2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Minnesota's official enrollment figures as of 2/24 are up slightly from a few days ago...Private QHPs are up just 434 people to 31,522 while Medicaid is up 3,015 people to 73,271.

After having my enrollment projection model confirmed by the administration twice in the past week, I thought this would be a good point to see how close I've gotten various milestones since I started this thing:

Private QHPs: Total thru the end of December
ACA Signups, 12/25 2,100,000 98.24% accurate
Actual (HHS), 1/13 2,137,630
Medicaid/CHIP: Total thru the end of December
ACA Signups, 1/21 6,320,000 99.68% accurate
Actual (CMS), 1/22 6,300,001
Private QHPs: Total thru the end of January
ACA Signups, 2/07 3,300,000 99.98% accurate
Actual (HHS), 2/12 3,299,492
Private QHPs: Percent Paid
ACA Signups, 2/13 (10 AM) 75-80%

basically the same

New York Times, 2/13 (5 PM) 75-80%
Private QHPs: Total thru Feb. 19
ACA Signups, 2/19 3,860,000 at least 95% accurate
Pres. Obama, 2/20 "close to 4M"
Private QHPs: Total thru Feb. 24
ACA Signups, 2/25 (3:48pm) 4,013,762 99.66% accurate
Actual (HHS), 2/25 (5:59pm) 4,000,000

 

On a completely separate note, I should also point out that while the actual enrollment period for Private QHPs ends on 3/31/14, we won't know how many actual enrollments there are until mid-April, and we won't know how many paid enrollments there are until sometime in early to mid-May.

ACA Signups February Enrollment Projection, 3:48pm today:

#ACASignups With #NY update, new Feb. projection is 870K QHPs for 4.17M total by 3/1 http://t.co/MYSDQWQTVC @LOLGOP @Eclectablog

— Charles Gaba (@charles_gaba) February 25, 2014

  • February 2 - February 24 = 23 days
  • 23 days / 28 days) = 82.1%
  • 82.1% x 870,000 = 714,270 enrollments from 2/02 - 2/24

714,270 + 3,299,492 = 4,013,762

The Huffington Post, 5:59pm:

WASHINGTON -- Approximately 4 million individuals how now signed up for health care plans under the newly created Obamacare insurance exchanges, a senior administration official told The Huffington Post on Tuesday.

The official press release hasn't been posted to the state exchange website yet, but here's the latest out of the Evergreen State:

Feb 25, 2014 - More than 100,000 Washingtonians have now enrolled in private health plans offered on the Washington state health insurance exchange www.wahealthplanfinder.org, exchange officials said Tuesday.

Overall, a total of 717,933 have enrolled in health insurance on the website. 

Here’s the breakdown: 

101,857 have enrolled in private plans
202,168 newly eligible residents have enrolled in Medicaid.

102,238 who had previously been eligible fro Medicaid but had not enrolled.
311,670 who had been previously eligible for Medicaid who have reenrolled.

And additional 82,249 have enrolled in private plans but have not yet paid their premiums.

These numbers bring WA's Private QHPs up from 90,723 Paid / 85,372 Unpaid as of 2/06 for a total increase of 8,011. More notable is that the state's Paid percentage is slowly increasing, from about 50% a month or so ago up to 55% this week.

OK, I'll have to pull the numbers apart a bit because this story with New York's latest enrollment tally has some overlapping dates and numbers:

More than 800,000 New Yorkers have completed applications to enroll in New York's health-care exchange since Oct. 31, and 501,205 have officially enrolled, a 22 percent increase since Feb. 10, the state Health Department said today....

The state said that 70 percent of those who have enrolled were uninsured at the time of application. But the state didn't immediately say how many of those lost insurance because of the federal Affordable Care Act.

Of the total 501,205 people enrolled, the state said 276,681 chose private insurance plans, while 224,524 qualified for coverage under Medicaid, the government-sponsored health insurance program for low-income Americans.

"Woodworkers", in ACA Medicaid parlance, refers to people who were already eligible for Medicaid coverage prior to the ACA expansion (in states which have done so),  but who didn't actually enroll in Medicaid until after October 1st for a variety of reasons, ranging from not being aware that they qualified, to finding the enrollment process too difficult, to not even knowing what Medicaid was before the ACA exchanges launched.

In other words, these are people who already qualified, but were "brought out of the woodwork" to sign up since the exchanges launched in October.

I've been struggling with the question of whether to include "woodworkers" in the Medicaid/CHIP tally or not since I first learned of the distinction between them and the far stricter definition of who should "count" (ie, limiting it to "people who only legally qualify for Medicaid/CHIP due to expansion provisions within the ACA".

There's really two questions here--a philosophical one (should they be included) and a data-driven one (if you do include them, how many people fall into this category?).

Yesterday I posted an analysis of the current enrollment trends and gave a range of possible final QHP tallies through the end of March, ranging from 5 to 7 million depending on a variety of factors. However, I didn't really go into what those factors actually are, so here's a simple list of the forces supporting and opposing higher or lower enrollment going into the final 6-week stretch:

POSITIVE FACTORS:

Well, this isn't exactly a positive article, but more enrollments are more enrollments...this brings Hawaii up about 700 people since the previous update.

