END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

New York

About a week ago, New York State of Health reported they had enrolled 166,000 people in Qualified Health Plans (QHPs) as of December 7th, plus another 710,000 in their Essential Plan (NY's name for the BHP program). The QHP number was around 13% ahead of the same point last fall.

Today they provided another (partial) update:

Press Release: As Major Enrollment Deadline Approaches, NY State of Health Enrollment Remains High 

Dec 13, 2017

New Yorkers Are Encouraged to Enroll by Friday, December 15th for January 1st Health Coverage

When NY State of Health released their first Open Enrollment update a week or so ago, they reported over 140,000 QHP selections in the first 28 days (up 13% vs. the same point last year) and 700,000 BHP enrollees (which is 5% more than they enrolled in all of last year's open enrollment period).

Today they've issued another update:

  • Enrollment in Qualified Health Plans and Essential Plan Reaches Nearly 900,000
  • December 15th is the Deadline to Enroll for January Coverage
  • New Yorkers Urged to Enroll Now

ALBANY, N.Y. (December 7, 2017) - NY State of Health, the state’s official health plan Marketplace, today announced enrollment in Qualified Health Plans (QHP) and the Essential Plan have reached nearly 900,000—continuing to outpace enrollment at the same point last year by 13 percent.

Nothing official yet, but New York-based Politico healthcare reporter Dan Goldberg just tweeted this out:

@charles_gaba new ny numbers out. 46,000 new enrollees. 13 percent ahead of last year’s pace. 31,500 in essential plan. Numbers through end of November

— Dan Goldberg (@DanCGoldberg) November 30, 2017

Unfortunately, a lot of the state-based exchanges have an annoying habit of not posting renewal numbers until after the enrollment period is over (including the biggest one, California), but this is still helpful. Also handy to have the early BHP enrollment numbers.

UPDATE: Whoops...the official NY State of Health press release is out, and it looks like I misunderstood Goldberg's tweet; it's 46,000 new enrollees total including QHPs and BHPs combined:

New York State of Health posted this press release today...

ALBANY, NY (November 8, 2017) – NY State of Health, the state’s official health plan Marketplace, today announced a new partnership with ride sharing companies Lyft and Uber. Through the partnership, Lyft and Uber will reach more than 200,000 drivers throughout New York State urging them to visit the Marketplace to shop for and enroll in quality, affordable health insurance. NY State of Health will work directly with Lyft and Uber to promote coverage options and enrollment opportunities for drivers through an email campaign, In-App notifications and in-person education on coverage options.

Shout-out to Dan Goldberg of Politico New York for the heads up:

NY State of Health Enrollment Tops 4 Million
Open Enrollment for Qualified Health Plans to Begin November 1, 2017

ALBANY, N.Y. (October 5, 2017) - NY State of Health, the state's official health plan Marketplace, today announced that more than 4 million people have signed up for health insurance through the Marketplace. Enrollment in the Essential Plan continues to grow, with more than 680,000 enrolled. The Marketplace is ready for its 5th Open Enrollment Period, which begins November 1, 2017 and has been extended to January 31, 2018, beyond the federal deadline of December 15, 2017, to allow New Yorkers sufficient time to enroll.

File this one under "Be Careful What You Wish For".

Just a couple of days ago I reported that the New York Dept. of Financial Services had issued their approved 2018 rate changes for the 15 insurance carriers participating in the state's individual and small group markets...and, in some welcome news, they whittled down the rate increases by a bit, from 17.7% on average to 14.5% on average in the individual market, and from 11.7% to 9.3% in the small group market.

Then, the very next day, Zach Tracer of Bloomberg News broke this story:

New York State’s biggest hospital system plans to stop selling Obamacare plans, blaming a costly plank of the law and uncertain prospects for a fix amid a wider Washington brawl over health care.

Back in early June, the New York Dept. of Financial Services posted the requested 2018 rate hikes for the individual and small group markets. In most states, the CSR reimbursement issue is a much bigger factor than whether or not the Trump Administration enforces the individual mandate, but in New York it's the exact opposite: According to the NY DFS, loss of CSR payments would only tack on 1.3 points to the total, while "a full repeal of the federal individual mandate would increase rates by an additional 32.6%".

The reason for the fairly nominal CSR factor is that the vast majority of NY's CSR-eligible population (those earning 138-200% FPL) is instead enrolled in the state's Basic Health Program. As a result, only 26% of New York's exchange enrollees receive CSR assistance, and the 200-250% FPL recipients only receive a fairly skimpy amount of CSR help anyway. At the opposite end of the spectrum, the 32-point mandate factor is far higher than most carriers are indicating (more like 4-5 points), but there's a big difference between the administration "not enforcing" the penalty and outright repealing it, which NY DFS is talking about.

In any event, this means that NY's requested average increases boiled down to: 15.0% if CSRs are paid/mandate enforced, 16.6% if CSRs aren't paid/mandate is enforced, or a whopping 50.5% if CSRs aren't paid and the mandate was repealed.

