A reader sent in an interesting report on the DoD's TRICARE program, which apparently was already an existing military version of the ACA "young adults on parents plans" provision. Prior to the ACA, TRICARE only covered young adults up to 21 or 23; the ACA expanded this to the same 26 year old cut-off as non-military families:
Page 52 - As shown in the chart at left, enrollment went from over 21,000 in FY 2012 to almost 31,000 in FY 2013.
Also, although TYA began with the Standard option, Prime now accounts for almost 60 percent of total TYA enrollment.
This is in reference to the Tricare Young Adult program coverage for those under 26. This is a small amount but doesn't seem to fit anywhere except the under 26 coverage.
Tricare used to cover dependents under 21 with extension to 23 for those in school. The ACA enable expansion to under 26 for a fee ($180/month)
I'm not adding this to the actual spreadsheet since a) it's such a tiny number and b) it's hard to say how many of the 10K increase is specifically due to the ACA, but I thought it was worth at least mentioning.
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.
Hmmm...this article about Michigan's final ACA exchange tally is very specific about the Healthy Michigan program (Michigan's ACA expansion program), claiming the total is nearly 200K total...but if so, this would be an increase of over 41,000 from just 3 days earlier, which I find hard to believe (though that'd be awesome if it's correct).
199,862 minus the 36,307 who were bulk-transferred over from the existing state program = 163,555. The update from just 3 days ago had the total as 158,654.
HOWEVER, it occurs to me that I may have actually assumed that the 158K figure included the 36K transferees...if it didn't, then this makes much more sense, since the difference over those 3 days is only 4,901 people.
If that's the case, then this is VERY impressive indeed, and I apologize for lowballing the earlier number! I'll go ahead and use the higher number for now; on Monday there will a new official update on the state government site, and I can verify things one way or the other:
Don't forget, there's still a few states with exchange QHPs trickling in...in the case of Oregon, they can tack on an extra 1,300 to their QHP tally & another 4,700 Medicaid enrollees...in addition to the 128,434 "fast track" Medicaid enrollees they added earlier this year. Their new grand totals now stand at nearly 70K exchange QHPs and over 305K Medicaid additions:
May 1, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon
Medical enrollments through Cover Oregon: 251,240
Total private medical insurance enrollments through Cover Oregon 1: 74,103
Oregon Health Plan enrollments through Cover Oregon: 177,137
Total private dental insurance enrollments through CoverOregon 1: 14,992
Net enrollments Net private medical: 69,586
Net private dental: 13,729
Well, I had it down as 8.03M as of 4/15; the actual was 8.02M as of 4/19. So...hard to say precisely how accurate I was since the dates don't match, but obviously I slightly overshot the mark. On the other hand, I also called 8.14M as of 4/30, so presumably there will be a follow-up report in another week or so with the "mop-up" enrollments from the final 11 days.
TEXAS: Was 295K as of 3/01; 734K as of 4/19
FLORIDA: Was 442K as of 3/01; 984K as of 4/19
GEORGIA: Was 139K as of 3/01; 317K as of 4/19
I'll start plugging the actual numbers into the spreadsheet next.
UPDATE: OK, I've plugged all of the official HHS numbers into the spreadsheet. There are a handful of states where the numbers don't quite match, presumably due to clerical cleanup, double-entries being removed, etc. However, there are six states with significant differences, two of which I can't figure out:
OK, I was suckered about this a couple of weeks ago, but I'm pretty damned certain about it this time: The HHS Dept. should be releasing their official ACA exchange report for all of March (and almost certainly the first half of April) in about 2 hours (around 2:15pm).
Their 67% figure assumed that all enrollees as of 4/15 were supposed to be due by 4/15 (in fact, only about 63% of the total enrollments were due by 4/15; the rest weren't due until yesterday, or even later depending on the insurance company)
Their "only 67%" claim flies in the face of public statements by the insurance companies themselves, who are quite clear that the actual paid percentages range anywhere from 80-95%
They curiously failed to include two states--Idaho and New Mexico--in their own state-by-state breakdown, even though both of those states were part of the Federal Marketplace for the 2014 open enrollment period (both are scheduled to switch to their own exchanges this fall, but that's irrelevant to the existing enrollments)
Even if the 67% figure was accurate for the 36 states on the federal exchange, the paid rates for the other 14 state-run exchanges (+DC) ranged from 68% - 100% as of 4/15, including WA & MA at 100%, CA at 85% (making up nearly 20% of the 8M total) and so on, meaning that the actual overall paid rate nationally as of 4/15 was considerably higher than 67%.
A nice little final-day wrap-up report out of Alaska: 13K on the exchange and another 2,700 off-exchange QHPs. Premera is part of BCBSA, so I can't double-count their off-exchange number, but Moda Health isn't:
About 13,000 Alaskans signed up for health insurance on healthcare.gov during the open enrollment period that closed March 31st. The two insurers offering plans on the exchange in Alaska shared their enrollment figures today with APRN. Moda Health says it has about 7700 healthcare.gov enrollees in Alaska and the company is still processing some additional sign ups.
Premera Alaska enrolled 5300 people on the exchange. Before the troubled launch of healthcare.gov, the company had hoped for more customers. But Premera spokesperson Melanie Coon is satisfied with the numbers:
“I think we readjusted our expectations. We’re very pleased with how enrollment went, based on the slow start to the exchange and… the last minute changes that were made where people could extend.”
An hour or so ago, the Republican Staff of the Committee on Energy & Commerce Republican, chaired by Republican Representative Fred Upton, issued a press release which claims that:
April 15, 2014, only 67 percent of individuals and families that had selected a health plan in the federally facilitated marketplace had paid their first month’s premium and therefore completed the enrollment process.
OK, let's unpeel this onion slowly, shall we?
First of all, the press release makes it very clear that the enrollment data which they're talking about includes all enrollments on the Federal exchange through April 15. Note the following wording (emphasis mine):
Rhode Island's ACA Medicaid expansion was at around 65K a couple of weeks ago, so this is a nice small bump:
Through April 19, 70,243 people had signed up for Medicaid under the Affordable Care Act rollout, according to state figures, with federal dollars paying for about two-thirds of those people and state and federal dollars roughly splitting the cost for the other third, because they were already eligible before Obamacare entered the picture.
My Medicaid spreadsheet currently estimates Illinois at roughly 200K "strict expansion" and another 115K "woodworkers". This article suggests that the woodworker number may be too high, but the "strict expansion" number may be dramatically low:
For the first time, low-income adults without children are eligible for government health coverage.
In Illinois, officials expect that'll mean 350,000 new people in Medicaid. And that's not all.
Julie Hamos, director of the Department of Health Care and Family Services, says the news reports and advertising and community outreach around the Obamacare deadline led to a separate spike.
"We have 80,000 more than the usual enrollment of people who already were eligible, they just didn't sign up. But because of that activity in the communities, now they're signing up."
The first article is mainly a breakdown of off-exchange QHP enrollments across various Blue Cross companies; normally this would be something of a jackpot for me, but since the BCBSA had already stated that they had over 1.7 million off-exchange enrollments not including March or April, these numbers don't really help out much. What I really need at this point are state-by-state off-exchange QHP numbers (ideally through at least the end of March), and I don't see those coming anytime soon.
HOWEVER, the article does also give an updated overview of where the "But how many have PAID???" situation stands...or at least, where it stood as of February 1st:
According to the Blue Cross and Blue Shield Association, between 80% and 85% of people who signed up for a Blues plan through a public exchange are paying their premiums. The percentage is based on a survey of member Blues plans as of Feb. 1. But individual Blues plans say that number is higher.