Charles Gaba's blog

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Here comes state exchange number 2...Minnesota!

ST. PAUL, Minn.—MNsure successfully enrolled 169,251 Minnesotans into comprehensive, affordable health insurance plans as of midnight on March 31, bringing the 2014 open enrollment period to a close, MNsure announced today.

“More than 169,000 Minnesotans have enrolled for health coverage through MNsure, blowing past our projection of 135,000 in October,” said MNsure’s interim CEO, Scott Leitz. “I am extremely proud of the MNsure staff who worked tirelessly, often sacrificing time with family over the last year to get Minnesotans enrolled in coverage. Our mission every day has been to make health insurance coverage possible for those Minnesotans who are uninsured and underinsured, including those who have been denied coverage up to now due to pre-existing conditions. Though the rollout of MNsure has not been perfect, we have worked hard to make critical improvements—which we will continue to do through the spring and summer, leading up to our next open enrollment period in November.”

To date, MNsure has enrolled 47,046 Minnesotans in a Qualified Health Plan, 34,219 in MinnesotaCare and 87,986 in Medical Assistance.

Here we go...Rhode Island is the first state-based exchange out of the gate with an (unofficial, but specific) final tally of 3/31 QHP enrollments: Nearly 28,000 by midnight yesterday.

HealthSource RI spokeswoman Dara Chadwick said 27,968 individuals signed up for private plans through the new marketplace between Oct. 1 and the 11:59 p.m. deadline for 2014 enrollment, 1,840 of whom signed up Monday. The number is expected to rise as those who encountered technical difficulties or weren’t able to speak to a representative on Monday finish getting processed.

There's no update on the Medicaid number since March 8th, unfortunately, but this still locks down at least one key number. More to come, no doubt...

Holy smokes.

From April Ryan, whose "HHS major scoop" batting average is now two out of three (at least since I started following her, anyway):

At 12:01 AM, White House Chief Technology Officer Todd Park acknowledged to QSSI, the Columbia, Maryland firm tasked with fixing Healthcare.gov that the ACA enrollments have surpassed the 7 million mark.

OK, that's pretty cool, but what's with the "holy smokes"? Well, when you listen to the audio clip of the countdown/7M announcement (and do so at the link...it's pretty cool), Todd Park states the following (emphasis mine):

Good Morning.

"Outstanding Numbers" has two meanings: The first, of course, is that in spite of everything--the terrible website launch of HC.gov and some of the state sites; the still-terrible status of some of the state sites even now; the actively-hostile opposition and obstructive actions in certain states, the negative spin on every development by some in the news media--in spite of all of this, over 7 million people nationwide enrolled in private, ACA-compliant healthcare plans between 12:01am on 10/1/13 and 11:59pm on 3/31/14...slightly surpassing the original CBO projection for that period.

There's the usual discussions about "But how many have PAID???", "But how many were ALREADY INSURED???", "How many were YOUNG???" and "What METAL LEVEL did they get???" etc etc etc. All of these are reasonable questions for actuaries, accountants and so forth to ask, and the answers will indeed help shape our understanding of what the overall economic and health impact of the law will be.

For the moment, however, none of that matters. This is an outstanding number any way you slice it.

  • 7.08 Million Exchange-based QHPs (estimate)
  • + 71,000 SHOP QHPs
  • + 9.0 Million total OFF-Exchange QHPs (estimate from the Rand Corp.)
  • + 4.71 Million New "Strict Expansion" Medicaid enrollees
  • + 1.80 Million New "Woodworker" Medicaid enrollees (estimate)
  • + 3.10 Million 19-26 Year Olds on their Parent's Plans (estimate)
  • - 3.70 Million Cancelled Non-Compliant Policies
    (see? I told you I'd subtract these once I knew the total number of off-exchange QHPs!)

= appx. 22.1 Million People (at the high end) or 14.6 Million (at the low end)

Of course, you can quibble about how many of the 9 million off-exchange QHPs were previously uninsured, or how many of the cancelled plans were swapped out with QHPs from the exchanges vs the off-exchange amount. You can quibble about whether the "sub26ers" should be 3.1 million or only 2.5 million. You can argue bout whether "woodworkers" should "count" or not (as if a massive outreach campaign which encourages previously-eligible people to enroll in a program they qualify for isn't an accomplishment to be proud of). You can argue about whether unpaid QHPs should be counted (yet) or not.

The bottom line is this: No matter how you slice it, this is a ton of people receiving decent healthcare coverage who either a) didn't have anything before or b) can no longer be dropped, denied or bankrupted by coverage that was scattershot, piecemeal or shoddy.

