Charles Gaba's blog

2018 MIDTERM ELECTION

Time: D H M S

A bunch of people have sent me this link to the latest Gallop poll, which is certainly welcome news but isn't exactly unexpected:

WASHINGTON, D.C. -- The uninsured rate among adults aged 18 and older in the states that have chosen to expand Medicaid and set up their own exchanges in the health insurance marketplace has declined significantly more this year than in the remaining states that have not done so. The uninsured rate, on average, declined 2.5 percentage points in the 21 states (plus the District of Columbia) that have implemented both of these measures, compared with a 0.8-point drop across the 29 states that have taken only one or neither of these actions.

So, this is awesome news. Aside from the obvious, though, let's look at the other key stats:

Key "final" numbers as of 4/15 (MN is actually allowing another week, through 4/22, for final stragglers):

QHP: 48,157

Medicaid: 140,678

SHOP (from Dashboard) 726 x 1.8 = 1,306

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

OK, this doesn't really change the numbers beyond a couple hundred, but it's encouragingto see that my "15% in Non-Expansion States" rule of thumb for estimating the number of people who fall into the "woodworker" category seems to be pretty accurate, at least in Indiana:

Even without expanding eligibility for Indiana Medicaid, the program had enrolled 40,577 more Hoosiers as of March than it had in the same month last year.

More than 15,000 of that year-over-year increase occurred in March alone this year, as a flood of people here and nationally sought coverage before Obamacare would hit them with a tax for going uninsured.

If you take a look at the Medicaid Spreadsheet, you'll see that I currently have the "woodworker" tally for Indiana at 40,951...only 374 more than the number reported above.

That 40,951 is 15% of the combined total number of new Medicaid enrollments for Indiana from both the HC.gov website as well as through traditional state Medicaid agency offices (273,005).

OK, the various ACA exchanges are just messing with my head now.

First, Nevada announced that they've extended their enrollment out to May 30 for those who started by March 31st.

Then Oregon announced that they've extended full open enrollment out to April 30.

Then I found out that anyone who submitted a paper application by April 7th in any of the 36 states run by HC.gov still have until April 30 to finish.

Colorado, I've discovered, is allowing people who applied for Medicaid but were denied up until May 31st to finish their enrollment process.

And, of course, Massachusetts has over 200K "Limbo Status" people who may (theoretically) get squared away as late as June 30.

Late last night I learned that Hawaii has bumped their extension deadline out to April 30.

I said I'd keep the poll for the "woodworker" terminology open until tonight, but until I decide what to do about it I'll be continuing to use that term for consistency.

This article from Kaiser Health News brings solid numbers for Colorado, but also gives other good info about the Medicaid situation. For instance, they give a simple explanation of where the term comes from...

Hundreds of thousands of those people were already eligible and could have signed up even before the Affordable Care Act made it much more generous.

They came “out of the woodwork” to get enrolled, analysts say, thanks to the Affordable Care Act’s individual mandate and publicity around its new marketplaces.

...then they give the exact number in Colorado...though only through the end of February...

Oh for the love of...(sigh) Look, I'm all for letting as many people as possible enroll in healthcare coverage, but even I admit that I'm getting awfully tired of having to change the final, FINAL deadline dates.

The Hawaii Health Connector has extended the  initial grace period— which would have ended on Tuesday — given to individuals in need of extra time completing the enrollment application process for health insurance by a couple of weeks to April 30.

Let's just hope they resolve their Heartbleed issue.

Every person counts...up to 8,182 through 4/12:

Total for the period of Apr. 6, 2014 through Apr. 12, 2014

Total since October 1, 2013

29,314 Applications completed in the Individual Marketplace
8,182 Enrollments in the Individual Marketplace

Leigh McGivern of coOportunity Health has helpfully provided their final (well, near-final...through 4/14) tallies for both on- and off-exchange enrollments. The exchange-based numbers aren't really relevant to me since those are reported by HHS, but the off-exchange QHPs and ESI's are vital:

IOWA

  • Individual/Family members: 18,358 (10,809 on exchange/7,549 off exchange)
  • Small group members: 7,848
  • Large group members: 274