The Connector had enrolled more than 5,000 people as of Friday, according to interim Executive Director Tom Matsuda. However, more than 18,000 applications have been processed as of Feb. 15.

With the October website disaster at HC.gov and serious problems still plaguing some of the state exchanges, is it still even remotely conceivable that private QHP enrollment could reach the CBO's original 7 Million projection? Well, the CBO doesn't think this is likely; they issued a revised projection last month which dropped that projection down to 6 million.

IMPORTANT: I should stress that this ONLY refers to exchange-based, individual/group policy enrollments. It doesn't include SHOP small business enrollments (about 58,000 to date) or direct/off-exchange enrollments (almost half a million confirmed, likely several million more as well). It also doesn't include Medicaid/CHIP enrollments either, though you probably figured that already.

However, let's look at the possible scenarios, about 6 weeks away from the enrollment deadline.

This is a great article; not only does it update West Virginia's Medicaid Expansion tally (up 16,561 from the current 70,574 number), but it gives other useful info, such as the total number of WV residents eligible for the expansion program (130K). Most importantly, it specifically states that these 87K are in Medicaid due to the ACA expansion provision, an important clarification.

According to West Virginia Department of Health and Human Services, over 87,000 residents have been enrolled for health care coverage through the Medicaid Expansion...

Jeremiah Samples, assistant secretary for the DHHS, said that number is about 70 percent of everyone eligible for the expansion....

The total estimated number of West Virginians eligible for coverage under the expansion is 130,000, according to Samples.

By Feb. 13, a total of 87,135 people have enrolled, which Samples said is about 25,000 more than the projected number for 2014.

Well I'll be damned! Oregon has finally managed to enroll a small number of people through their website! (Until today, all 35,247 private QHP enrollments in OR have been processed manually...literally, paper forms filled out by hand and then manually entered into the system). With only 6 weeks to go, this may seem a bit underwhelming, but it's still something...

A Cover Oregon official says insurance agents and community groups have been able to enroll about 700 people in health coverage entirely online.

Chief Information Officer Aaron Karjala revealed the number to a state legislative committee on Friday.

Cover Oregon launched its website for a limited group of experts earlier this week, more than four months after it was originally scheduled to be operational.

There's still no date for when the system will launch to the general public. Karjala says developers are regularly testing and fixing elements of the system.

Individuals working without an agent or certified expert can continue to apply, but Cover Oregon staff will have to process a portion of their application by hand.

Massachusett's ACA exchange website is still undergoing massive technical problems, but there's been significant progress made in processing a mountain of paper applications. The immediate impact isn't that significant (11,000 total enrollments = only 2,861 more than the Feb. 1st tally), but the article suggests that another 50,000 applications should be getting pushed through the system any day now... 

Officials running the state’s troubled health insurance marketplace reported progress on Friday toward addressing its most immediate problem -- a massive backlog in processing applications...

As a result, people were urged to file paper applications instead, both to replace expiring policies and to enroll for the first time. The nearest-term problem has been simply processing 72,000 applications, many of which come from uninsured residents....

Overall, a spokesman for the marketplace said that there have been about 11,000 people who have newly enrolled successfully for coverage since October, almost all in unsubsidized coverage.

Maryland continues to creep along, adding 2,139 to their QHP tally (about 7%) and another 8,581 to their Medicaid enrollments (a bit under 6%).

Through February 15, 33,251 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

95,889 Marylanders signed up through the Primary Adult Care (PAC) program were automatically enrolled in Medicaid coverage on January 1, 2014, and now have full Medicaid coverage. As of February 18, 2014, an additional 60,672 individuals were newly enrolled in Medicaid effective January 1. 

Minnesota issued an official update today (as opposed to the estimate that I came up with a few days ago based on a "nearly 95K" line in an unrelated press release); I was only off by 888 people on the private enrollment side, but by more than 5,500 on the Medicaid/CHIP side of the equation:

ST. PAUL, Minn. — Today MNsure announced that more than 100,000 Minnesotans have enrolled in quality, affordable health insurance through the state’s new insurance marketplace. MNsure is working to enroll thousands more Minnesotans in coverage before open enrollment concludes on March 31, 2014. Today’s new milestone highlights the progress MNsure has made to significantly improve its performance, and the services it provides to Minnesota consumers....

31,088 Minnesotans selected private health plans;
21,574 Minnesotans enrolled in MinnesotaCare; and
48,682 Minnesotans enrolled in Medical Assistance (MA).

101,344 total enrollments

This update/correction also makes a slight improvement in the overall Feb/Jan enrollment model (from 75.6% of January's total to 75.8%).

Well this was unexpected...apparently at a fundraiser, President Obama gave a very rough update on the current ACA exchange tally:

President Obama said Thursday that "close to 4 million Americans" had signed up for insurance on the ObamaCare exchanges, a hint that enrollments may be accelerating as the deadline to purchase coverage nears....

"Right now, we've already got close to 4 million Americans who signed up for exchanges," Obama told a gathering of Democratic donors and governors at a luxury hotel just blocks from the White House.

Let's see how that jibes with my current February-vs-January rate projection.

At the moment, based on the still-limited data available, I'm showing an expected February total enrollment of around 866,000 people through March 1st:

President Obama's statement was yesterday (the 20th), which presumably means that the "close to 4M" number was based on data through the end of the day before (Feb. 19th).

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