New York

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.

This Just In...

154,000 have enrolled in QHP + Medicaid in NY #obamacare @charles_gaba @charlesornstein

— Dan Goldberg (@DanGoldbergCNY) December 12, 2014

Unfortunately no breakout between the two yet...hopefully soon...I also don't know what date that number runs through, nor do I know if the QHP tally includes new enrollments only (a la California & Connecticut) or if it also includes renewals as well.

Also, we now have our first official Deadline Extension due to the massive snowstorm in Buffalo/etc recently:

@charles_gaba State also says deadline to enroll for jan. extended to Dec. 20 b/c of "extreme weather"

— Dan Goldberg (@DanGoldbergCNY) December 12, 2014

Dan Goldberg and his colleagues over at Capital New York are killing it repeatedly when it comes to demographic breakdowns of NY's ACA enrollment. In the past they've provided awesome interactive maps of April enrollments of the entire state (by county) as well as September enrollments of just New York City itself (by zip code). Not just total enrollments, mind you: They've broken them out by QHPs, Medicaid and CHIP.

Considering that NYC has around 400 zip codes by itself, this was no doubt a rather Herculean task.

Today, however, they've gone one step further, with a state-wide map of September enrollments by zip code...and when you include the entire state of NY (not just NYC), you're talking about 2,200 zip codes (!) Excellent job!

This is a pretty short article, and it pretty much covers the bases, so I don't have too much to add...

As New York gears up for the Obamacare open-enrollment period that begins on Nov. 15, state officials have a vested interest in making sure things go smoothly. The success of health care reform in New York will be measured by how many residents maintain their coverage or sign up for the first time.

Just over 75% of those who used the state's new Obamacare exchange last year would recommend it to others, according to a new survey. But 92% of respondents who used the exchange to become newly insured were satisfied with the coverage, according to the survey, released Monday by the New York State Health Foundation.

However, there is one additional point I should add. Remember that ridiculous Bankrate survey I posted about yesterday which claimed that over half of ACA enrollees don't plan on using the exchanges again this year? Well...

Faced with a decision on whether to enroll again, 92% of respondents said they are at least somewhat likely to renew their coverage.

This is absolutely awesome...and extremely frustrating at the same time. Dan Goldberg and his chums at CNY have put together another extremely detailed breakdown of ACA enrollments in New York City, with QHPs, Medicaid and CHIP enrollees sorted out by individual zip code (a pretty herculean task given how many zip codes there are in NYC). Even more interesting (from my perspective, anyway) is that they've managed to get the current enrollment figures--updated through September. Since the NY exchange pointedly informed me back in June that they had no plans to release updated enrollment figures during the off-season at all, this is a huge development from my POV.

The only problem, of course, is that this map only gives the tally for NYC itself (about 8.4 million people total) not the rest of the state (about 19.6 million). Since my data is focused on the state-level numbers, this is frustrating; so close, and yet so far. I suppose I could extrapolate the numbers by multiplying each by 2.3x, but that doesn't work because the demographics are so vastly different between the two.

Anyway, for NYC itself, there's gobs of data-nuggety goodness to be found:

On Tuesday, the New York Daily News posted a story about a man in New York who is suing Empire BlueCross BlueShield because the insurance policy he purchased from them is essentially useless. As the header summarizes it:

Man sues Empire insurance company, claims search for doctor became ‘frustrating’ runaround

Jon Fougner says his simple search for a doctor through the insurance company website turned into a ‘Dickensian nightmare.’ Some doctors did not accept new patients, others never returned his calls, and some had wrong contact information listed on the Empire BlueCross BlueShield website, he claims. He accuses Empire of breach of contract, fraud and false advertising.

Between my son being sick for the past 4 days (he's better now, thanks!), losing my internet connection for 2 days (it's back up now, thanks!) and just generally being swamped with work, I don't have time to give these stories the attention they deserve, but they're all worth checking out:

Health Insurance: Enrolling Rural America

Americans living in rural areas will be a key target as states and nonprofit groups strategize how to enroll more people in health law insurance plans this fall.

Though millions of people signed up for private insurance or Medicaid in the first year of the Affordable Care Act, millions of others did not. Many live in rural areas where people “face more barriers,” said Laurie Martin, a RAND Corp. senior policy researcher. Brock Slabach, a senior vice president at the National Rural Health Association, said “the feds are particularly concerned about this.”

More legislators want to shut down Cover Oregon

Me, July 17th, re. Rhode Island's 2015 rate report:

The preliminary rate requests are just that: Preliminary. You can REQUEST anything; that doesn't mean you'll get it.

