In week three of the 2019 Open Enrollment, 500,437 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. Consequently, the cumulative totals reported in this snapshot reflect one fewer day than last year.
Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchanges and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.
The final number of plan selections associated with enrollment activity during a reporting period may change due to plan modifications or cancellations. In addition, the weekly snapshot only reports new plan selections and active plan renewals and does not report the number of consumers who have paid premiums to effectuate their enrollment.
*"Not as bad as expected" depends on your perspective. Even the 6-7-point average premium increase caused by mandate repeal is still an average of $430 - $500 per unsubsidized enrollee for the year...or $1,300 - $1,500/year for a family of three.
Earlier this year, most healthcare wonks (along with the Congressional Budget Office) projected that Congressional Republicans repealing the ACA's individual mandate last December (effective January 1, 2019) would have a significant Adverse Selection impact on the ACA-compliant individual market risk pool. Projections of the premium increases imposed in response to the drop-off of healthy enrollees ranged from 10% (CBO) to as high as 16.6% (Urban Institute, although that also included a small increase due to Trump's expansion of short-term plans as well).
Last week, Bernie Sanders posted the following video (click to view) on Twitter. It tells the tragic story of a young Minnesota man named Alec Smith with diabetes who died soon after after no longer being able to afford either health insurance or the insulin and other medical supplies needed to keep him alive:
Alec Smith died at 26 because he was rationing insulin that was too expensive. The greed of the pharmaceutical industry is killing Americans and it has got to stop. (with @NSmithholt12) pic.twitter.com/xmryYm0Enr
The main point of the video is the horrific price gouging on insulin, and a new drug price control bill which Sen. Sanders is pushing for which would tie U.S. drug pricing to that of a half-dozen other countries.
It's a genuinely depressing story, and the proposed drug pricing bill is interesting and worthy of discussion.
I just received an official 2019 ACA Open Enrollment Period report from the Massachusetts Health Connector...
As of today, we have 254,177 enrolled for January 1. That is up about 10,000 from last year's 244,308 at the same date. When you include people with plans selected but not paid, we are at 264,118.
The high number is again explained by the fact that Massachusetts, like several other state-based exchanges, front-loads their auto-renewals. 254K / 244K = around a 4% increase year over year, which is solid and right in line with other state-based exchanges to date...while the federal exchange (HC.gov) continues to lag around 11% behind last year. On the other hand, HC.gov doesn't front-load auto-renewals, so it's a bit of an apples to oranges comparison.
Now that the Democrats have officially retaken control of the U.S. House of Representatives, everyone's expecting them to try and save and improve the ACA. I stress "try", of course, because without the Senate, it's unlikely that any bill to protect or improve the law will get passed...and even if it did somehow, the odds are high that it would then be vetoed by Donald Trump (or Mike Pence, in the unlikely-but-still-conceivable event that Trump is removed from office before January 20, 2021).
HOWEVER...they can certainly at least try. With a likely 235:200 advantage in the House and a caucus which is far more progressive on healthcare issues than it was a decade ago, the Dems shouldn't have too much trouble passing a fairly robust healthcare reform package even knowing that it's unlikely to go anywhere in the Senate. The question is how robust?
In week three of the 2019 Open Enrollment, 748,244 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. Consequently, the cumulative totals reported in this snapshot reflect one fewer day than last year.
Every week during Open Enrollment, the Centers for Medicare & Medicaid Services (CMS) will release enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Exchanges and some State-based Exchanges. These snapshots provide point-in-time estimates of weekly plan selections, call center activity, and visits to HealthCare.gov or CuidadoDeSalud.gov.
The final number of plan selections associated with enrollment activity during a reporting period may change due to plan modifications or cancellations. In addition, the weekly snapshot only reports new plan selections and active plan renewals and does not report the number of consumers who have paid premiums to effectuate their enrollment.
Last spring, both New Jersey and Maryland were among the states which were the most pro-active about passing lesiglation to cancel out Donald Trump's attempts to deliberately sabotage the Affordable Care Act. Both states passed laws cracking down on non-ACA compliant short-term and association health plans (NJ actually already didn't allow short-term plans before the ACA anyway), both states established robust reinsurance programs, and both states tried to pass bills reinstating the ACA's Individual Mandate Penalty which Congressional Republicans repealed last winter in different ways.
New Jersey was successful: They kept their mandate penalty restoration bill pretty much identical to the version repealed at the federal level and plan on using the revenue from it to help pay for the reinsurance program. The combined impact of all of their anti-sabotage efforts led to roughly a $1,500 annual premium savings for every unsubsidized individual market enrollee in the state.
With all the attention being paid to the midterm elections causing ACA Medicaid expansion to be passed in Utah, Nebraska and Idaho (while also now being at risk in Alaska and Montana), I've kind of lost track of the situation in Virginia, where it was expanded last May to over 400,000 Virginians.
Thankfully, Esther F. linked me to this article from the Virginia Mercury, which brings me up to speed on the actual implementation of the VA expansion program:
Less than two weeks after Virginia opened registration for its expanded Medicaid program, officials say they’ve already drawn thousands more applicants than initially anticipated.
The state had expected the new program to enroll 300,000 over the next year and a half. They now expect that number to reach 375,000. The new estimates won’t alter the total expansion population, which the state has said will be about 400,000.
...For many low-income families, the Arkansas experiment has already proved disastrous. More than 12,000 have been purged from the state Medicaid rolls since September — and not necessarily because they’re actually failing to work 80 hours a month, as the state requires.
...McGonigal, like most non-disabled, nonelderly Medicaid recipients, had a job. Full time, too, at a chicken plant.
...More important, McGonigal’s prescription medication — funded by the state’s Medicaid expansion, since his job didn’t come with health insurance — kept his symptoms in check.
