GRAHAM-CASSIDY REPEAL BILL DEADLINE:

Time: D H M S

It was just brought to my attention that there's a story in today's L.A. Times that mentions my name and this site several times. Given that the site has received quite an uptick in traffic and attention the past week or so, I just wanted to welcome new visitors, ask you to please read the FAQ and also stress a few additional points:

  • No, I don't guarantee that my numbers are accurate. I'm fairly confident of them, but my data is only as good as that of my sources, which are a variety of local & national news media websites as well as official state & federal government reports/media releases. If their data is wrong, mine will be as well, though I do the best I can to double-check any numbers which seem suspicious.
  • A few of the spreadsheet cells are color-coded; scroll to the bottom of the page for explanations of those.
  • Other numbers are italicized; those are either verified as being unpaid or are otherwise questionable (Massachusetts has a pretty messed-up situation at the moment).
  • Numbers that don't have any source link mean that they come from the official monthly HHS Dept. report (whcih currently only runs through 11/30/13).
  • At the right side of the spreadsheet is a "Notes" column; I'm currently in the process of changing this to direct links to the corresponding blog entries about that state. This will help simplify the spreadsheet as well as allowing me to go into detailed explanations for the entries.

Otherwise, thanks for visiting!

Massachusetts is a mess. I've been debating how to handle this; for private enrollments, it looks like I need to combine 497 subsidized, 3,262 unsubsidized (the previous number) and 22K temporary plans, which are apparently qualified/approved but haven't been processed yet. This adds up to 25,759 total, but the article refers to a lower number of 24,256. Given the confusion, I'm using that as the total and listing it below the other number in italics, which I normally use for "unpaid" enrollments. This brings the new tally to 3,759 fully enrolled and 20,497 "semi-enrolled"...I think.

The Medicaid number is more straightforward: 130K transferred automatically from a state-run public health program over to Medicaid proper.

As of Dec. 30, only 497 people had successfully enrolled in new subsidized health plans throughMassachusetts' health connector.

State officials have put another 22,000 people on temporary insurance plans, paid for by the state, while the connector processes coverage applications.

After last week's confusing numbers, Minnesota is back on track with private exchange enrollments increasing by 6,440 over a week earlier, or 33%. Enrollment in MinnesotaCare and Medical Assistance went up to 15,997 and 25,948 respectively.

MNsure got through the first round of customer sign-ups, which had a Dec. 31 deadline. On Friday the agency reported that 67,805 Minnesotans had used the site to enroll in a health plan by year’s end. Some 25,860 consumers bought an individual plan on the commercial market, with the rest eligible for one of the publicly subsidized programs.MNsure said that 14,600 people signed up in the last four days of December, a last-minute burst that Leitz described as “an encouraging sign.”

Kentucky's enrollment continues to quietly but steadily increase, with private exchange enrollments up 5% over Christmas Eve (from 31,672 to 33,289) and Medicaid expansion up 7% (from 84,480 to 90,254). Ironically, for all the praise they receive for their exchange running so smoothly, KY is actually still only at about 15% of their CBO goal, mainly because it was set absurdly high in the first place (220,000, or slightly higher than New York which has a population 4.5x as large).

Maryland's latest tally has just been released. They went from 11,715 private enrollments on 12/21 to 18,257 as of 12/28, a whopping 55% increase in the final enrollment week. They also added another 13,000 people to Medicaid either via the exchange or transfers from the MD Primary Adult Care program.

Through December 28, 18,257 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

91,570 Marylanders signed up through the Primary Adult Care (PAC) program to be automatically enrolled in Medicaid coverage on January 1, 2014, and now have full Medicaid coverage. Separately, through December 28, 43,065 Marylanders have been found eligible for a Medicaid program through Maryland Health Connection. As of January 1, 19,578 of those individuals were enrolled in Medicaid, and we expect many more of those found eligible to be enrolled in the coming weeks, with coverage retroactive to January 1. 

