Washington State

2018 MIDTERM ELECTION

Time: D H M S

I just posted an entry noting that Washington State was reporting having exactly 156,155 paid exchange-based QHP enrollments as of June 1st.

Now, this is noteworthy because according to an earlier update, as of around a week earlier, the state had reported adding "between 2,000 - 3,000" exchange QHP enrollees between the end of open enrollment on 3/31 (WA did not offer an extension period) and May 27th; let's split the difference and call it 2,500. Add that to the official 3/31 total and you get around 166,500.

What accounts for the roughly 10,000 person difference? Well, the first number includes both enrollments and cancellations after the first month. Remember, Washington State only reports enrollments once the first month's premium has actually been paid, so these should be "clean" numbers.

WOW!! This article from last week is chock full of data-nuggety goodness, including the first solid updates out of Washington State in some time:

The share of Washingtonians going without health insurance has fallen by nearly 40 percent, thanks to factors put in play by the federal Affordable Care Act.

That’s the word from the state Office of the Insurance Commissioner, which estimates that the overall 970,000 of uninsured residents had fallen by 38 percent to about 600,000. That drops the uninsured rate to 8.65 percent of the state, down from about 14 percent, OIC spokeswoman Stephanie Marquis said Wednesday.

...OIC has said the individual market has grown to more than 327,000 – which was about 81,000 more insured people than were in the individual market on Oct. 1, the date that the Washington Health Benefit Exchange opened for enrollments for 2014 coverage. The individual market included 156,155 people buying private insurance policies through the exchange and 171,286 who bought policies outside the exchange.

BRAVO to Washington State!

OLYMPIA, Wash. – Washington Healthplanfinder today announced a limited special enrollment period for Washington state residents whose same-sex domestic partnerships were recently converted to marriages on June 30. The 60-day enrollment window provides these couples with a unique opportunity to enroll in a Qualified Health Plan before the next open enrollment period that starts on Nov. 15, 2014 for coverage beginning in 2015.

A related article has the number of people impacted (3,600 couples, or about 7,200 people total):

Washington’s health benefit exchange is opening up a 60-day special enrollment period for couples in same-sex domestic partnerships that were recently converted to marriages.

On June 30, most state-registered domestic partnerships were converted to marriage automatically in Washington. This affected an estimated 3,600 gay and lesbian couples in the state.

Three stories which didn't seem worthy of their own full blog entry but each of which are pretty interesting...

Washington State, 06/25/14: Kreidler calls for health insurers to end discrimination based on gender identity

OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler is asking all health insurers doing business in Washington state to end discrimination in health insurance based on gender identity and related medical conditions.

In a letter sent to health insurers this morning, Kreidler reminded health insurers that exclusions and denials of coverage on the basis of gender identity are against the Washington Law Against Discrimination (RCW 49.60) and the federal Affordable Care Act (Section 1557).

...“Transgender people are entitled to the same access to health care as everyone else,” said Insurance Commissioner Mike Kreidler. “Whether specific services are considered medically necessary should be up to the provider to decide on behalf of their patient.”

Good.

This press release JUST showed up in my in box; I don't have a link to it on WA's website, so I'm reposting it verbatim below (emphasis mine):

FOR IMMEDIATE RELEASE – June 12, 2014

Media contact: Public Affairs (360) 725-7055

Individual health insurance market expands more than 30 percent – enrollment now at 327,000

OLYMPIA, Wash. – The individual health insurance market grew  30 percent in one year to more than 327,000 people in Washington state, according to new information reported by health insurers to the Office of the Insurance Commissioner.

The latest enrollment numbers and other insurance market data also indicate that Washington state has succeeded in reducing the number of uninsured by more than 370,000.

Today’s individual market total includes 171,286 people enrolled outside the Washington Health Benefit Exchange, Wahealthplanfinder, and 156,155 people enrolled inside the Exchange as of June 1, 2014.

Don't let the snarky headline fool you; I'm still very much a single-payer guy. However, anyone who still claims that the ACA exchanges are "socialized medicine" doesn't have the slightest clue what they're talking about. In case you needed even more proof that the ACA is very much private-market friendly:

Illinois:

After sitting out the first year, UnitedHealth Group Inc. intends to offer individual policies on the Illinois health insurance exchange next year, according to sources familiar with the company's plans.

The decision by UnitedHealth, the nation's largest and the state's No. 2 insurer, has the potential to shake up the Illinois market, which was dominated in 2014 by Blue Cross and Blue Shield of Illinois, the state's dominant insurer.

...United's participation also could help lower rates for consumers, a key concern among the law's supporters.

While United would neither confirm nor deny its plans to offer policies in Illinois next year, a spokesman said the Minnesota-based insurer intends to increase its participation over time in exchanges nationwide.

Nice catch by contributor Esther F....in this article about new parents having a 60-day "Qualifying Life Event" period to add their newborn child to their healthcare plan, there's this bit at the end:

About 164,000 Washington residents enrolled for private health coverage during the last open-enrollment period. About 2,000 or 3,000 have enrolled since then, Frey said.

Those include special enrollments along with “special special” enrollments — people still completing applications because of technical problems, Frey said.

OK, kind of a fuzzy number, but let's split the difference and call it 2,500. That means Washington State has increased their enrollment by about 1.5% since the end of March (WA was one of 2 states--Connecticut was the other one--which did not offer an official extension period). As the article was originally posted on 5/27, the latest the figures could run through is 5/26, so that's about 45 people per day since 3/31. Assuming this pace holds steady, WA should add over 10,000 QHP enrollees to their total by the time the 2nd enrollment period starts on 11/15.

