2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Idaho

I'm expecting final official #OE2 enrollment reports from Massachusetts and Minnesota later today, but otherwise have to catch up on a bunch of my actual day job work. Here's three quick things to note:

MARYLAND: The Maryland Health Connection has released a big slideshow PDF with a mountain of demographic info. The only gripe I have is that it only runs through 2/15, so doesn't include the extra folks who signed up during the #ACAOvertime period. Data nerds, rejoice!!

Over the past 2 days, enrollment data updates were released through at least the official February 15th deadline by DC, Vermont, Colorado, Massachusetts and Kentucky (Massachusetts and Rhode Island's new full deadline is now 2/23). In addition, Connecticut released a partial update which ran through Friday the 13th (not including the final surge weekend).

That means that aside from the 2 days in Connecticut, there's only 1 state which is missing significant enrollment data prior to the 2/15 deadline: Idaho. Idaho hasn't issued a full enrollment update report since January 13th, and their QHP tally hasn't been updated since the 2nd monthly ASPE report on January 27th, which brought their data up through January 17th (90,567 QHP selections).

Yesterday I poked fun at many of the ACA exchanges for issuing vaguely-worded, non-specific statements about "making sure that everyone who tried" to enroll by midnight would be assisted, without any particular deadlines being given or other specifics.

Since then, most of the exchanges which hadn't done so already have clarified the extension policies--hard end dates, what the procedure is and so on.

And then there's Your Health Idaho, which features this on their home page:

I checked the most recent entry on their Twitter feed...

You’re close to missing out on health coverage for 2015! Today is the final day to enroll in a YHI plan. Don’t wait! pic.twitter.com/HAn8qeERqs

OK, this is a pleasant surprise: Your Health Idaho has issued their 2nd enrollment report, and it's pretty darned good:

BOISE, Idaho – In the first two months of open enrollment, Your Health Idaho processed 83,383 customers, which includes consumers renewing coverage for 2015 and new applicants.

“Having health insurance gives Idahoans peace of mind that if something horrible should happen they are covered” said Your Health Idaho executive director, Pat Kelly. “We are happy so many Idahoans have been able to find a health insurance plan that meets their needs, however, we know many more people still need to find coverage and we will continue to reach out to them until open enrollment ends on February 15.”

ID had 74,689 enrollees as of December 14th (including autorenewals). They bumped out their January deadline a bit, but that's still a pretty good baseline for the post-deadline numbers: 8,694 between 12/15 - 12/31, or 511 per day.

They also include some demographic data for the 83.4K QHPs:

A quick reminder: If you live in Idaho or New York, today is the deadline to enroll in a private healthcare policy if you want coverage starting on January 1st, 2015.

Here's the upcoming deadlines for January coverage for other states:

Massachusetts, Rhode Island & Washington State: Tuesday, December 23rd

Minnesota & Vermont: Wednesday, December 31st

If you live in any other state, you have until January 15th to enroll for coverage starting on February 1st.

This is important for a couple of reasons: First, it's the first enrollment update of any sort we've heard from Idaho (which was, until tonight, the only exchange I didn't have any info on). Secondly, it's important because Idaho is the only state which moved off of Healthcare.Gov onto their own exchange. Finally, the number is absolutely fantastic, especially considering that it doesn't include Monday:

BOISE, Idaho – During the first month of open enrollment, Your Health Idaho processed 74,689 enrollments, which includes new applicants and those renewing coverage for 2015.  The numbers released by Your Health Idaho at its Tuesday board meeting include enrollments processed from November 15 through December 14.

For comparison, last year Idaho enrolled 76,000 people for the entire enrollment period.

That's right: They managed to essentially equal 6 1/2 months worth of private policy enrollments in just 1 month...and that doesn't include the surge from yesterday (or for the following 5 days, since ID's deadline isn't until the 20th).

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.

OK, this is a bit...um...confusing.

Back on October 1st, Your Health Idaho posted the following blog entry launching their "window shopping" tool for 2015 private policies, which also included very specific deadlines for both selecting a plan as well as paying the first premium for January 1st coverage:

BOISE, Idaho – As the December 23 deadline for health coverage to begin on January 1 is days away, Your Health Idaho and insurance companies selling plans on Your Health Idaho are taking several steps to provide consumers with a smooth transition to coverage.

There's been a lot of fuss made about 2015 ACA exchange premium rates not being available at Healthcare.Gov until after the election. The presumption, of course, is that this is being done for political reasons. While this may be true, it could also simply be that there's a lot of different policy figures to plug into the federal system, and some states haven't even finalized their rates yet.