There's no specific breakdown given between private and public accounts, but the previous numbers were 14K and 24K, so I'm assuming the extra 2,000 are broken out in a similar 37/63 ratio. The article also reaffirms the 100,000 enrollments in the publicly-funded Oregon Health Plan.

The website still has not enrolled anyone, though roughly 40,000 have enrolled using the exchange's paper applications, and more than 100,000 have enrolled in the Oregon Health Plan using a system set up by the state in August to bypass the exchange.

It looks like my previous source for Colorado's Medicaid Expansion tally (114,192) was mistaking applications for actual enrollments. This number has been reduced by 27,760 as of 12/31/13.

In addition, in a previous entry I mentioned a study by the Commonwealth Fund from earlier this year which claimed that the correct number of "Under 26'ers" on their parent's plans thanks to the ACA is actually closer to 7.8 million instead of the 3.1 million figure that I've been using. However, I've been reluctant to switch to that figure since a) it's much larger and b) the HHS itself is only using the 3.1 million number. Today I found out why this is the case; contributor jdld provided a link to this report on the HHS website which states:

Colorado has increased their private total enrollment from 42,771 on Christmas Eve to 52,773 as of New Year's Eve.

Not too much to add here. This is significant not just because of the hard number, which is impressive and pushes CO ahead of their CBO enrollment schedule (92K by 3/31/14; they're 57% of the way there while the period is only 50.5% over), but because of the implication--the state extended their January enrollment deadline to 12/27, and managed to increase their tally by more than 23% in that last week. If this trend held true for other late-enrollment states, it could mean some nice last-minute mini-spikes.

On Christmas Day I posted "New ACA Attack: "But how many have actually PAID???" in which I pointed out that unless there prove to be significant technical issues preventing large numbers of premium payments from going through, this is pretty weak tea in terms of being an anti-ACA talking point...or at least it won't have any teeth to speak of until after January 10th, the date which most insurance companies have agreed to extend their January payment deadlines out to.

However, in the interest of completeness, I did point out that in at least one case (Washington State), the enrollment numbers are indeed broken out between paid and unpaid; specifically, 65,000 out of 134,000 total enrollments had been paid, or 48.5%. The next day, Nevada's numbers came out and once again, 49% (6,219 out of 12,740) were paid. So the short answer I gave at the time was "almost half of enrollees have paid."

In 2012, more than 50 million Americans lacked any form of health insurance. The Affordable Care Act was enacted into law in order to reduce that number. This website aims to give an accurate picture of how much.

In April this year, after the six-month open enrollment period has ended, it will be interesting to examine the statistics. Foremost among those numbers, in the minds of political pundits, will be how many Americans enrolled in private health plans? We will then know whether we reached, surpassed or fell short of the 7,066,000 enrollments projected by the Congressional Budget Office – long since elevated to a “target” rather than the projection it was.

How many more people are insured?
As we start this new year, at least 2.1 million people will be covered by new private plans, roughly 30 % of CBO’s first-year projection. However, this is by no means the only key figure. More than 4 million people are embraced by the Medicaid expansion. In addition, an estimated 3.1 young adults are now insured though their parents’ health plans. That adds up to 9.2 million people, which is a respectable start and should significantly reduce the number of uninsured. However, it must be underscored that many complex factors make it impossible to quantify that reduction, at least for the time being.

On top of that are an unknown number of people who have purchased ACA-compliant insurance plan off-exchange, i.e. directly from the insurance company. There are strong indications that total is significant – and we’ll return to that issue.