NEBRASKA

  • Individual/Family members: 30,668 (20,308 on exchange/10,360 off exchange)
  • Small group members: 11,292
  • Large group members: 2,774

TOTAL ON EXCHANGE IOWA AND NEBRASKA (individuals/families): 31,117

TOTAL OFF EXCHANGE IOWA AND NEBRASKA (individuals/families): 17,909

TOTAL BUSINESS (employees and dependents) IOWA AND NEBRASKA: 22,188

TOTAL BOTH STATES ON AND OFF EXCHANGE (individuals/families/businesses): 71,214

This represents increases as follows:

This doesn't change the actual total number of Rhode Island's Medicaid expansion numbers, but it does specify the ratio between "strict expansion" and the "woodworker" enrollees...66% to 34%. Interestingly, this is virtually identical to the Washington State ratio (again, 67% to 33%).

This isn't enough to apply to the other expansion states yet, but if it does prove to be the case, that should be helpful in figuring out how accurate my current estimates are. I currently have "strict expansion" at roughly 3.7 million, while "woodworkers" are at 2.05 million. A strict 67/33 ratio would have the "woodworker" number at around 1.82 million...except that the non-expansion states also have some woodworkers as well, which should account for the additional 230K or so.

Figures obtained from the Chafee administration by WPRI.com show that out of the 64,590 Rhode Islanders who signed up for Medicaid from October through March using the state’s new HealthSource RI marketplace, 34% were eligible before the new law expanded the rules for who could sign up.

A few days ago, Michigan's newly-expanded Medicaid tally sat at around 32,000, plus another 54,000 people transferred into the program from an existing state-run one, for a total of about 86,000 people.

Today that number has grown to over 109K:

Healthy Michigan Plan Enrollment Statistics

• Updated every Tuesday at 3 p.m.

Total Healthy Michigan Plan Beneficiaries (including ABW transition prior to April 1): 109,228

Total Enrollment in Healthy Michigan Plan after April 1: 72,921

*Statistics as of April 15, 2014

No breakout between Private QHPs & Medicaid/CHIP yet, but NY State of Health just issued this press release:

ALBANY, NY (April 15, 2014) – NY State of Health (NYSOH), the State’s official health plan marketplace, reported that as of 9 a.m. today, 1,311,271 New Yorkers have completed their applications and 949,428 have enrolled for coverage since the launch of the Marketplace on October 1, 2013. More than 70 percent of those who have enrolled to date were uninsured at the time of application. The Marketplace is well on its way to meeting or exceeding its enrollment goal of 1.1 million people by the end of 2016.

This figure is about 16,200 higher than just 4 days ago, meaning NY is averaging around 4K/day. Assuming no final day spike (or drop-off), their final total should come in at around 954,000 people.

Not gonna update the spreadsheet or graph until I get the actual QHP/Medicaid breakout, however, since those are almost always provided within a few hours of the combined number in NY.

I've been shouting from the rooftops about OFF-exchange QHPs for months now (I first added a column for them on January 3rd and had my first significant data update on January 31st), and until recently few in the news media seemed to catch on to the significance of these.

Until a few weeks ago, I had only officially documented about 560,000 off-exchange QHPs, but guestimated that there were easily 4 million or more out there (I had mused off-handedly back in mid-February that the total could potentially be 7.7 million, but decided to backtrack to "4M or more" out of caution).

Nothing major, just another 4,000 people added to NM's Medicaid tally:

An estimated 107,000 New Mexicans have enrolled in Medicaid since the state expanded the qualifications in October to include low-income adults, state Human Services Department spokesman Matt Kennicott said Monday.

...A total of 26,412 New Mexicans had enrolled in health plans through the state insurance exchange by the March 31 enrollment deadline, the state office of the Superintendent of Insurance said in a news release issued recently.

...An additional 10,000 applications had been submitted by the deadline but remained unprocessed, the statement said.

That's right. Thanks to high winds and a mid-April snowfall, I have no electricity today. Expect updates to be few and far between.

--posted from my iPhone

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