Time: D H M S

Covered California Announces Continued Strong Enrollment and Reminds Consumers That Penalty Remains in Place Through 2018

  • The Patient Protection and Affordable Care Act’s requirement that consumers have health insurance remains in place, and consumers may face stiff tax penalties if they are not covered in 2018.
  • A recent study estimates 70 percent of consumers, who are uninsured and eligible for financial help, could purchase health insurance coverage for less than the price of the tax penalty.
  • Most consumers are paying less in monthly premiums than they did a year ago.
  • More than 342,000 consumers have newly enrolled during the current open-enrollment period, which remains ahead of last year’s pace, and continues in California through Jan. 31.

SACRAMENTO, Calif. — Covered California announced new enrollment figures as it approaches the final weeks of the annual open-enrollment period, and sought to quell consumer confusion by clarifying the federal penalty rules in place for 2018.

That's really about the simplest way I can summarize the situation today:

Daily on Healthcare: Dems agree to deal to reopen government, fund CHIP

by Philip Klein , Robert King and Kimberly Leonard | Jan 22, 2018, 12:52 PM

Dems agree to deal to reopen government, fund CHIP.

It looks to me like after his short-lived 2016 Presidential campaign (seriously, it only lasted 70 days...heck, even Lincoln Chafee's campaign lasted twice as long), Wisconsin Governor Scott Walker decided to go back to shoring up his image in his home state...and since Wisconsin is one of 14 states which doesn't have any term limits for the top spot, it looks like he's scrambling to move back to the center policy-wise just in time to run for a third term this November:

Scott Walker proposes plan to prop up Obamacare marketplace

The Children's Health Insurance Program (CHIP) has been around for 21 years. It was co-created in a bipartisan way in 1997 by Sen. Ted Kennedy and Sen. Orrin Hatch, with support from Hillary Clinton while she was First Lady of the United States.

CHIP was originally funded as a 10-year program. When the original funding ran out in 2007, it was extended for two years (to 2009) under George W. Bush with little incident (he had previously vetoed an expanded version but later signed the extension of the existing version).

Under President Obama, CHIP was extended (and expanded) again through 2013. The Affordable Care Act added another 2 years to CHIP, extending funding through 2015. In 2015, CHIP funding was extended again, through September 30, 2017.

The completely GOP-controlled Congress allowed CHIP funding to expire. Most state still had a few months worth of money held in reserve for the program, but some started sending out termination notices to the parents of enrollees, letting them know that they'd be kicked off the program within the next month or two.

via Covered California, yesterday:

  • An analysis of potential premium changes in states across the nation shows increases of 16 to 30 percent likely in 2019 if federal steps are not taken.
  • While the Patient Protection and Affordable Care Act’s subsidies would largely insulate subsidized consumers from these costs, millions of unsubsidized consumers would pay the full price of these increases. Many would likely be priced out of coverage.
  • Continued policy and premium uncertainty risks further carrier withdrawals, leaving more consumers with only one health plan and even the prospect of “bare counties.”
  • The analysis reviews three federal policy options that could stabilize markets and mitigate the impact of premium increases in many states.
  • Covered California’s open-enrollment period is still underway and consumers have through Jan. 31 to sign up for coverage.

Flashback to September 24, 2013:

The United States federal government shut down for the first 17 days of October 2013 because Ted Cruz and other Congressional Republicans, furious about the Affordable Care Act surviving everything they had thrown at it over the preceeding 3-4 years, thought that pulling the plug would torpedo the launch of the ACA's first Open Enrollment Period.

Unfortunately for them, that simply wasn't in the cards:

Rather, any defunding would be temporary, because of a government shutdown. On the day the exchanges were due to open, much of the federal government would go offline, including a big portion of the Health and Human Services Department that is running the coverage expansion. But legislative inaction cannot gut Obamacare in the way that legislative action could. During a shutdown, implementation would “substantially” continue.

That’s according to a Congressional Research Service report prepared for Senator Tom Coburn, an Oklahoma Republican. In no small part, the reason is that much of the Affordable Care Act’s financing comes from mandatory spending, rather than discretionary spending, and a continuing resolution concerns only the latter. Moreover, some of the law’s money comes from multiyear or “no-year” discretionary funds that do not get wrapped up in the continuing-resolution process either. The Health and Human Services Department says its reform implementation fund would not get touched by a lapse in appropriations.

A few days ago I reported that the Washington Health Benefit Exchange had enrolled 234,000 people in private policies for 2018 when they had just a couple of days left to go.

Today Hannah Recht provided a link to this WA state navigator meeting in which rough final numbers were included as part of the slideshow presentation, along with a bunch of other data points which should be of interest to other healthcare/navigator wonks. 242,800 is a rough number but assuming it doesn't get changed by much, it means the Apple State enrolled 7.6% more people in QHPs this year than last, with nearly 1/3 of them being new to the WA exchange.