Mississippi: Private up to 2,000 from 802 (h/t Steve Mullinax, aka rsmpdx)

Transcript from Jeffrey Hess of Mississippi Public Radio, NPR Audio:

Only two insurance companies are offering plans in Mississippi, and they only overlap in four of the state’s 82 counties. However, those two companies appear to be betting that the web site problems and skepticism about the exchange in general are passing. One of the two companies, Humana, launched a late-December ad campaign to drive more people to the site, says spokesman Mitch Lubitz. “There’s been a ramp-up as the HealthCare.gov web site has gotten easier to use and there have been other options for people to go on and get information and enroll.” Mississipi’s Insurance Commissioner Mike Chaney says the improvements to the enrollment process are good, but he’s still skeptical they’ll be able to get enough people signed up this year. “From zero to ten, I’d give it a confidence level of about a three.” Hess: “That’s still not very good.” Chaney: “That’s not, but it’s better than where I was, a one, a week before last. “Chaney says the unofficial count is around two thousand people enrolled, but he says if the confidence trend continues upward, his confidence will rise to a five.”

My only update today was to finally post the F.A.Q.

I have a dozen or so submitted updates to check into, so hopefully I'll have a lot to add tomorrow, but otherwise I'm spending a quiet New Year's Day curled up in front of James & the Giant Peach and Hugo with my family.

Happy 2014, everyone!

Two quick last-minute updates before the ball drops on 2013:

Rhode Island: private enrollments up to 9,800 (h/t to Betsy Cazden aka rugbymom)

Individuals and families had until the end of the day Tuesday to enroll throughHealthSource RI for coverage beginning Wednesday. About 9,800 people had signed up from Oct. 1 through Dec. 28 for commercial plans offered in the marketplace. It was not immediately clear how many of them were previously uninsured.

As Ms. Cazden notes: "We were at a bit over 5,000 at the end of November, so this means it's almost doubled. Our CBO target number is 12,000, which we're on track to hit by mid-January at this pace....there will be more numbers coming out since people can sign up until midnight tonight (12/31)."

In a conference call earlier today, the HHS announced a few things, most of which I already knew, but a few new items. First, they confirmed the 2.1M private enrollment figure which ACASignups has been projecting for a week now (my original prediction was 2.0M by 12/24 and up to 2.3M by midnight tonight, but that was before several states extended their enrollment deadliens; I changed this to 2.1M who will have their coverage start on January 1st).

They also confirmed the 3.9M Medicaid/CHIP enrollments through 11/30 (not surprising since I had already gotten that number from them anyway) and the 3.1M "Under-26'ers" on their parents plans thanks to the ACA.

To be honest, there wasn't a whole lot of new information given out.  The most interesting news is that they've gotten both CVS and Walgreens to agree to some sort of special "transitional phase policy" regarding prescriptions and other pharmacy transcations; the gist of it is that for a short period of time (A week? Two weeks? They didn't specify), you'll be able to get prescriptions filled and so forth from CVS or Walgreens as long as you provide some sort of proof of your insurance coverage, even if it's not in their regular system yet. I didn't catch what sort of proof would be required, but this makes sense and is a smart move under the circumstances.

Last night I teased that I'd be providing some context and insight into the Iowa and Nebraska updates posted on the spreadsheet, and I still plan on doing so later today. However, there's been an interesting development over at Minnesota which I need to address first.

Yesterday, Jackie Crosby of the Minnesota StarTribune posted "MNsure grids for late crush of enrollees", which among other things gave an update on the MNsure enrollment numbers, stating:

More than 53,000 Minnesotans have bought coverage as of last Friday, with the biggest gains coming from those buying private health plans on the individual market. By Friday, 19,420 had signed up for individual or family plans; 12,051 had been enrolled in Medical Assistance; and 12,708 were getting coverage through MinnesotaCare.

So far, fair enough. However, in the original version of the article posted yesterday, there were two more paragraphs immediately following this. The first paragraph specified that these enrollments actually represented about 125,000 actual people (i.e., additional family members, etc). It also specified that about 20,000 of those were being held up due to paperwork issues and so forth. The next paragraph stated that around 3,900 people had completed enrollment but hadn't actually paid their first premiums yet.

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