2018 MIDTERM ELECTION

Time: D H M S

Nice find out of South Dakota from contributor Maurice H.; SD was at 6,765 on 3/01. This represents only an 8% increase over February's rate in March so far, although I'm not sure how much "just over 8K" is or what date that number runs through (I'm assuming 3/20).

Just over 8,000 people have signed up for health care coverage in South Dakota.  Those signing up in the last week will also need to pay their first month's premium to get coverage. But those premiums may be lower than people expect. 

"In the state of South Dakota about 90 percent of the people purchasing insurance are getting subsidies from the federal government," Krystolpolski said.

Excellent news out of West Virginia: Medicaid expansion has increased yet again, from 87,000 to 98,000 residents. This is particularly impressive considering that the total number of people in WV who are eligible for Medicaid post-expansion is about 143,000, according to the Kaiser Family Foundation.

Doris Selko, Southern Regional coordinator for the West Virginians for Affordable Health Care, said over 98,000 residents had enrolled in the Medicaid expansion by March 15 and an estimated 105,000 are expected to be enrolled by the end of the month.

Selko said three southern counties — Nicholas, Summers and Wyoming — have all enrolled over 100 percent of the anticipated enrollment numbers, and Raleigh County has enrolled 99 percent.

(sigh) OK, at this point I guess there's no point in even continuing these "no sleep 'til..." posts.

First, out of Mississippi, of all states, comes this:

Tavenner’s involvement made a difference in other ways, too. Beginning this summer, Mississippi will have one of the nation’s few state-run small-business exchanges. Federal officials approved the request even though Chaney doesn’t have the support of Gov. Phil Bryant, a Republican who doesn’t want anything to do with the law. Bryant didn’t expand Medicaid and shunned creating a state insurance exchange, which he called a portal to a “massive and unaffordable” new federal entitlement.

In addition to the 15 state-run exchange SHOP programs (only 12 of which are actually operational right now), Utah and New Mexico are actually running their own SHOP exchanges; this means that Mississippi will join them.

The number is given in a negative context, but NM is up to 18,691 from 15,012 as of March 1st...263/day, up nearly 2.2x from February's 121/day:

As of March 15, 18,691 New Mexico residents had enrolled in the exchange, Ezekiel said. After already adjusting enrollment expectations for 2014 downward from 83,000 to 50,000 because of problems with the federalhealthcare.gov portal, the state is struggling to reach its target.

Nice find by deaconblues: OH Sen. Sherrod Brown was pushing people to enroll at an event on Thursday. His office had a press release posted on the site on the same day, so I presume that the 97K figure was as of Wednesday at the latest.

More than 5 million Americans, 97,000 in Ohio, have entered the health insurance marketplace, but more than 115,000 Ohioans are eligible to enroll with financial assistance.

This gives Ohio a daily QHP average of 1,004 in March, up 50% over the February rate of 672.

Really just a clarification from yesterday more than anything; up from 35,475 to 35,610 (up 135) and from 94,329 to 95,867 (up 1,538).

To date, MNsure has enrolled 35,610 in a Qualified Health Plan, 26,297 in MinnesotaCare and 69,570 in Medical Assistance.

This just in...KY was at 60,837 QHPs as of 3/13, so this is an increase of 3,618 in 7 days. Medicaid is up to 257,477 from 239,453, an increase of 18,024.

As of 6:00 p.m. on Thursday 3/20/2014

321,932: Kentuckians are enrolled in new health coverage, including Medicaid and private insurance

257,477 have qualified for Medicaid coverage and 64,455 have purchased private insurance.

But wait, there's more (from the Kynect Facebook Page):

More than 321,000 Kentuckians are now enrolled in new healthcare coverage through kynect, and that number is expected to keep growing in the final 10 days of open enrollment. A preliminary analysis has found that approximately 75 percent of all enrollees report that they did not have insurance before signing up for healthcare coverage through kynect.

...and then there were eight...

A spokesman for the insurance exchange, Ben Davis, said Colorado already has enrolled enough people to make the Connect For Health Colorado exchange sustainable.

Some states have extended open enrollment deadlines because of glitches in their exchanges. Davis said Colorado won't extend the deadline but will give credit to those who attempted to enroll by the end of the month.

This is also a perfect opportunity to work in a special Guest Post by contributor Esther Ferington, who gives a nice roundup of just what will happen to the ACA Enrollment situation after March 31st:


What Happens after March 31st?
Guest Post by Esther Ferington

For some reason Maryland's thru-dates are different for QHPs and Medicaid; not sure why. Anyway, they're up to 44,836 QHPs (up over 4,100 from 40,693 on 3/08) and Medicaid enrollments are up to 107,505 from 97,781 on 3/11 (up 9,700).

From October 1, 2013, through March 15, 2014, there have been more than a million unique visitors to the Maryland Health Connection website. 197,818 Marylanders have created identity- verified accounts. Through March 15, 44,836 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

As of March 18, 203,394 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage.

On the March Surge side, Maryland is ramping up from 116% of their February rate the first week of March to 150% when you include the second week.

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:

I just posted a lonnnnnng explanation the details of the "But how many have PAID???" situation. It gets kind of deep into the weeds, so I'll stop now, but I do just want to simplify things with a shorter, separate post:

Let's be clear about this: SOME of the people who haven't paid ARE going to prove to be deadbeats. That's inevitable in any industry that serves millions of people, just as shoplifting is a real problem that retailers have to deal with (and as I noted earlier, what was the insurance industry norm for cancelled/unpaid premiums prior to the ACA? Probably fairly low, but how low? 1%? 2%?).

The problem is that the "But how many have PAID???" attack seems to be based on the premise that ALL of the non-payments are deadbeats (or, alternately, that they're ALL due to exchange technical problems).

Here's the thing, though: There's 5 reasons I can think of why the first premium might not be paid yet:

Not exactly a huge spike, but a person covered is a person covered...

As of March 18, 524 people had enrolled in health plans through the New Mexico small business, or SHOP exchange, according to figures from NMHIX. That includes 345 employees and 179 dependents.

In response to my Paid/Unpaid Brouhaha update last night, a commentor brought this story out of BizTimes.com to my attention, which in turn links to this memo (PDF) from the Wisconsin Insurance Commissioners Office.

In the middle of it we find this (partial) paid/unpaid data, which indeed only applies to January and February start-dates:

4. How many consumers have enrolled in coverage through the federal exchange? How many consumers have paid their premium?

(Reposted with updated numbers and additional info given that NewsBusters has decided to launch a hit piece on me using the "But how many have PAID???" attack point)

I've written about the "But How Many Have PAID???" issue many times before, but going into the final stretch, I wanted to explain my reasoning as clearly as possible.

The following chart only includes states which have broken out Paid vs. Unpaid Enrollments. If you only use these 10 states as a guideline, it looks like the paid rate is around 85%:

NOTE: This represents the Paid vs. Unpaid enrollments out of all enrollments reported to the HHS as of the Thru Date listed.

Massachusetts doesn't report unpaid enrollments at all, and Washington lists unpaid enrollments separately in their press releases but does not included them in HHS report data. As a result, both states are actually at 100% paid (in terms of the numbers in the HHS reports, which is what we're talking about here).

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).

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