Washington State finally wraps things up with their final numbers, breaking 164K QHPs and keeping their Strict Expansion / Woodworker ratio to the same 2:1 ratio that it's been pretty much the entire enrolllment period:

The state has previously reported that 147,000 people signed up for private health coverage, but said Wednesday that the total grew to 164,062 as officials finalized applications after the March 31 deadline. Open enrollment began last October.

Updated enrollment numbers from Oct. 1 to March 31 are included below.

Qualified Health Plans: 164,062

Medicaid Newly Eligible Adults: 285,275

Medicaid Previously Eligible but not Enrolled: 137,930

Washington State is doing a fantastic job of tracking pretty much every data point about health insurance in the state (I already had the 146K number):

OLYMPIA, Wash. – The individual health insurance market has grown to more than 324,900 people in Washington state, according to updated enrollment information reported by health insurers to the Office of the Insurance Commissioner this week.

This number includes 178,981 enrolled outside the Exchange and 146,000 enrolled inside the Exchange, Washington Healthplanfinder, as of March 31. The total is expected to increase as late enrollments through the Exchange are processed and reconciled.

...Before open enrollment began on Oct. 1, 2013, approximately 278,000 people were enrolled in health plans in Washington state’s individual market. Some 238,000 people received discontinuation notices from their insurers and had to find new coverage by Jan. 1, 2014. Estimates were made earlier this year that 113,000 of those who received notices would qualify for subsidies and 30,000 would qualify for the state’s newly expanded Medicaid program, Apple Health.

Thanks to deaconblues for all three of these items:

Avalere Health, with whom I've both clashed and agreed with on ACA-enabled Medicaid enrollments in the past, is projecting as high as a net gain of 4.3M Medicaid enrollees through the end of March:

700K to 1.3M Additional Medicaid Enrollees through March, If Current Trends Continue.

However, March and April figures could bring more dramatic increases if outreach and enrollment efforts targeting the end of exchange open enrollment translate into new Medicaid enrollees. Specifically, if Medicaid sign-ups follow a similar pattern as exchanges, new Medicaid enrollees could reach 4.3 million by the end of March. In addition, recent figures released by CMS do not account for individuals assessed eligible for Medicaid through HealthCare.gov who have yet to be determined eligible by states.

Washington State gives the official 3/31 total (except for Medicaid, which is still missing a few days):

Enrollments Completed

Qualified Health Plans: 146,497

Medicaid Newly Eligible Adults (through March 27): 268,367

Medicaid Previously Eligible but not Enrolled (through March 27): 135,485

Medicaid Redeterminations (Previously Covered - through March 27): 408,086

Total: 958,435

*Note: These numbers reflect enrollments and applications through March 31.

No final numbers or Medicaid, but it's something for the moment:

According to preliminary numbers, approximately 140,000 people had purchased insurance plans through the state by the end of the weekend, said Michael Marchand spokesman for the Washington Healthplanfinder exchange. That’s a bump of about 9,000 people over four days.

The headline is negative (shocker!), but the data is positive (imagine that!):

The Washington Health Benefit Exchange reported Thursday it had 131,000 private insurance sign-ups through its online portal, wahealthplanfinder.org.

The milestone comes on the eve of a major Obamacare deadline. Individuals not exempted by law due to low incomes must have health insurance by Monday or risk paying tax penalties next year.

The private insurance sign-ups are in addition to the more than 250,000 newly eligible adults who have enrolled in Medicaid since the exchange opened Oct. 1. Thousands more are enrolled in other Medicaid programs for the first time, according to the state Health Care Authority.

If they "reported" the numbers Thursday the 27th, I presume they were through midnight on the 26th at the latest. The previous tally (125,207 QHPs) was through the 23rd, so that's about 5,800 more in 3 days, or 1,933 per day.

This compares with WA's February rate of 654/day (nearly 3x) and their existing March rate of 816/day (over 2.3x).

I can't really use any of these numbers directly in the spreadsheet, but some excellent data to show the impact in Washington (state). Also note the point regarding many people enrolling directly with the insurance companies:

Statewide, about 375,000 people have insurance due to this law. That’s the net gain, counting those who had their policies “canceled” last winter (most simply signed up for a new one with their same company).

The Medicaid program in the state has grown 25 percent since October, from 1.2 million to 1.5 million.

...The private individual insurance market has also grown, by 19 percent, from 272,000 plans last October to 325,000 today. These figures include plans sold on the state exchange and directly by companies.

Whether that’s big enough to be stable and affordable remains to be seen. But before Obamacare it was shrinking.

Plus the state says there are 32,000 young adults on their parents’ policies due to the new law.

A huge turnaround from last week, when it looked like WA was starting to slow down. Exchange QHPs are up from 112,225 as of 3/13 to 125,207 as of 3/23...an increase of 12,982 in 10 days (not quite the "past week" described in the press release, unless it took the first 3 days for 901 of them to go through).

The impact on the projection chart is equally dramatic: Washington State has now gone from running 37% below February's daily average to 25% higher than February did.

On the Medicaid side, new enrollments now stand at 250K "strict expansion" and 130K "woodworkers", up from 235K & 122K respectively, for a total increase of 23,000 new enrollees.

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