2018 MIDTERM ELECTION

Time: D H M S

A rough total number (which I suspect we'll see a lot of this weekend...things are moving very quickly now). Assuming a 20/80 split (typical for Kentucky) of the additional 17,600 total, this should mean roughly 3,500 more QHPs and 14,100 more added to Medicaid, to around 69,500 and 280,500 respectively.

We've been seeing a tremendous increase in the number of people applying and approved each day," says Gwenda Bond in the Kentucky Cabinet for Health and Family Services.  "We've been seeing about 3,100 each day and I suspect that's even higher this week."

According to the state, an estimated 350,000 uninsured Kentuckians have enrolled in Medicaid or private coverage.

UPDATE: OK, someone provided the hard numbers, thanks:

Another quick Minnesota update; non-specific numbers (and why they say "Medicare" alongside Medicaid I have no idea):

Currently, about 42,000 Minnesotans are enrolled through qualified health plans, while 110,000 are through Medicare and Medicaid.

I posted an Arkansas update last night, but here's another...and the "private Medicaid option" numbers are either a little higher or a lot higher depending on the number you use; the wording from the AR DHS is confusing:

233,676 – Total number of private option applicants from state and federal levels.

Of those, 149,666 have been determined eligible for the private option so far and will begin receiving coverage.

Of those determined eligible for the private option, 106,324 have completed the enrollment process (as of 3/21/14). An additional 14,969 have been determined to be better served by traditional Medicaid for a total of 121,293 people who have fully completed the enrollment process. 

It sounds like there's 28,373 who are still in the middle of paperwork or something, but the DHS is quite clear that one way or another all 150K will be enrolled in either the "private option" or "standard Medicaid", so I'm going with the higher number until they clarify otherwise. I normally err on the side of caution, but in this case the "will begin receiving coverage" is part of an official DHS press release.

Back when I assumed that I'd be pulling the plug on this website after March 31st, I didn't see the point of keeping track of the states which finally came around and added Medicaid expansion after the end of the Open Enrollment period. Not that I didn't think it was important, mind you; I just assumed that this site would be winding down in early April anyway, so it would be kind of pointless.

However, now that practically every state is extending their enrollment out to April 15 (or beyond, in a couple of cases) for those who started their application before Monday, along with the fact that Medicaid enrollment doesn't have a deadline anyway along with numerous other exceptions, it behooves me to make note of additions to the Expansion party as they come along.

Final report before the official 3/31 deadline...exchange QHPs are up to 49,293 from 44,836 (up 4,457), while Medicaid is up to  220,043, which includes 124,154 regular enrollments (up from 107,505) and 96K auto-transfers.

The impact on the projection chart is slight but positive; MD's increase over the February rate has gone from 50% to 66%.

Through March 22, 49,293 Marylanders have chosen to enroll in private health plans through Maryland Health Connection. As of March 25, 220,043 have gained Medicaid coverage in 2014 and remain active in Medicaid....This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage. 

I've got to give a big shout-out to Uri Manor, who has written an excellent follow-up to my Response to Avik Roy regarding the "How many were previously insured?" issue.

It's very late, I'm very tired and I haven't had a chance to review all of his math, so I can't comment specifically on his conclusions, but if nothing else he adds one more crucial factor to the subject: NOT EVERY INSURANCE COMPANY PARTICIPATES IN THE EXCHANGES AT ALL.

Just as a quick example:

(CNSNews.com) – Major health insurance companies--Blue Cross, Aetna, United, Humana--have decided not to participate in various states in the Obamacare health-insurance exchanges that will be the only place Americans will be able to buy a health insurance plan using the federal subsidies authorized under the Obamacare law.

One more update tonight, out of Arkansas...nothing shocking either way, about a 21% increase over the February daily average; takes the projection down a smidge but nothing significant:

LITTLE ROCK, Ark. (AP) - Arkansas officials say more than 33,500 people have signed up for the health insurance exchange set up under the federal health law, well below the numbers they hoped to see before the enrollment deadline next week.

State officials on Thursday said the signup for the exchange, a marketplace where consumers can select health plans, has lagged in comparison to enrollments in the state's "private option" compromise Medicaid expansion. More than 106,000 people have signed up for the private option, the state's program using federal Medicaid funds to purchase private insurance for the poor.

A very nice little update from CT. Clean numbers, and this is the first specific reference to policies being subtracted from the total due to non-payment (presumably for policies that started in January, February and possibly March), which is perfectly fine.

I've said all along that I have no problem at all with subtracting any people who truly are deadbeats or cancel their policy for one reason or another...it's just that they shouldn't be subtracted until they actually are past due, that's all.

Connecticut’s health insurance exchange has been enrolling between 3,000 and 4,000 members per day as the sign-up deadline approaches, exchange CEO Kevin Counihan said Thursday.

