California

I've confirmed that Rhode Island's weather-induced enrollment extension is indeed state-wide and is of the "full" variety (ie, people can start the application process, not just finish it), through February 23rd. This is exactly the same policy that the Massachusetts exchange announced the other day.

Also, a late-breaking extension announced from Maryland.

11:45pm: OK, add the DC exchange to the pile.

9:00am 2/16/15: OK, HHS/CMS has clarified the specifics for the 37 Healthcare.Gov states.

11:50am 2/16/15: Idaho's policy took some work to decipher...

2:24pm 2/16/15: ...and Minnesota...

This just in...

Obamacare: @CoveredCA says enrollment hits 1.36M ahead of Sunday deadline. More than 25K signed up Friday #ACA

— Chad Terhune (@chadterhune) February 14, 2015

OK, CoveredCA had hit 1.314M as of Wednesday, and added about 46,000 more on Thursday & Friday (21K & 25K respectively) to reach 1.36 million as of last night.

That means they'd have to enroll a whopping 340K today and tomorrow, or 170K each day, to reach their 1.7M target. To reach my own just-lowered target of 1.6 million, they'd have to enroll 120K/day, which might be feasible.

Of course, with the extra 5 day "waiting in line" extension, they might be able to pull off one or the other.

Two late-breaking news items, one negative, the other potentially positive:

Arkansas: The good news a few weeks ago was that newly-elected Republican Governor Asa Hutchinson did not kill off AR's unique "private option" Medicaid expansion program as many had feared; instead, he actually proposed extending it pretty much as is for another 2 years, to the relief of decent folks, and the state legislature seemed to be OK with that (another surprise).

The bad news today is that, while the program looks safe for 2 more years...the same legislation kills the program after the 2 years are up:

LITTLE ROCK, Ark. (Reuters) - Governor Asa Hutchinson of Arkansas has signed legislation that will end by 2017 the state’s innovative but controversial adaptation of the Affordable Care Act, which has provided nearly 190,000 residents with health coverage.

Here we go...from a Final Days to Enroll press release from Covered California:

Since open enrollment began on Nov. 15, more than 354,000 people have selected a plan, including 13,000 people on Tuesday — the second-highest single day of enrollment after the rush to meet the deadline on Dec. 15 to have coverage start on Jan. 1. They join the 944,000 consumers who signed up for coverage for 2014 and began the process of renewing their coverage for 2015.

Let's see how California has ramped up the past week or two:

*I'm not sure whether the "13K on Tuesday" means that Wednesday isn't included or not.

UPDATE: I've already confirmed that this number does not include Wednesday, which is important at this stage of the game.

As of January 26th, California's 2015 QHP selection total was at least 1.217 million people. I say "at least" because the actual renewal number is a bit fuzzy (it's either 944K or 947K depending on whether you go by the CoveredCA or HHS/ASPE report). Anyway, today they issued a press release which at least updates the new enrollee number...if you do the math:

(etc etc...too long to post the whole list)

Add them all up and you get 288,568 new enrollees for 2015. Add those to the 944K (minimum) renewals from 2014 and you get 1,232,568 or more through Feb. 2nd.

Since the prior number was 1,217,111 as of 1/26, that's an average of around 2,200/day over the course of the slowest patch of the enrollment period.

CoveredCA issued this press release yesterday. Normally I would've pounced all over it, but the major data point (944K QHP renewals) was already included in Tuesday's big monthly ASPE report anyway (although that had the renewals being 3K higher...)

However, I just realized that they also threw in a new QHP enrollee update:

In addition, Lee reported Wednesday that as of Jan. 26, 273,111 consumers had picked a plan during open enrollment. 

Add that to the 944K renewals and you have a grand total of 1,217,111 through 1/26.

That's an increase of 44,345 since January 12, or 3,167/day. Of course, this also includes the January 15th deadline, so it doesn't tell me much about the next week or so. For that, I'd have to look at the increase since 1/18 (1,200,427), which is just 16,684, or 2,085/day.

I've had a couple of days to shake off the funk I was in after CoveredCA director Peter Lee stated that they would not be releasing any 2014 renewal data until as late as February. I'm still pretty grumpy about that.

Still, today brings some cheerier news: The CoveredCA BoD had a meeting, including this slideshow which includes a bunch of data stuff. No, it doesn't have any renewal data...but take a look at page 4:

2015 OPEN ENROLLMENT

Through January 12: 228,766 New Individuals Selected a Qualified Health Plan for 2015

Big deal, right? It updates the new enrollment figure a bit, but that's about it. But wait a minute...what was the CA QHP total just 1 day earlier (through January 11th)?

217,146 NEW QHPs total

Ouch. I was expecting CoveredCA to announce somewhere in the neighborhood of 314K new QHPs for 2015 through Sunday night (the 144K already announced, plus another 170K since 12/15). Instead, the total turned out to be just 217,146. I was way off on this figure, and I'm willing to accept that. In fact, in retrospect, I must've miscalculated something, since the odds of enrolling more new people in the 28 days following the January coverage deadline (which also included the "dead zones" of Christmas Eve, Christmas Day, New Year's Eve and New Year's Day) than the 31 days before that deadline were almost nil.

What I don't find acceptable is that Peter Lee, after promising to release renewal data "in January" is now saying that they may not do so until February.