Me, July 22nd, re. New York's 2015 rate request report:

...as I noted last week, there's a huge difference between what the insurance companies are asking for and what they actually get approved. As noted in the article CNY article:

Last year, insurers requested 9.5 percent increases in premiums for their individual plans, but the state Department of Financial Services, which regulates insurers, approved, on average, only a 4.5 percent increase. 

Well, guess what?

Usually I'm able to track down my data either by myself or with the help of several people who send me data links on a fairly regular basis. This has resulted in my being able to fill in off-season QHP enrollment data for almost 20 states.

However, there are several states whose data has eluded me so far...and unfortunately, this includes the two largest state-run exchanges: California and New York. I've contacted both exchanges; CoveredCA told me that updated enrollment numbers would be released "soon" but that was a good month ago. The New York State of Health exchange flatly stated that they, like HHS, would not be giving out any sort of official off-season enrollment update. There's also the Rhode Island exchange, which hasn't responded to my requests at all. (Update: Never mind that last one; just heard directly from the RI exchange, hopefully they'll be able to provide an update soon...)

A week or so ago, I posted an entry about the requested rate changes for 2015 from the insurance companies operating on the New York exchange (I'm emphasizing "requested" since, again, those changes still have to be approved by state regulators, who have already lopped the average increases down dramatically in both Rhode Island and Connecticut, and I just announced that CA kept them to a quite reasonable 4.3% (weighted) average). The overall unweighted average requested change in New York appeared to be 14.6% increase, which isn't good news at all.

Thanks to contributor Bob H., however, for not only crunching the numbers to give the properly weighted average increase, but also for noting that it turns out that the number of companies listed in the original report (a whopping 42 of them) is slightly overstated, to put it mildly. You see, it turns out that, according to Bob...

With all my stories about the requested premium increases in various states not living up to the "sky is falling" hype, several people have called attention to the fact that in New York State, it's not looking good:

ALBANY—New York insurance companies are looking to raise health insurance premiums by an average of 13 percent, according to proposed rates released by the state's Department of Financial Services on Wednesday.

The requests come from the 41 insurance companies operating in New York's insurance market. Last year, 16 insurers offered plans on the state's health exchange, which was created by the Affordable Care Act.

The six most popular plans on the state’s exchange requested double-digit increases in their premium rates for next year, with an average request of a 14.6 percent rate hike.

Visit the link for a pretty cool rollover county-by-county map showing ACA exchange enrollments in New York State:

Last week, the state's health department released demographic information on who used New York's new health insurance exchange to enroll in a health insurance plan.

The data showed how many people across New York signed up for private health insurance plans, enrolled in Medicaid and took advantage of Children's Health Plus.

In total, nearly 1 million people got health insurance coverage through New York State of Health, or about 5 percent of the state's population. The exchanges were created by the Affordable Care Act.

Capital broke that down by county: We found Queens County had the highest percentage (6.78) of its population enroll while Madison County (2.86) had the lowest. But in Madison about half the people who enrolled signed up for a Medicaid plan while half signed up for private insurance. In Queens, twice as many people signed up for Medicaid compared to a private insurance plan.

I contacted the NY State of Health exchange a couple of weeks back and spoke a couple of times with a very nice media relations woman who explained that yes, a highly-detailed, comprehensive enrollment report would be released sometime in late June, but that no, it wouldn't include any information about exchange enrollment since the end of the first Open Enrollment period (ie, the extension period which ended on April 15th).

She said that she'd see about trying to get "off season" enrollment data back on the agenda, but just like the HHS Dept. running 36 other states, it looks like NY has decided not to bother. This leaves me crossing my fingers that California will release their off-season data sometime soon; since CA handles almost 20% of the total enrollments by itself, that (combined with the other half-dozen state exchanges providing regular updates) should be enough to extrapolate for the rest of the country. NY is the 2nd largest exchange, however, so it would've been helpful if they'd done so as well.

As I noted yesterday, there are three states which had unusually large discrepancies between the official HHS and state exchange QHP enrollments:

  • New York came in over 65,000 lower than the number I had for a simple reason: The New York exchange lumps enrollees in their Child Health Plus program in with QHPs, even though technically this isn't a QHP program. There were over 40,000 of these as of the end of February; this number has climbed to 65,028 as of 4/19.
    Since Child Health Plus is privately funded (and therefore isn't on the Medicaid/CHIP side), but also isn't officially a QHP either according to HHS, I've moved it over to the "Off Exchange QHP" column.

This is actually pretty impressive; NY had been averaging around 4,200/day up until yesterday, when they hit 949,428, so this means they racked up another 11,334 in the final day (around 5,600 QHPs and 5,700 Medicaid):

.@charles_gaba @charlesornstein final NY Enrollment total: 960,762 Medicaid: 525,283 Private: 435,479

— Dan Goldberg (@DanGoldbergCNY) April 16, 2014

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