END OF 2018 OPEN ENROLLMENT (MASSACHUSETTS)

Time: D H M S

Washington State

According to the last official HHS enrollment report from back in May, as of April 19, 2014, Washington State had enrolled 163,207 people in private policies via their ACA exchange. Of those, 8,310 people never actually had their coverage start due to non-payment (WA requires payment of the first month's premium as part of the enrollment process, so I'm not sure what happened in these cases, but presumably there was some sort of credit card account approval glitch, insufficient funds in debit card accounts and/or the like).

In any event, that means the actual paid tally as of 4/19 was 154,897, or 95%, which is pretty darned good.

Well, a couple of days ago the WA exchange issued a press release regarding the renewal process for 2015, and included 2 key data nuggets. First up:

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:

D.C.’s health exchange is still hampered by delays, glitches 11 months after launch

While Democratic partisans tout the latest conventional wisdom that Obamacare is finally going strong, the experience of many ordinary people who apply for it says otherwise.

The ongoing delays and irritation that consumers endure while navigating the District’s health insurance exchange offer a window into the reality on the street.

More health insurance options increase choice — and possibly confusion

Wow! The WA Health Benefit Exchange, which hasn't issued an actual enrollment update since the end of the Open Enrollment period, just came through in a big way:

OLYMPIA, Wash. – Washington Healthplanfinder today announced 11,497 Washingtonians have taken advantage of special enrollment periods since March 31 that allow them to enroll through wahealthplanfinder.org if they have a qualifying life event outside of the standard open enrollment period. The next open enrollment period starts on Nov. 15, 2014 for coverage beginning in 2015.

Data also shows that nearly 700,000 residents are now enrolled in new free or low-cost health coverage options, with more than 147,000 customers currently enrolled in Qualified Health Plans. Including customers who are renewing their existing Medicaid coverage, more than 1.28 million residents have enrolled in health coverage through wahealthplanfinder.org.

The Washington State Insurance Commissioner just released a chart listing all of the companies operating on the exchange this fall (including 3 new ones, bringing the total to 12), how many plans they're each offering, the requested rate change and the approved ones for most of them.

Unfortunately, they don't include an actual enrollee breakdown, so I can't tell whether this is a weighted or unweighted average. Judging from the numbers provided, it looks like an unweighted average would be just 0.1%, so I'm guessing that the 1.9% mentioned in the press release is weighted, but I'd be more confident of this if they included how many people were enrolled by each company.

(h/t to Josh Z. for pointing out the uncertainty here)

In any event, the original average requested increase was 8.6% (4.8% unweighted), so this is still great news either way.

In addition, the total number of plans has doubled from 46 to 90:

90 health plans approved for next year’s Exchange with a record low 1.9 percent rate change – Exchange Board set to certify plans on Aug. 28

Even in states whose ACA exchanges have operated pretty smoothly such as Connecticut and Kentucky, there's bound to be some technical problems. Washington State is no exception. As a result, the WA insurance commissioner has announced that anyone who tried to enroll earlier but has struggled with billing, payment or other technical issues (WA is one of only 2 states that run payments through the exchange and require the 1st months premium to be paid before even reporting the enrollment) can now give it another shot or make whatever changes are necessary without requiring a "qualifying life event" to do so:

The Washington Health Benefit Exchange (the Exchange), also known as the Washington Healthplanfinder, is making progress to correct the enrollment and payment difficulties that have affected some consumers. Those fixes are continuing, but may take additional time to resolve.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

ARKANSAS:

Mark Pryor shows Democrats how they should campaign on the Affordable Care Act in a red state. You don't have to mention Obamacare (which technically doesn't even exist), you don't have to even mention the Affordable Care Act. You do have to personalize what the law actually means for real people with real medical issues which were fixed or improved by the law:

Read more on this ad & angle from Greg Sargent of the Washington Post.

VERMONT:

I just posted an entry noting that Washington State was reporting having exactly 156,155 paid exchange-based QHP enrollments as of June 1st.

Now, this is noteworthy because according to an earlier update, as of around a week earlier, the state had reported adding "between 2,000 - 3,000" exchange QHP enrollees between the end of open enrollment on 3/31 (WA did not offer an extension period) and May 27th; let's split the difference and call it 2,500. Add that to the official 3/31 total and you get around 166,500.

What accounts for the roughly 10,000 person difference? Well, the first number includes both enrollments and cancellations after the first month. Remember, Washington State only reports enrollments once the first month's premium has actually been paid, so these should be "clean" numbers.

WOW!! This article from last week is chock full of data-nuggety goodness, including the first solid updates out of Washington State in some time:

The share of Washingtonians going without health insurance has fallen by nearly 40 percent, thanks to factors put in play by the federal Affordable Care Act.

That’s the word from the state Office of the Insurance Commissioner, which estimates that the overall 970,000 of uninsured residents had fallen by 38 percent to about 600,000. That drops the uninsured rate to 8.65 percent of the state, down from about 14 percent, OIC spokeswoman Stephanie Marquis said Wednesday.

...OIC has said the individual market has grown to more than 327,000 – which was about 81,000 more insured people than were in the individual market on Oct. 1, the date that the Washington Health Benefit Exchange opened for enrollments for 2014 coverage. The individual market included 156,155 people buying private insurance policies through the exchange and 171,286 who bought policies outside the exchange.

BRAVO to Washington State!