Given the Wyoming Sen. John Barrasso's accusation that the Obama administration is "cooking the books"
and the epic meltdown that Sean Hannity had earlier today, this came to mind...

More great news: Specific numbers out of New York, and apparently the 826K figure included about 6K more QHPs than I thought (and 6K fewere on Medicaid, of course):

Since the state website launched on Oct. 1, 826,812 people had signed up for coverage as of 9 a.m. Monday, with 436,304 qualifying for Medicaid and 390,508 obtaining private insurance, she said.

In addition, while I thought the extra 14K total was between 9am and this evening, according to this article 826K was actually the 9am figure, meaning an even higher eventual total. Doesn't really matter at this point, I suppose; the final numbers will all come out soon...

Sarah Kliff posts a hell of a Tweet about Maryland: Over 3K QHPs so far today...nearly 10x the 322/day they averaged in February:

RT @drJoshS Seeing our @MarylandConnect enrollment numbers ... >6000 enrollments so far today, including >3000 in QHPs #biggestever

— Sarah Kliff (@sarahkliff) April 1, 2014

There's a few days missing in between so I don't really have a total number for MD, but this is still worth an entry.

Beating expectations, President Barack Obama's health care overhaul was on track to sign up more than 7 million Americans for health insurance on deadline day Monday, government officials told The Associated Press.

...Two government officials confirmed the milestone, speaking on condition of anonymity because they were not authorized to discuss the matter ahead of an official announcement.

OK, I've updated the "official projection" to 7,080,180 just for the hell of it, but I'm not trying to pretend that I had this thing nailed to the decimal point; my last real projection was between 6.9M - 7.0M, so I'm willing to divide 7,000,000 into whatever the final number is to find out how far off I am.

Believe me, I'd be perfectly happy if the final number as of 11:59pm ends up being 7.1M, 7.2M or even higher.

Short and sweet...Alabama was at 55,034 as of 3/01, so this appears to be a spike of nearly 22,000 QHPs. It's technically feasible that the 77K figure includes the 18K Medicaid enrollees which Alabama (a non-expansion state) has added, but I doubt it; that would only leave 4K QHPs in March, and they had over 11K in February, so I think I'm safe here:

So far 77,000 Alabamians have signed up for health insurance through the marketplace.

1,256 new QHPs may not sound like much, but for Hawaii this is huge:

On Monday, about 7,000 people were enrolled in health insurance plans, up from about 5,700 a week ago, said Eric Alberg, deputy executive director of the Hawaii Health Connector.

A solid number, a fairly solid date (assuming 3/16) and a confimation that it's private QHPs only, since they include the 3/01 number:

Jarvis Dortch, program manager and staff attorney for Mississippi Health Advocacy Program, said federal figures show roughly 32,000 Mississippi residents had enrolled in health exchange coverage through mid-March. That's up from the 25,554 who had enrolled by the end of February, but still thousands short of the original projection that 46,000 would enroll in the first five months.

WV's Medicaid expansion has been absolutely astonishing. They've now added nearly 105K, up from 98K, meaning that 73% of the state's eligible population has now been enrolled in the program:

The total federal projection since Jan. 2014 in West Virginia was 63,000, said Jeremiah Samples, Department of Health and Human Resources assistant to the secretary. By Friday, 104,820 people had signed up, he said.

...Samples said the reason West Virginia nearly doubled the projected number of enrollment was by identifying potential participants using information on existing food stamps and Medicaid applications. Only one of four states with this kind of auto enrollment, the process garnered around 118,000 enrollees, he said.

Vermont's numbers can be a bit squirrelly, but in this case they're very specific about 46.8K being exchange QHPs (VT doesn't allow off-exchange enrollments anyway, and the the 30-40K figure is the same from the last update).

As of Monday morning, 46,800 individuals had enrolled to be covered with private insurance either from Blue Cross Blue Shield of Vermont or MVP Health Care. An additional 30,000 to 40,000 people were enrolled through their employers, Yahr said. The federal target enrollment was 56,000 by Monday.

If that's not a typo or a misunderstanding on my part, it means that Vermont has just skyrocketed to 4.5x their February enrollment rate.

The numbers are tiny, but what the hell...DE was at 6,538 as of 3/01, so this is at least 1,463 higher...if it really is only 8,001, that's actually down 13% from the February rate, which I find hard to believe, but the numbers are so small it doesn't matter much anyway:

State officials initially had hoped to enroll 35,000 of the roughly 90,000 uninsured Delawareans for coverage under the ACA, but federal officials set a much lower target last fall of 8,000 enrollments, a benchmark that state officials say has been exceeded.

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