2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Week 2 via CMS:

Week 2, Nov 4-10, 2018

In week two of the 2019 Open Enrollment, 804,556 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. Consequently, the cumulative totals reported in this snapshot reflect one fewer day than last year.

Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchanges and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.

The final number of plan selections associated with enrollment activity during a reporting period may change due to plan modifications or cancellations. In addition, the weekly snapshot only reports new plan selections and active plan renewals and does not report the number of consumers who have paid premiums to effectuate their enrollment.

This Just In via MNsure, Minnesota's ACA exchange...

More than 97,000 Minnesotans have signed up for private health plans through MNsure since the start of open enrollment
Open enrollment runs until January 13, 2019

ST. PAUL, Minn.—Today MNsure announced that over 97,000 Minnesotans have signed up for private health plan coverage through MNsure during the first two weeks of open enrollment.

MNsure's open enrollment runs until January 13, 2019. For coverage that begins January 1, 2019, Minnesotans must enroll by December 15, 2018.

“We are excited with our smooth start to open enrollment and that over 97,000 Minnesotans have signed up for private health plans,” said CEO Nate Clark. “With rates decreasing from 7 to 27 percent across the state, we encourage Minnesotans to visit MNsure.org to see if they can save.”

BY THE NUMBERS—

Over at Bloomberg News, Aziza Kasumov has written up what is, for the most part, an excellent profile of a middle-class family who crystalize the single biggest real flaw in the design of the Affordable Care Act (as opposed to the bullshit ones made up by opponents over the years): Those enrolled in individual market policies who earn more than 400% of the Federal Poverty Level (around $48,000/year for an individual, or $98,000 for a family of four):

David and Maribel Maldonado seem the very definition of making it in America. David arrived in the U.S. from Mexico as a small child...His wife Maribel, whose family is also from Mexico, worked as a hairstylist while caring for the couple’s two children. David’s annual salary reached about $113,000 by the time the children were in their teens. It was more than enough to live in a pretty suburban house outside Dallas, take family vacations, go to restaurants and splurge at the nearby mall. And to afford health insurance.

The bold-faced bit above has some relevance later in the story.

With the 2018 Midterm Elections mostly out of the way (there's still at least 7 statewide races which haven't been called yet in Georgia, Florida and Arizona which are currently in the process of various counts, recounts and/or run-off elections), the Democratic Party has indeed retaken the U.S. House of Reprentatives by a solid margin, adding anywhere from 33 - 40 House seats when they only needed a net gain of 23 to take control. Starting in January, the House Democrats will be able to vote on and pass pretty much whatever bills they want, presumably under the leadership of Nancy Pelosi as Speaker of the House.

Last year, the Washington Health Benefit Exchange reported enrolling roughly 4,500 new ACA exchange enrollees in the first 8 days, which was a whopping 53% increase over 2017. This was in addition to what I estimated was roughly 13,000 current enrollees actively renewing their existing policies or switching to a different one, for a total of perhaps 17,500 QHP selections.

This year, the WA exchange hasn't posted any official press release yet, but the Seattle Times claims that they've already enrolled over 190,000 people:

Despite changes to the Affordable Care Act during the past couple of years, local health-insurance officials are optimistic that the state’s health-insurance exchange will flourish in 2019.

Since enrollment for 2019 began Nov. 1, about 190,000 people have signed up for health insurance through the Washington Health Benefit Exchange, which is about 5 percent more than the same period last year.

Press Release: NY State of Health Drives Home the Importance of Affordable Health Coverage with Ridesharing Partnerships
Nov 9, 2018

Collaborations with Lyft, Uber, Independent Drivers Guild Reach Drivers Across NYS 

ALBANY, NY (November 9, 2018) – NY State of Health, the state’s official health plan Marketplace, today announced it is partnering again during the Open Enrollment Period with ridesharing companies Lyft and Uber, and with the Independent Drivers Guild. Through the partnership, tens of thousands of drivers throughout New York State will be urged to visit the Marketplace to shop for and enroll in quality, affordable health insurance. Open Enrollment for 2019 coverage began November 1. Consumers must enroll by December 15, 2018 for coverage beginning January 1, 2019.

MNsure, Minnesota's ACA exchange, posted a Week One enrollment update yesterday, and while it's generally positive, there's not much in the way of the key data I'm always seeking:

MNsure Update on First Week of Open Enrollment
November 8, 2018

ST. PAUL, Minn.—MNsure CEO, Nate Clark, issued the following statement recapping the first full week of open enrollment:

“This year’s open enrollment continues to go smoothly with consistently low wait times throughout the first week. With lower rates across the state, we have seen a steady stream of Minnesotans signing up for health coverage. We encourage Minnesotans to visit MNsure.org to see if they are eligible for exclusive tax credits that could lower their monthly premiums.”

This year to date, MNsure has renewed more people into coverage than ever before. Open enrollment figures will be released next Wednesday (11/14) at MNsure’s public board meeting at 1 p.m.