As I noted the other day, CoveredCA will be releasing (hopefully) completely updated ACA enrollment data, right up through Sunday night (1/11) in about a half an hour. So far they've only said that 144K new QHP enrollees have been added, and even that only includes 11/15 - 12/15. They haven't released any data on renewals of the 1.12 million 2014 enrollees yet, nor have they issued any further updates on new additions since Dec. 15th, 4 full weeks ago.

I've noted several times that I'm expecting them to announce roughly 960K renewals (active + automatic) from California, or around 85% of current enrollees to be renewed/re-enrolled. If that proves accurate, that would bring their 12/15 total up to around 1.1 million. That just leaves the new enrollments since 12/15.

Obviously the real unknown here is the renewal/autorenewal number. If it's fairly close to 85%, I should be pretty close on my total.

As I noted Saturday, CoveredCA is supposedly going to finally release their full, updated ACA enrollment data between now and Wednesday. So far they've only said that 144K new QHP enrollees have been added, and even that only includes 11/15 - 12/15. They haven't released any data on renewals of the 1.12 million 2014 enrollees yet, nor have they issued any further updates on new additions since Dec. 15th, 4 full weeks ago.

I've noted several times that I'm expecting them to announce roughly 960K renewals (active + automatic) from California, or around 85% of current enrollees to be renewed/re-enrolled. If that proves accurate, that would bring their 12/15 total up to around 1.1 million.

This article pretty mostly is a more in-depth explanation of the Medicaid/Medi-Cal situation in California that I wrote about the other day. However, the final line in the article also addresses my other post from a couple of days ago, asking when the heck CA and NY are going to release updated enrollment data (including renewals from 2014, which should account for around 960K in CA alone):

Medi-Cal Ranks Grow by Nearly 500K

...New enrollment numbers from Covered California for the rest of December will be released next week, exchange officials said, before the exchange board meets Jan. 15.

Woo-hoo! Today is the 10th, tomorrow is Sunday, so they should be coming out with fully-updated (I hope) data from the largest state in the country sometime between Monday & Wednesday.

Stay tuned...

LA Times reporter Chris Megerian has posted an important story about California's looming healthcare budget crisis. It mostly deals with the headaches facing the state budget as it tackles major increases in both Medi-Cal (CA's name for Medicaid) and the cost of caring for public employee retirees, and is a good read for healthcare/budget wonks.

What caught my eye, however, was this line about halfway through:

Over the next year, total Medi-Cal enrollment is expected to reach 12.2 million, he said — about one-third of the state's population. It was less than 8 million in 2013.

Hmmm...that sounds a bit high to me, so I ran the numbers against my own current estimates and came up with the following:

Yesterday I publicly declared that total QHP selections nationally had reached the 9 million milestone. I based this on 4 data points:

  • The 6.59 million confirmed by the HHS Dept. for the 37 states run through HC.gov,
  • The 980K confirmed by the 14 assorted state-run exchanges,
  • The unreported renewals (both active and automatic) from California & New York, and
  • Another roughly 150,000 scattered amongst all 50 states & DC since the date of their most recent updates until today (which varies from as little as 1 day to as much as 25 days in the case of Idaho).

If you do the math, you'll see that the biggest missing piece here is the 3rd item above: Covered California and New York State of Health have, to date, still refused to give out any re-enrollment/renewal data for 2014 QHP enrollees. Not just autorenewal numbers, but active renewals as well.

THIS JUST IN...

As CoveredCA has noted before, they have no plans on posting renewed policy enrollments until January, but this at least gives data on the new additions:

COVERED CALIFORNIA AND DEPARTMENT OF HEALTH CARE SERVICES RELEASE EARLY RESULTS FOR FIRST MONTH OF OPEN ENROLLMENT THROUGH HEALTH INSURANCE EXCHANGE

Demand for Coverage Continues to Be Strong, with Applications Submitted for More Than 592,000 People Through Dec. 15

SACRAMENTO, Calif. — More than 592,000 people sought coverage and were determined eligible for private health insurance and eligible or likely eligible for Medi-Cal in the first month of open enrollment, Covered California and the California Department of Health Care Services announced Wednesday.

The consumers, who applied for coverage through Covered California since open enrollment began on Nov. 15, include 157,361 eligibility determinations and an additional 144,178 plan selections for private coverage, as well as 216,423 enrollments into Medi-Cal coverage and 74,965 who are likely eligible for Medi-Cal. So far in 2014, Medi-Cal has enrolled more than 2.2 million consumers.

As you can see from the graphic I posted yesterday (and had to revise several times throughout the day), the official enrollment deadline for private policies starting on January 1st, 2015 has now passed for all 37 states operating via HealthCare.Gov, as well as residents of DC, Hawaii and Kentucky. It's certainly possible that any or all of these will announce some sort of "special circumstances" allowance for those who didn't make the midnight cut-off (10pm in Alaska), but I'm assuming those would be done strictly on a case-by-case basis.

OK, so what about the remaining 11 states?

Well, 4 of them (MD, MA, RI & WA) had later deadlines for January coverage all along: Maryland on 12/18 (Thursday) and the other 3 on 12/23 (next Tuesday).

New York and Idaho bumped their deadlines out from yesterday until 12/20 (Saturday), although Idaho had previously claimed that their deadline was 12/23, but are now claiming that it was originally 12/15. I still don't understand what happened there, but so be it: 12/20 it is for ID.

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