Estimated Exchange QHPs as of 8/26/14: 7.96M PAID (9.18M Total)

Estimated Total, all sources: (24 Million - 29 Million)

Exchange + Off-Exchange QHPs: 15.9M  •  Medicaid/CHIP (6.9M - 9.8M)

ESIs (155K confirmed; up to 8M more possible)  •  Sub26ers (1.6M - 3.1M)

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The big news ACA yesterday was that Kevin Counihan, the guy who ran AccessHealthCT (one of the best-run state exchanges) has left that post to become the new "CEO" of Healthcare.Gov, just in time to prepare things for the 2nd open enrollment period.

By all accounts, this is excellent news all around. Counihan has been widely praised for his work in Connecticut--as well as in Massachusetts prior to that (he was one of the guys in charge of the original "RomneyCare" initiative).

So. We now have a new HHS Secretary (Sylvia Burwell, who's been in charge since early summer), a new Healthcare.Gov CEO (the first, actually), and a new Communications Director for CMS (Centers for Medicare & Medicaid Services), Lori Lodes.

Sarah Kliff at Vox broke the news a few hours ago, but I just received the official press release from CMS; there seems to be some discrepancy about the total number eligible, but it's fantastic news no matter what:

Pennsylvania has apparently struck a deal with the Obama administration to expand its Medicaid program to more than 300,000 poor residents, Joan Alker at Georgetown University tweets:

Pennsylvania would be the 27th state (not including the District of Columbia) to participate in Obamacare's Medicaid expansion, and Gov. Tom Corbett would be the ninth Republican governor to sign on.

According to the CMS Dept, however, the actual number eligible in Pennsylvania could top 500,000:

FOR IMMEDIATE RELEASE Contact: CMS Media Relations

August 28, 2014
(202) 690-6145 or

CMS Statement on Approval of Medicaid Expansion in Pennsylvania

I post guest entries once in a blue moon, and this one could be huge, if his conclusions are accurate (and still well worth discussion even if they aren't). Recently, both Sarah Kliff over at Vox and Margot Sanger-Katz & Kevin Quealy at the NY Times Upshot have delved into some fascinating and unexpected news regarding Medicare & Medicaid spending in the U.S. over the past few years.

Well, an ACASignups supporter named Jim Stuart (all I really know about him is that he's a retired executive and educator who attended Princeton and lives in Illinois) has gone even deeper into the weeds on this and, well, I'll let those who know more about such things than I do decide how much of a Big Deal this is.

With Jim's request/permission, I'm reposting his piece verbatim, but I'd also advise checking out his own blog.

This is an interesting overview/update about the state of the ACA's small business "SHOP" exchanges, which, by my calculations, have only enrolled around 72,000 people nationally to date (a rounding error compared to the 9,000,000 or so who've enrolled in individual QHPs so far):

But Askew is in a tiny minority. Only 2 percent of all eligible businesses have checked out so-called SHOP (Small Business Health Options Program) exchanges in the 15 states where they have been available since last October under the Affordable Care Act. Even fewer purchased policies.

The good news is that things should start ramping up on the SHOP side this fall:

In November, three more state-run SHOP exchanges are slated to open, and the federal government will unveil exchanges for the 32 states that chose not to run their own.

In spite of their amazingly successful manual workaround process (which has enrolled 465,000 people in either private or Medicaid coverage), Oregon's website debacle continues to fester. Even so, until recently they've ironically been one of the most reliable state exchanges when it comes to publicly posting updated enrollment data. New detailed data has been posted pretty much once a week since the crazy days of March/April on a regular basis.

That all came to a screeching halt just over 3 weeks ago; the last update out of CoverOregon was August 6th. Again, this is still much better than most other states which only publish updates monthly or not at all, but for Oregon it's been worrisome for me, since they're one of only a handful of states giving that info out at all during the off-season.

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 373,171
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of August 25, 2014 
*Updated every Monday at 3 p.m.

Oh, and by the way, while Michigan Governor Rick Snyder may deserve some credit for pushing his party to accept Medicaid expansion, this was only possible due to THE AFFORDABLE CARE ACT, AKA "OBAMACARE".

Amazing how many people can't seem to get that through their skulls, even as they heap praise on the Governor for basically "not being a jerk" in this instance. Apparently "not being a jerk" on one issue is worthy of high praise when it comes to Republican elected officials these days.

A few days ago, David Ramsey of the Arkansas Times reported about a leaked document with the proposed & approved private QHP premium rate changes for 2015. At the time, he calculated the weighted average of the approved rates to be a drop of around 3.5% overall.

Today he reports that the official rate approvals have now come out, and while there was a slight error in the original numbers, the final weighted average is still excellent news: An overall weighted drop of 2%:

Insurance companies have proposed a net reduction in premiums of 2 percent next year for the Arkansas Health Insurance Marketplace, the health insurance exchange created by the Affordable Care Act. The Marketplace includes all of the plans used for the private option, the state's unique plan which uses Medicaid funds to purchase private health insurance for low-income Arkansans.

That "private Medicaid option" factor is important as well, because...