Charles Gaba's blog

Note: This is more of a placeholder for the moment; it'll be updated as soon as the numbers are available.

At around 10:30am this morning, Covered California will be announcing their final, official 2018 ACA Open Enrollment Period numbers, along with other various demographic info.

Keep in mind that California is second only to Florida in terms of ACA exchange enrollees, with around 13% of the national total each year, so this is a big deal.

The most recent updates from the largest state-based exchange pegged their numbers at 1,542,000 QHP selections as of January 21st, including:

  • "more than" 1.2 million renewing enrollees, and
  • "more than" 342,000 new enrollees signing up.

Last year Covered CA's 1/31 total hit 1,556,676 (or just under 15,000 enrollees higher). In 2016 they had their all-time high of 1,575,340, so they'd have to have tacked on about 34,000 more over the final 10 days of Open Enrollment this year in order to beat their record.

Last month, Covered California issued an extensive analysis of the individual market landscape for 2019 and concluded that the recent actions taken by Donald Trump and Congressional Republicans (especially, of course, the repeal of the individual mandate) will collectively cause rates to spike by up to 30% even without taking into account the normal medical inflation one would normally expect every year anyway. I didn't see a whole lot of reporting on this report other than my post and Michael Hiltzik's story on it at the L.A. Times, but I might've missed others.

Now that the 2018 Open Enrollment period is officially over in every state +DC, I've started compiling more detailed demographic breakouts of the data on a state-by-state basis. The official CMS report from the Assistant Secretary for Planning & Evaluation (ASPE) report should be released at some point in the next couple of weeks, but until then, I'll have to settle for whatever reports I can patch together from some of the state-based exchanges.

So far I've dug up final (or near final) data for six states: Colorado, Connecticut, Idaho, Maryland, Minnesota and Washington State. Collectively, these states only represent about 890,000 2018 exchange enrollees, or roughly 7.5% of the 11.8 million total, so I have no idea how representative they are nationally, but it's all I have to work with for the moment.

The type of demographic data available varies greatly from state to state, but a major data point available from all six of them also happens to be one of the more interesting points, especially this year, given the " CSR Silver Loading" gambit available in most states this year.

Maryland was originally one of 3 state-based exchanges which stuck to the "official" half-length, December 15th Open Enrollment Period deadline this time around. However, with just 2 days to go before the original deadline, the MD Health Connection announced that they had decided to bump out their deadline by an extra week after all, through December 22nd.

When the dust settled, 153,571 Marylanders had signed up for 2018 coverage, down about 2.7% from 2017. This made MD one of only three fully state-based exchanges to come in short year over year...and the only one to do so with an extended deadline (both Idaho and Vermont stuck with the 12/15 cut-off). Even so, achieving over 97% of their prior-year numbers is still pretty impressive, all things considered.

I want to be clear about something: Much of my data analysis has a bit of snark to it, adding an acrid tinge of dark humor to healthcare, a topic which is often fraught with pain, suffering, grief and sadness. Once in awhile I take pause before twisting the sarcasm knife too much.

This is one of those moments. I'm therefore limiting the snark to the headline only.

From today's Detroit Free Press:

Three Januarys ago, Gov. Rick Snyder described a River of Opportunity all Michiganders could enter as long as the state improved third-grade reading proficiency.

“One of the important metrics in someone’s life on the River of Opportunity is the ability to be proficient-reading by third grade,” he said in January 2015. “How have we done? We were at 63% in 2010, and we are at 70% today. … But 70% doesn’t cut it.”

Over the past month or so, former CMS Administrator and healthcare hero Andy Slavitt has been urging people to fill out a sparsely worded, cryptic online form if they're interested in "making our nation's health care system work better for all Americans."

There are too many agendas that aren’t about making health care work for all Americans. We need to put health care over politics again.

Within a month, a major initiative will be announced that I and many Americans will come together for. If interested... https://t.co/7BBDUS2J8u

— Andy Slavitt (@ASlavitt) January 13, 2018

I filled it out, of course, as did what I presume are thousands of others, but few had any idea what Slavitt specifically had in mind at the time. Today he's gone public with the details:

Note: Ironically, I had to make a slight correction myself below--for some reason I originally had "Alleigh" down as "Allison".

Flashback to May 24, 2017:

From Alleigh Marre, HHS Dept. National Spokesperson, less than an hour ago (h/t Kimberly Leonard for the heads up):

"Even Charles Gaba, the author of ACAsignups.net admits in his analysis, “The simple truth is: Yes, full-price, unsubsidized premiums for individual market healthcare policies probably have doubled since 2013…” His analysis of the report drives home that Obamacare’s one-size-fits all mandates and regulations have driven up prices for all."

Here's the actual quote she's referring to:

Look what I dug up on the Washington Health Benefit Exchange website!

That's right...it's time for another state-level Datapalooza!® The first two slides come from the Feb. 2nd board meeting Open Enrollment Report; the rest come from the "Open Enrollment For 2018 Plan Year Performance Dashboard" report, which is a bit different; it actually runs through January 26th instead of January 14th for whatever reason. so some of the numbers are slightly different.

 

NOTE: The last few paragraphs of this post have been reformatted for clarity only.

All of Twitter is abuzz with this tweet (since deleted) by Republican Speaker of the House Paul Ryan:

A secretary at a public high school in Lancaster, PA, said she was pleasantly surprised her pay went up $1.50 a week ... she said [that] will more than cover her Costco membership for the year. https://t.co/yLX1Bod1j0

--Paul Ryan (@PRyan) February 3, 2018

While Ryan deleted the tweet above (fear not...a whole mess of people took screen shots before he did so), he has yet to remove another tweet quoting another passage from the same AP article (I took a screen shot of this one in case he deletes it as well):

“I have heard time and again that the middle class is getting crumbs, but I’ll take it!” https://t.co/yLX1Bod1j0

Idaho is one of only 2 state-based exchanges which stuck with the "official" December 15th deadline for the 2018 Open Enrollment Period (the other was Vermont). Unfortunately, they haven't released an official, detailed demographic breakout report yet, but they did discuss some relevant stats in their December board meeting...which, as it happens, took place on December 15th, which means it's still missing a bit of final data. For now this is the best I can do:

d) Enrollment Update

Mr. Kelly said YHI’s goal in enrollments is to be flat year-over-year, and it is within reach. When we look at average enrollments for 2017 of around 90,000 Idahoan’s, we appear to be ahead of that for 2018. As of this morning, we have almost 96,000 enrollments. This week alone, we have gained over 6,000 enrollments, way ahead of our growth for the same time last year. We also had well over 2,100 calls into the support center yesterday.

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