By the numbers 
As of end of day, November 7 

FULL DISCLOSURE: HealthSherpa has a paid banner ad at the top of ACASignups.net.

A year ago, I posted the following about HealthSherpa:

Here's the Wikipedia entry for HealthSherpa:

HealthSherpa is a California-based technology company focused on connecting individuals with health coverage. The site was initially developed as an alternative to research plans from Healthcare.gov, and now provides individual health, dental and vision benefits to both part-time employees and retirees. As of February 2017, over 800,000 people have been enrolled in individual health coverage through HealthSherpa.

First, I want to clarify that I'm not shilling for HealthSherpa here. They aren't paying me for this post. I have no idea whether their customer service is awesome or sucks or anything like that.

About a year ago I did a little back-of-the-envelope number crunching regarding the insanely stupid way in which the Affordable Care Act handles the Hyde Amendment.

In U.S. politics, the Hyde Amendment is a legislative provision barring the use of federal funds to pay for abortion except to save the life of the woman, or if the pregnancy arises from incest or rape. Legislation, including the Hyde Amendment, generally restricts the use of funds allocated for the Department of Health and Human Services and consequently has significant effects involving Medicaid recipients. Medicaid currently serves approximately 6.5 million women in the United States, including 1 in 5 women of reproductive age (women aged 15–44).

One of the biggest stories playing out nationally in the aftermath of the 2018 election is the Georgia gubernatorial election saga, in which corrupt-as-hell Republican Secretary of State Brian Kemp currently holds a narrow lead (50.3% vs. 48.7%) over former Democratic minority leader of the Georgia House of Representatives Stacey Abrams.

Under Georgia law, if no candidate ends up with more than 50% of the total vote, the top two candidates move on to a run-off election, so if Kemp's lead ends up dropping by around 13,000 more votes as the thousands of remaining ballots are counted, it's on to a run-off between the two.

Covered California, the largest state-based ACA exchange for the largest state in the country, actually launched their 2019 ACA Open Enrollment Period over three weeks ago, on October 15th.

They still haven't posted any 2019 enrollment numbers, which I find rather irritating, but they did just send out the following press release regarding a promotional bus tour they're doing which highlights a couple of interesting data points:

Covered California Launches Iconic Bus Tour to Promote Enrollment and Show How “Life Can Change in an Instant”

As I noted a few days ago, now that the 2019 ACA Open Enrollment Period is actually underway and the approved individual market premium rate changes have been posted publicly for every state, I'm finally able to go back and wrap up my 2019 Rate Hike Project for the nine states which I was still missing final numbers for.

As I further noted, the approved rates in most of those states didn't change much compared to the preliminary/requested rate changes I had already analyzed earlier this year:

*(for comparable days...see below)

In past years, this blog post would be a pretty big deal for me, given that it's all about the very core of this website: ACA Signups. As both enrollees, carriers, analysts and reporters have gradually become more used to the annual Open Enrollment Periods, however, these Weekly Snapshots, while still extremely useful, have become somewhat mundane.

"Weeks" are measured from Sunday - Saturday regardless of what day November 1st falls on, thus the partial week being tallied. Last year, HealthCare.Gov enrolled over 601,462 people in the first four days of Open Enrollment, with 464,140 current enrollees manually renewing their policies and 137,322 new enrollees signing up. How about this year? Here's the official report from CMS:

OK, it's 3:00 in the morning, and I've been running around either canvassing, phone banking, attending various election night events or simply watching/tweeting about the results as they came in from around the country as well as here at home, so forgive me if this is kind of disjointed and scattershot. I'll have more coherent thoughts in the coming days...after I've gotten some sleep and recouperated.

Michigan:

  • With Gretchen Whitmer winning as Governor, ACA Medicaid expansion is mostly safe for the next four years. Unfortunately, it looks like the Dems will come up short in both the state House and Senate (though they made impressive gains in each), which probably means a stalemate on the issue.
  • The net effect will likely be that the just-passed work requirement law will end up going into effect after all starting January 1, 2020, which will almost certainly lead to tens of thousands of Michiganders losing coverage anyway, unless Whitmer is somehow able to convince a still-GOP controlled state legislature to modify the law back to where it stands today.

I realize this may seem a bit late in the game seeing how the 2019 ACA Open Enrollment Period has already started, but I do like to be as complete and thorough as possible, and there were still 9 states missing final/approved premium rate change analyses as of yesterday which I wanted to check off my 2019 Rate Hike Project list.

Fortunately, RateReview.HealthCare.Gov has finally updated their database to include the approved rate changes for every state, which made it easy to take care of most of these.

Nebraska has a slightly confusing siutation, which is surprising since Medica is the only carrier offering ACA policies in the state, When I first took a look at the requested premium changes for 2019 back in August, it looked like the average was around 1.0%...that was based on splitting the difference between the 3.69% and -2.60% listings, since the filing form was redacted and I didn't know what the relative market split was between Medica's product lines.

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