That being said, residents of some states can check out the 2015 premiums now and compare them against their current premium:

IDAHO: Idaho is the only state moving from HC.gov to their own exchange. Idaho residents can check out their 2015 rates directly via the state exchange site.

CALIFORNIA: CoveredCA has 2015 rates available right now as well.

VERMONT: Federal Law Raises Questions About Who Can Bid For IT Projects That Support The Exchange

A provision of the Affordable Care Act precluding health insurers or companies in the “same controlled group of corporations” as a health insurer from holding exchange contracts raises questions about Optum working on Vermont Health Connect.

Concerns regarding Optum were raised at the federal level by Sens. Orrin Hatch, R-Utah, and Chuck Grassley, R-Iowa, the ranking members of the Finance and Judiciary committees respectively.

IDAHO: Your Health Idaho to launch sign-up system

Basically just an overview of the new Idaho ACA exchange; ID is the only state moving from HC.gov to their own website for the 2nd year, giving them a unique perspective. Most interesting to me is that they're spinning the "autonomy/states-rights" angle, which was the whole reason for pushing states to set up their own exchanges in the first place:

Well this is a nice surprise date point!

Earlier today I noted that Idaho, which is the only state moving off of Healthcare.Gov onto their own exchange this year, is already allowing people to comparison shop 2015 policy plans. However, I just noticed something else on their new exchange site:

If you are among the 78,000 Idahoans who purchased a health insurance plan for 2014, we are here to help you renew your policy for 2015 on Idaho’s own health insurance exchange.

This is noteworthy because the official April 19th enrollment number in Idaho was 76,061. Assuming a 10% non-payment rate (which has been proven to be about right repeatedly over the course of the off-season period), that means around 68,400 of those enrollees paid their first month's premium. The gross number, of course, should be around 14,000 higher (assuming an off-season gross addition rate of around 87 per day), and of that grand total, it appears that 78,000 are still currently enrolled (otherwise they wouldn't need to renew their policy, would they?)

A couple of weeks ago, I reported that Maryland, which was one of the states which had embarrassingly bad technical problems with their ACA exchange--and which ended up scrapping their platform completely and moving to an all-new system based on Connecticut's excellent platform--was making some very wise decisions for 2015 based on lessons hard-learned from 2014:

BALTIMORE (Tuesday, Sept. 16, 2014) — The second year of Maryland’s health insurance marketplace for individuals and families begins on Nov. 9 when consumers will have access to a newly redesigned website that enables “anonymous browsing,” the ability to compare plans — without registering personal information — before enrolling. This feature is being launched earlier than originally planned to enhance the shopping experience for Marylanders.

Four important stories about the technical situation status on various ACA exchange websites:

Idaho moving forward with state-run Obamacare exchange

Officials in Idaho say they’re undaunted by the well-documented failures of Obamacare exchanges in neighboring states and are moving  full-steam ahead with plans to launch their own web portal this November.

While executives at Cover Oregon and Nevada Health  Link abandon their state-run websites and turn to the federal exchange (HealthCare.gov), Your Health Idaho is headed in the opposite direction.

The state relied on the federal website for the open-enrollment period that ended in mid-April because it had less than 200 days last year set up its own web-exchange when state lawmakers authorized the project. It was one of two states — New Mexico is the other — that had to wait a year for its own site, and exchange officials say the delay has been a plus as they meet with other states to discuss what went right or wrong during Obamacare’s first round.

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.

This article is interesting not so much because of how close I came to the actual situation in Idaho (I had ID woodworkers pegged at around 5,600; the actual number is more like 5K even), but because of how far off Idaho's own official prediction on "woodworkers" was--they were assuming more than 7x that number:

But even without Idaho expanding its program, experts predicted a surge in Medicaid enrollment. A report prepared for the Idaho Department of Health and Welfare by Milliman Inc. predicted that more than 35,000 people would join Medicaid when they learned they already qualified for it. That was known as the "woodwork" group, for eligible people coming out of the woodwork.

The report said the cost of new enrollment — aside from the expansion — would total about $14.8 million in this fiscal year, then rise to between $32 million and $45 million per year over the next decade. That's not quite what happened, at least in these early months, Shanahan said.

"We just haven't seen the large increases we had expected," he said. Only about 35 percent — 5,000 people — of new Medicaid members are from the "woodwork" group, he said.

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