Washington State was already beating their 2017 numbers anyway, so this update just pads their lead.

UPDATE: Arrrrgh!!! Literally moments after I went live with this, Hannah Recht pointed out to me that the Washington Health Benefit Exchange has (unofficially) posted their (rough) final 2018 enrollment numbers via an internal slideshow presentation. The table and all numbers below have been updated to reflect the additional 8,800 enrollees added in WA over the final few days of its enrollment period.

UPDATE 1/22/18: Covered California has just issued a major update to their enrollment data, adding another 122,000 QHP selections to the national tally. Everything below has been updated to include this.

UPDATE 1/28/18: The deadline for Massachusetts has passed and they've posted their final numbers. Everything below has been updated to reflect this update.

No official link or press release yet, but This Just In from Politico NY's Dan Goldberg...

.@charles_gaba new numbers from NY

243,600 -- qhp surpassing last year's
726,300 in the Essential Plan

— Dan Goldberg (@DanCGoldberg) January 18, 2018

Last year, New York State of Health enrolled a total of 242,880 people in ACA exchange policies; this means they're slightly ahead of that number with two weeks left to go before the January 31st Open Enrollment deadline. This makes NY the fifteenth state to surpass last year's total...as well as the 7th State-based Marketplace (or the 10th if you include SBMs which are piggybacking on the federal exchange platform). I'll be writing something up about that later today.

Access Health CT already reported their top-line 2018 Open Enrollment Period number and a few other data points via Twitter a couple weeks ago, but they just issued a more detailed press release:


(HARTFORD, Conn.) – Lt. Governor Nancy Wyman and Access Health CT (AHCT) CEO Jim Wadleigh today provided the results of the Connecticut healthcare exchange’s fifth open enrollment period, which ran from November 1 to December 22, 2017. During this open enrollment cycle, 114,134 residents signed up for private health insurance coverage, reflecting a 2.3 percent increase compared to enrollment figures last year.

Well THIS falls under the Good News department:

CMS Announces Additional Special Enrollment Periods to help Individuals Impacted by Hurricanes in Puerto Rico and the U.S. Virgin Islands
Agency provides extended special enrollment periods for 2018 Medicare and Exchange coverage

En español

This just in via email...

MNsure ends open enrollment with record number of signups

116,358 Minnesotans enrolled in private health plans through MNsure for 2018 health coverage

ST. PAUL, Minn.—Today MNsure announced that a record number of Minnesotans in the individual market signed up for health coverage through MNsure during open enrollment, breaking the previous year’s record of 114,810. Despite an open enrollment period three weeks shorter than 2017 and significant challenges stemming from the federal level, MNsure enrolled more Minnesotans than ever. Thirty percent of MNsure enrollees were new this year.

*According to these numbers, MNsure beat out last year's enrollment total by about 1.3%...impressive in its own right. But it's actually better than that, because the official 2017 Open Enrollment number according to CMS was only 109,974 people...which means that officially, MNsure has actually outperformed last year by 5.8%!


I've been operating ACASignups.net for nearly 4 1/2 years. It started out as a nerdy hobby thing in my spare time, but quickly overtook my life. I always planned to shut it down after the first Open Enrollment Period ended back in April 2014...and then in March 2015...and again in 2016. Year after year, people clamored for me to keep it going one more year.

via Email just moments ago...

Connect for Health Colorado® Reports Plan Selection Totals for 2018 in Line with Target and Nearly Matching Longer 2017 Enrollment Period

DENVER —  More than 165,000 Coloradans selected healthcare coverage for 2018 through the state health insurance Marketplace by the close of Open Enrollment, according to new data released today by Connect for Health Colorado®. 

“These are positive results that show us holding steady and in line with our targets for the year,” said Connect for Health Colorado CEO Kevin Patterson.  “Despite the uncertainty that created some confusion in the market, we have seen volumes that nearly match last year’s longer Open Enrollment Period. I am happy to see so many families and individuals put this protection for their health and financial well-being in place for the year. We will be reporting our results in coming weeks in our annual End of Open Enrollment Report.” 

Except he's not threatening to shoot a dog; he's threatening the lives of nearly half a million of his constituents.

Bevin issues ultimatum: If courts block Medicaid plan, half million Kentuckians will lose care

Gov. Matt Bevin has issued an executive order that would strip Medicaid coverage from nearly half a million Kentuckians should his proposed overhaul of the federal-state health plan be struck down in court.

No one has filed a legal challenge to Bevin's changes to Kentucky's Medicaid program that federal authorities approved Friday.

But several advocacy groups have said some of the changes — such as requiring some "able-bodied" adults to work or volunteer at least 20 hours a week — likely will be challenged in court because they violate federal law that establishes Medicaid purely as a health program and does not authorize work requirements.