Obama on his signature healthcare law happening to be the same guy who implemented essentially the same law in his own state as Governor in the first place aside, there were a lot of similarities between the 2006 Massachusetts healthcare law and the Affordable Care Act. This article from last fall does a good job of going over the main ways that the two are similar...and how they're different. In short:

An interesting, if somewhat disappointing update from Washington State this evening. Paid QHPs are up 3,204 from 3/06 - 3/13 to 112,225, but this still leaves WA at 63% of their February rate for March so far (granted this is better than the 54% they were at through last week).

More interestingly, the number of unpaid enrollments has dropped from 82,060 down to 71,787...a reduction of 10,273 people.

What this means is that even if all 3,200 of the paid enrollees are "conversions" (enrollees actually paying for their policies), that still leaves over 7,000 people who are apparently being, as deaconblues put it, "purged" from the list. I'm guessing that these are mostly people from last fall or early this winter who let their final payment deadline expire without paying.

An unexpected QHP update from Mississippi: 28,500 QHPs "last week". This was posted on Monday afternoon, so I'll assume "Last Week" ran through...Saturday?

Mississippi Marketplace enrollment surpassed 28,500 last week. #14DaysLeft #GetCovered #ACASurge

— Cover Mississippi (@CoverMS) March 17, 2014

Mississippi started March with 25,554 as of 3/01, so this means they went up 2,946 in about 14 days (3/01 - 3/15), or 210/day. However, this is actually a 28% drop from February's 293/day. So far, out of 15 states which have provided March data, 10 are showing daily average increases from 116% to 295%, 1 is holding steady (Rhode Island) and 4 are showing a slowdown...but the overall increase over February is 176% as of today.

The Private QHP side is just a confirmation of the 100K update from this morning with an exact figure (100,112), but this also provides the updated Medicaid total as well (151,050):

Another non-official update from Minnesota; no QHP/Medicaid breakout, but based on the 28/72 ratio to date, I'll assum the 4,350 or so new additions since 3/12 break out around 1,220 / 3,130, for totals of 34,942 QHPs and 90,062 Medicaid respectively.

If I'm correct about the split, that means that like most of the other states so far, Minnesota's daily average has ramped up to 50% higher than February's in March so far.

In addition to the increased enrollment opportunities, MNsure also announced today more than 125,000 Minnesotans have enrolled in quality, affordable coverage through the state’s health insurance marketplace. MNsure aims to enroll 135,000 by the March 31 deadline.

Ka-pow! This is the other big state exchange number I've been looking for this week (after California, of course). The New York State of Health exchange hasn't put out an official press release yet, but within the past hour they quietly updated the home page of their website with the new total enrollment number: 666,397.

Lame "Mark of the Devil" jokes aside, this represents a nearly 13% increase over just 8 days ago.

The overall story out of Hawaii is pretty ugly, but the QHP number is actually good news, given what a mess HI's exchange has been: QHP enrollments are up from 4,969 as of 3/08 to 5,400 as of yesterday, an increase of 431. While this isn't exactly worth cheering about, it does raise Hawaii's daily average up from 37/day in February to 46/day in March...a 24% increase.

Tom Matsuda, the interim executive director of the Hawaii Health Connector, told lawmakers at a Senate hearing Monday that the nonprofit is woefully behind its projections of individual enrollment, with only about 5,400 people fully through the process of buying coverage. While that number doesn't count those still in "a backup in the system," Matsuda said, it's far behind the projected pace of 50,000 enrollees through 2014 it would have needed to break even.

The other day I noted that I've made little progress on the Off-Exchange QHP Enrollment Project. Not only have few people volunteered to help (though I do appreciate those who have), hunting down the data itself has proven harder than bullseyeing Womp Rats.

Case in point: Aside from my success with Washington State (I don't deserve any credit--they voluntarily published their data in a press release that I stumbled across), I've contacted 24 state Insurance Commission offices so far (Alabama - Mississippi). Out of those 24, here's the responses:

Yesterday was a pretty big day here at ACASignups--not only did the site get the 2nd most traffic to date (the busiest day was Feb. 13, when the January HHS report came out), but my Twitter feed went a bit nuts as my double prediction of California hitting 1M QHPs and HHS announcing 5M QHPs nationally gained attention; I think I picked up more new Twitter followers yesterday than any day since Sarah Kliff featured The Graph back on December 26th.

Whoa. Not an official update, but Colorado already had 93K QHPs as of Thursday the 13th; they're now at over 100K as of yesterday (the 17th). that's 1,750/day for the past 4 days, or 1,033/day in March so far. It doesn't specify QHPs vs. Medicaid, but CO was already at 135K Medicaid as of 3/01, so yes, these should all be private QHPs.

For comparison, Colorado was at 536/day in February, so CO in March is nearly double the February rate.

More than 100,000 Coloradans purchased health insurance through Connect for Health Colorado. 14 days left to enroll! http://t.co/jXVrGTnHQ0

— C4HCO (@C4HCO) March 18, 2014

It took Ohio awhile to get on board with the Medicaid expansion train, but once it did, enrollments really started to take off; it's more than doubled since 2/20, from 23K to over 54K:

COLUMBUS, Ohio (AP) - More than 54,000 Ohioans have enrolled in Medicaid under an expansion of the taxpayer-funded program.

Gov. John Kasich's administration moved forward last fall with extending Medicaid eligibility to cover thousands more people under the federal health care law. Coverage took effect Jan. 1.

The state's monthly report on Medicaid caseloads shows that 54,031 residents have gained coverage under its extension as of February. That's about 15 percent of the roughly 366,000 people who the state projected would be newly eligible by the end of June 2015.

Now that the Arkansas legislature has finally agreed not to screw over tens of thousands of their own citizens, a few thousand more people have enrolled in their unusual "Private Medicaid Option" (their version of "Expansion", which appears to basically be effectively the same as an entry-level QHP enrollee who receives a 100% tax credit...I think). Anyway, the Private Medicaid Option is up to about 98K plus an additional 13.4K added to "regular" Medicaid; this is up from 94,000 and 11,500 a few weeks ago, for a total increase of 5,844 altogether.

DHS said Wednesday that 207,967 people have applied for the private option and that 137,809 have been found eligible. Of those, 97,934 have completed the process of enrolling in private plans and 13,410 have been determined to be better served by traditional Medicaid.

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