California

Looks like the 39K on Monday & Tuesday continued at the same pace all week...supporting my "California 20%" rule (20K in CA = 100K nationally):

SACRAMENTO (AP) — California is seeing a late surge in the number of people signing up for healthinsurance coverage  ahead of next week’s deadline – and state officials are encouraging more people to apply.

The state already reported surpassing 1 million enrollees. But Covered California Executive Director Peter Lee said Friday that another 80,000 people enrolled in the past four days alone.

20,000 per day in California is 4x the rate they hit in February.

I'm pretty sure California has now broken 1.2 million all by itself (which makes sense if the 20% rule holds...1.2M = 20% of 6M...)

Based on this and the Oregon entry, I'm increasing my projection from 6.54M to 6.58M as of 3/31.

Blammo. Remember how I noted that back in December, California managed to hit 30K exchange QHPs in a single day, and 20K/day for several other days between Christmas and New Year's Eve?

Well, it looks like we've hit the 20K/day mark. From today's L.A. Times:

The site — the main portal for insurance marketplaces in 36 states — drew 1.2 million visitors Tuesday and 1.1 million visitors Monday, according to the administration.

Over the same period, call centers received more than 500,000 calls. California's state-run health insurance exchange reported a similar surge in interest, with nearly 40,000 people picking a health plan Monday and Tuesday.

Now, this is awesome news, as it suggests a national rate of around 100K/day (CA has averaged around 20% of the national QHP enrollments all along).

However, it also poses a slight dilemma for me, since there's an 8 day gap between the existing March data (03/02 - 03/15) and these 2 days (03/24 - 03/25).

Oregon has been talking about this for weeks, but now it's official:

Oregonians now have an additional month to apply for private health insurance. New deadline to apply is April 30. The Oregon Insurance Division and Cover Oregon urge people to apply now to get coverage as soon as possible and avoid potential end-of-month rush. 

Colorado said something about this the other day, but now it's official:

DENVER - Colorado will give health insurance applicants extra time to finish the enrollment process, if they start before the March 31 deadline.

Connect for Health Colorado will make an official announcement about the extension Wednesday afternoon.

Add New York to the list as well:

While waiting to see whether I was right about the national exchange-based QHP total hitting the 5.5M mark yesterday (and bear in mind that there's no guarantee that HHS will make an announcement about it even if I was correct; they didn't do so for 3.5M or 4.5M...I just figure that they will since it's a logical milestone and would be a nice momentum-building PR move going into the final stretch), I just wanted to call attention to this article from yesterday out of KTVU/Fox in California:

SAN FRANCISCO — One week from Monday is the open enrollment deadline for Covered California. The insurance exchange hit the one million mark for sign-ups last week, and is expecting about 20,000 people a day to sign up in the final push.

I've already contacted the reporter who wrote the story to make absolutely certain this doesn't include Medicaid enrollees, but the context makes me pretty sure they're talking about exchange QHPs only. Also, "expecting" 20K/day doesn't necessarily mean they've already ramped up to that; it could just mean that they're preparing for that volume just in case.

Contributor Ruth 37 sent a link to this open letter from Peter Lee from 2 days ago, regarding California's 1M QHP milestone and what CoveredCA's plans are going forward.

The number of people who have picked a Covered California health insurance plan now tops 1 million. This is an amazing accomplishment, and it means that with two weeks to go we have exceeded the highest “enhanced forecast” for the entire open-enrollment period. The health insurance companies report that more than 85 percent of those who have enrolled are paying their premium and getting coverage. That means 850,000 Californians are on their way to coverage through Covered California, which surpasses the top projection of 830,000....

There we go; I originally projected California to hit 1M last Tuesday or Wednesday, but didn't realize at the time just how bad the mid-February outage had hit the exchange. It ended up taking them 2 extra days to hit the 1M mark (Friday night). Fortunately, it looks like they've bounced back nicely:

Covered California’s enrollment reached the 1-million mark late Friday. By the end of Saturday, enrollment reached 1,018,315 in the health care exchange marketplace. The figure represents the number of people applying for coverage and selecting insurance plans for themselves and their family members through the exchange.

Looks like California is fully recovered from their ugly February outage, but they're still not quite up to where I thought they were this week:

#CoveredCA enrollment reaches 923,832 through March 9. 1 million just around the corner!

— Covered California (@CoveredCA) March 13, 2014

In addition, California's NEW Medicaid enrollee numbers continue to skyrocket, up from 877K (exchange) / 652K (bulk transfers/other) at the end of January to a whopping 1.136 Million + 968,500 = 2,104,500 total (!)

The wording of the 1.136M Medicaid number specifies that this is a combination of NEW enrollees as well as "ongoing caseload activity", which sounds to me like people who enrolled a few months earlier but are still having paperwork issues. Either way, it sounds clear to me that these are not "renewals (aka rederminations)".

The February HHS Report included some especially confusing numbers out of the two largest state-run exchanges, California and New York, as both seemed shockingly low given how successful they both seemed to be doing in the first half of the month.