Back in early June, I took the misleading, disingenuous, incomplete report from Trump's ASPE head which tried to make it appear that the Affordable Care Act had caused individual market health insurance premiums to "more than double" by 105%.

Regular readers may recall that this study was deeply flawed in several ways:

Thanks to Bill Hammond of the Empire Center for the heads up.

Like Pennsylvania, the New York Dept. of Financial Services made it very easy for me this year:

This chart sets forth the average premium rate adjustments that health insurers have requested from the New York State Department of Financial Services (DFS). There are 16 insurers that have submitted individual rates and 20 insurers that have submitted small group rates for 2018. These are the rates insurers have requested and are not the final premium rates DFS will approve. Under the Insurance Law, the Superintendent may deny or modify the requested rates if she finds that the insurer's request is unreasonable, excessive, discriminatory or inadequate based on sound actuarial assumptions and methods (Insurance Law §§ 3231(e)(1), 4308(c)). From the date DFS posts insurer rate applications on the DFS website, the public will have 30 days to submit comments to DFS on the proposed rates. The total percentage requested rate increase for individual and for small group on the chart below represent a weighted average that accounts for the relative share of overall enrollment for each insurer.

So, I got back from my trip to the NIHCM awards dinner in DC late last night, and am groggily attempting to bone up on all the healthcare stuff which happened while I was gone (ironic, of course, given that I was attending a healthcare-related event filled with other healthcare wonks/reporters).

In the past 2 days...

There are so many stories I could be writing right now about the fallout, potential fallout, next steps and so forth of yesterday's House vote on the AHCA. But this one in particular really says it all.

Here's an article in the Buffalo News regarding New York Republican Congressman Chris Collins (NY-27), who voted for the bill:

Watch: Chris Collins admits he didn't read health care bill

WASHINGTON – Rep. Chris Collins told CNN that he didn't read the entire Republican health care bill that the House passed Thursday.

And then he told The Buffalo News that he was unaware of a key provision in the bill that decimates a health plan that serves 635,000 New Yorkers.

Asked by CNN's Wolf Blitzer if he had read the entire health bill, Collins, R-Clarence, said: "I will fully admit, Wolf, that I did not. But I can also assure you my staff did. We have to rely on our staff. ... I'm very comfortable that we have a solution to the disaster called Obamacare."

I'm actually a bit surprised that NY State of Health is the first state exchange out of the gate with final enrollment numbers, but good for them:

Press Release: NY State of Health Announces Enrollment Surges: More Than 3.6 Million New Yorkers Secure Health Coverage

Feb 1, 2017

  • Nearly 50,000 sign up during final two days of Open Enrollment
  • An additional 800,000 New Yorkers enroll through the Marketplace since January 2016

ALBANY, N.Y. (February 1, 2017) -- NY State of Health, the state’s official health plan Marketplace, today announced that more than 3.6 million New Yorkers enrolled in comprehensive health coverage through NY State of Health, a 28 percent increase from 2016.

“New York continues its commitment to bring affordable, comprehensive health coverage to New Yorkers” said NY State of Health Executive Director, Donna Frescatore. “New Yorkers now have access to affordable health insurance coverage, giving hundreds of thousands of previously uninsured individuals economic and healthcare security.”

With the GOP Congress still obsessed with repealing the ACA and Donald Trump doing everything in his power to sabotage the law whether it gets repealed or not, the final 5 days of the 2017 Open Enrollment Period, which would normally see a spike in enrollments regardless, is going into a bit of a panic mode. Trump and his Republican cohorts are doing whatever he can to discourage people from enrolling before the deadline, while the insurance carriers, healthcare advocates and everyone else is doing whatever they can to encourage it.

New York State of Health, the NY ACA exchange, just announced that with the 1/31 final deadline rapidly approaching next Tuesday, they're extending their customer service hours on Saturday and Sunday.

In their first enrollment update report two weeks ago, the NY State of Health exchange reported these numbers as of Christmas Eve:

The breakdown of enrollment as of December 24, 2016, is as follows:

  • Total cumulative enrollment: 3,472,214
  • Total Medicaid enrollment: 2,332,683
  • Total Non-Medicaid enrollment: 1,139,531
  • Essential Plan: 635,909
  • Qualified Health Plan: 217,995
  • Child Health Plus: 285,627

On Saturday they updated their numbers through January 19th:

Back in mid-December, just about all of the ACA exchanges bumped out their enrollment deadlines for January 1st coverage by a few days. I was mildly surprised because improvements in the bandwidth, coding, layout and support staffing have meant a smoother process towards the big last-minute surge. Still, I wasn't blown away by the development or anything, as mid-December has always seen a massive spike in enrollment.

On the other hand, this announcement by the New York State of Health exchange is very surprising:

New Yorkers Now Have Until January 18 to Enroll in or Renew Health Insurance Coverage Beginning February 1

Consumer Demand Remains High Prompting Deadline Extension

ALBANY, N.Y. (January 12, 2017) – NY State of Health, the state's official health plan Marketplace today announced that consumers now have three additional days to enroll in a health plan with coverage starting February 1. The deadline has been extended through 11:59 p.m., January 18. The previous deadline was January 15.

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