As of Wednesday afternoon, 178,601 state residents had signed up for Medicaid or private insurance through the exchange, Access Health CT.

Of those, 62 percent, or 111,050, will receive Medicaid coverage. The other 67,551 signed up for private insurance. Among private insurance customers, 78 percent are receiving federal financial aid to pay their premiums.

OK, after all of today's excitement it's back to the state-by-state grind...

More than 55,000 Vermonters have picked a health plan through Vermont Health Connect since open enrollment began in October and more than 43,000 are fully enrolled in new coverage. That means roughly 12,000 Vermonters have yet to pay their first premium or are having problems completing the process.

Contributor deaconblues has done the math for me this time, which I appreciate since my brain is fried today:

I know Vermont is a tricky beast, but this article specifically says 55K through the Vermont Health Connector (no bulk transfers or SHOP)

The current numbers on the spreadsheet say:

  • QHP: 28,950 (18,507 paid + 10,443 unpaid)
  • Medicaid: 21,525
  • Total: 50,475

This would imply they've newly added about 4,500. If you prorate the 55K across QHP and Medicaid (58/42), and use the paid QHP as a "hard number", you get

  • QHP: 31,900 (19,900 paid + 12,000 unpaid)
  • Medicaid: 23,100

This looks right to me, so there you go.

Well, first of all, I've gone ahead and increased my official 3/31 projection to 6.5 million exchange QHPs.

This may go up a bit more, but we're really into uncharted territory at this point. This is where I really am not the "Nate Silver of..." anything. I don't run 10,000 simulations across a complex computer model or anything like that, I can only rely on the existing data, and things are ramping up a bit more quickly than I figured a few days ago, so a lot of this is going to be "back of the envelope" guesswork going into the final weekend.

There's another huge factor to consider as well: The post-3/31 QHP enrollments.

These impact things in several ways:

First of all, since at least 43 states (I think...possibly more) are now doing the "as long as you start by 3/31 you have until 4/15 to complete" thing, some people who otherwise would have scrambled this weekend may ease up, start the process this weekend and then come back to finish the first week of April.

Here you go...hot off the presses...um, Twitter-feed, anyway...

@charles_gaba MT @igorvolsky: BREAKING: Obama says on a call that 6 million people have enrolled in Obamacare.

— Seth Trueger (@MDaware) March 27, 2014

Things are moving VERY quickly now, and events are quickly overtaking my ability to keep up. I'll post more details as quickly as possible, but all sorts of stuff may get by me.

For example, I just added this update from the WSJ, which claims 100K QHPs per day on Mon/Tue.

UPDATE: Just received confirmation that the 6M milestone was indeed reached sometime yesterday (Wednesday).

 

Note: This entry is purely speculative at this point (I'm ignoring Gandalf's advice here and straying off the path).

OK, earlier today I said:

IF it's true that around 79,000 people per day have been enrolling nationally all of this week, that means that yes, we could indeed have already surpassed the 6 million mark...THIS week.

My current projection has exchange QHPs breaking the 6M mark sometime late today (Thursday) or early tomorrow (Friday), but it's conceivable that we did already pass it late last night or early this morning.

Then, about an hour ago, I posted this update which embraced the bold-faced part of that last sentence:

I'm gonna go for it and predict an announcement later today that the 6 million exchange QHP milestone has been hit.

OK, I'm probably gonna go down in flames for this, but this "50K Households Started Applications Yesterday" tweet from Covered California keeps coming to mind.

50,000 households started #CoveredCA health insurance applications yesterday - our highest number yet.

— Covered California (@CoveredCA) March 26, 2014

I'm gonna go for it and predict an announcement later today that the 6 million exchange QHP milestone has been hit.

(to clarify: if they announce it today, it probably actually crossed 6M sometime last night or early this morning)

I'm leaving the 3/31 projection as 6.39M for the moment, but will update this (or not) depending on whether I'm correct about a 6M announcement (or not).

Just to get this out of the way since so many have asked...

April D. Ryan, who broke the awesome scoop about HC.gov enrolling 40K in a single day back on 3/15, reported a very eye-opening claim yesterday: That supposedly total exchange QHP enrollments had already broken the 6 million mark last week:

Sources who do not wish to be identified, contend last week that the ACA enrollment numbers surpassed the six million mark.  A source also says  ”People are swarming to the healthcare.gov website and enrollments are rising.” On Tuesday March 25, 2014 over 1.2 million people visited the healthcare.gov website.  Enrollments have exceeded 60,000 per day since Sunday March 23, 2014.

The White House denied the claim, but her sources insisted that it was true:

No exact numbers, but the previous update as of 3/15 was 22,533 paid / 10,520 unpaid (33,053 total), so this looks right. NV's March pace is still running around 45% above February's daily average.

As of March 22, more than 35,000 people have signed up for a health insurance plan. Approximately 23,000 of them have already started making payments on their health care coverage.

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