OLYMPIA, Wash. – Washington Healthplanfinder today announced a limited special enrollment period for Washington state residents whose same-sex domestic partnerships were recently converted to marriages on June 30. The 60-day enrollment window provides these couples with a unique opportunity to enroll in a Qualified Health Plan before the next open enrollment period that starts on Nov. 15, 2014 for coverage beginning in 2015.

A related article has the number of people impacted (3,600 couples, or about 7,200 people total):

Washington’s health benefit exchange is opening up a 60-day special enrollment period for couples in same-sex domestic partnerships that were recently converted to marriages.

On June 30, most state-registered domestic partnerships were converted to marriage automatically in Washington. This affected an estimated 3,600 gay and lesbian couples in the state.

Three stories which didn't seem worthy of their own full blog entry but each of which are pretty interesting...

Washington State, 06/25/14: Kreidler calls for health insurers to end discrimination based on gender identity

OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler is asking all health insurers doing business in Washington state to end discrimination in health insurance based on gender identity and related medical conditions.

In a letter sent to health insurers this morning, Kreidler reminded health insurers that exclusions and denials of coverage on the basis of gender identity are against the Washington Law Against Discrimination (RCW 49.60) and the federal Affordable Care Act (Section 1557).

...“Transgender people are entitled to the same access to health care as everyone else,” said Insurance Commissioner Mike Kreidler. “Whether specific services are considered medically necessary should be up to the provider to decide on behalf of their patient.”

Good.

This press release JUST showed up in my in box; I don't have a link to it on WA's website, so I'm reposting it verbatim below (emphasis mine):

FOR IMMEDIATE RELEASE – June 12, 2014

Media contact: Public Affairs (360) 725-7055

Individual health insurance market expands more than 30 percent – enrollment now at 327,000

OLYMPIA, Wash. – The individual health insurance market grew  30 percent in one year to more than 327,000 people in Washington state, according to new information reported by health insurers to the Office of the Insurance Commissioner.

The latest enrollment numbers and other insurance market data also indicate that Washington state has succeeded in reducing the number of uninsured by more than 370,000.

Today’s individual market total includes 171,286 people enrolled outside the Washington Health Benefit Exchange, Wahealthplanfinder, and 156,155 people enrolled inside the Exchange as of June 1, 2014.

Don't let the snarky headline fool you; I'm still very much a single-payer guy. However, anyone who still claims that the ACA exchanges are "socialized medicine" doesn't have the slightest clue what they're talking about. In case you needed even more proof that the ACA is very much private-market friendly:

Illinois:

After sitting out the first year, UnitedHealth Group Inc. intends to offer individual policies on the Illinois health insurance exchange next year, according to sources familiar with the company's plans.

The decision by UnitedHealth, the nation's largest and the state's No. 2 insurer, has the potential to shake up the Illinois market, which was dominated in 2014 by Blue Cross and Blue Shield of Illinois, the state's dominant insurer.

...United's participation also could help lower rates for consumers, a key concern among the law's supporters.

While United would neither confirm nor deny its plans to offer policies in Illinois next year, a spokesman said the Minnesota-based insurer intends to increase its participation over time in exchanges nationwide.

Nice catch by contributor Esther F....in this article about new parents having a 60-day "Qualifying Life Event" period to add their newborn child to their healthcare plan, there's this bit at the end:

About 164,000 Washington residents enrolled for private health coverage during the last open-enrollment period. About 2,000 or 3,000 have enrolled since then, Frey said.

Those include special enrollments along with “special special” enrollments — people still completing applications because of technical problems, Frey said.

OK, kind of a fuzzy number, but let's split the difference and call it 2,500. That means Washington State has increased their enrollment by about 1.5% since the end of March (WA was one of 2 states--Connecticut was the other one--which did not offer an official extension period). As the article was originally posted on 5/27, the latest the figures could run through is 5/26, so that's about 45 people per day since 3/31. Assuming this pace holds steady, WA should add over 10,000 QHP enrollees to their total by the time the 2nd enrollment period starts on 11/15.

Washington State finally wraps things up with their final numbers, breaking 164K QHPs and keeping their Strict Expansion / Woodworker ratio to the same 2:1 ratio that it's been pretty much the entire enrolllment period:

The state has previously reported that 147,000 people signed up for private health coverage, but said Wednesday that the total grew to 164,062 as officials finalized applications after the March 31 deadline. Open enrollment began last October.

Updated enrollment numbers from Oct. 1 to March 31 are included below.

Qualified Health Plans: 164,062

Medicaid Newly Eligible Adults: 285,275

Medicaid Previously Eligible but not Enrolled: 137,930

Washington State is doing a fantastic job of tracking pretty much every data point about health insurance in the state (I already had the 146K number):

OLYMPIA, Wash. – The individual health insurance market has grown to more than 324,900 people in Washington state, according to updated enrollment information reported by health insurers to the Office of the Insurance Commissioner this week.

This number includes 178,981 enrolled outside the Exchange and 146,000 enrolled inside the Exchange, Washington Healthplanfinder, as of March 31. The total is expected to increase as late enrollments through the Exchange are processed and reconciled.

...Before open enrollment began on Oct. 1, 2013, approximately 278,000 people were enrolled in health plans in Washington state’s individual market. Some 238,000 people received discontinuation notices from their insurers and had to find new coverage by Jan. 1, 2014. Estimates were made earlier this year that 113,000 of those who received notices would qualify for subsidies and 30,000 would qualify for the state’s newly expanded Medicaid program, Apple Health.

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