In the case of California, they were kicking serious ass in the first half of February, averaging around 7,200 QHP enrollments per day. Unfortunately, a few days later the CoveredCA exchange was hit with a very nasty technical problem which brought things to a standstill for not the 3 days that I thought, but 5 days. Result? The daily average dropped from 7,200/day in the first half to only 2,800/day for the second half of the month:

Enrollment in Obamacare coverage slowed last month in California, hurt by a recent website outage.

New federal data show 868,936 Californians signed up for health insurance in the state's exchange through March 1.

UPDATE: On the down side, I was off by 4% this time around.

On the up side, I UNDERESTIMATED:

Actual Feb. enrollments: 942,833, for a total of 4,242,325 thru 3/01/14.

Sarah Kliff at Vox just announced that the February HHS report is expected to be released today at around 4:00pm. A few items in anticipation of that:

  • As I've noted several times, I'm projecting the report to total around 902,000 exchange-based private QHP enrollments for the month of February (technically 2/02 - 3/01)
  • If accurate, this would bring the cumulative total of exchange-based private QHP enrollments to 4.202 million (from 10/1/13 - 3/01/14)
  • From the data I have, the average daily enrollment rate in February was almost identical to that of January, which had about 1.146 million QHP enrollments. HOWEVER, the January report included five weeks of data (12/28 - 2/01), while the February report will only include four weeks (2/02 - 3/01). Therefore, even at the same daily average, it'll be about 20% lower no matter what.
  • Don't be surprised if Peter Lee of CoveredCA decides to steal some thunder by announcing that California has enrolled 1,000,000 QHPs all by itself either today or tomorrow. However, that would include the past 10 days, while the HHS number will only run thru 3/01.
  • If you want to get REALLY specific, call it 902,800 and 4,202,292.
  • I've been dead-on target 6 times in a row without hyping up my projections beforehand. This time I am hyping myself up beforehand, so I'll probably be way off...but as long as I've UNDERestimated the tally, I'll be perfectly fine with that...
  • The report will be released in about 5 minutes, but my kid gets home from school in about 10, so it'll be a good 20 minutes before I can really post anything. Feel free to follow Sarah Kliff of Vox in the meantime!

This article is both very helpful but also has 2 frustrating data points missing. The key numbers: While CA was averaging around 7,200 QHP enrollments per day in the first half of February, that rate is apparently up to 8,000/day now. This is excellent, but I don't know whether that 8K/day rate is only for the past week or if it includes the full 2nd half of February (I would guess that it's risen steadily since then.

On the other hand, CoveredCA also suffered from a 3-day outage, which could skew the daily average...they had 3 days of no enrollments, followed, presumably, by the 22K people who tried on those days possibly joining another 22K over the subsequent week or so. Either way, it's looking pretty good, though California will have to end up averaging around 20,000/day in March to do their part in hitting 7M total by 3/31, or 13,000/day to hit 6M.

The other big news here (the main point of the article) is that payment rate for enrollees through 1/31 has gone up from 80% as of 2/19 to 85% as of a couple of days ago:

Contributor Steve Ciccarelli just pointed out a fun fact about California's ACA exchange using my February QHP Projection Table:

California was averaging 7,182 QHP enrollments per day in the first half of February; they hit 828,638 QHPs as of 2/15.

Assuming this average has held at around that rate since Feb. 15th, they should have added another 151,000 through today, bringing them to around 979,000.

That leaves them just 21,000 away from 1 Million even, which they should reach sometime on Tuesday.

Yesterday the Obama administration announced several new modifications to ACA implementation. The one that's getting the most attention is a 2-year extension on non-compliant, pre-ACA healthcare plans. After getting criticized for "lying" about his "if you like your plan you can keep it" statement last fall, Pres. Obama gave individual states the option of extending existing plans by 1 year if they wanted; this just extends that period further, out to pretty much the end of Obama's term of office:

Americans with health coverage that predates Obamacare can stay on their plans for two more years, insurers will have an extra month to enroll customers next winter and states will get more time to decide whether to manage the law themselves, officials said. Also, a program aimed at covering financial losses for insurers will be adjusted to help ensure it doesn’t cost taxpayers, the Obama administration said.

There's so much info in today's California press release I've had to move the Medicaid info to a third entry. There's a ton going on in the following passages:

Additionally, 877,000 applicants were determined to be likely eligible for Medi-Cal coverage. DHCS also transitioned 652,000 individuals into the Medi-Cal program from the state’s Low Income Health Program. Automated enrollment allowed county human services agencies to enroll 106,000 individuals into Medi-Cal coverage, and another 65,000 were enrolled through the Express Lane program.

approximately 1.5 million additional Californians have enrolled or been found likely eligible for Medi-Cal since October. 

** Does not include applicants for current Medi-Cal coverage through county human services agencies. 

OK, let's break this out: The 877K figure is up fro 850K in the January HHS report, which itself was already up from 584K as of January 15, which means a ton of new people enrolled in the 2nd half of January alone.

Some additional positive news out of California today; so much going on I decided to break it out into a second post:

Lee also noted that of those enrolled through Jan. 31, 626,210 are eligible for subsidies, and insurance companies are reporting that 80 percent of all enrollees have paid their first month’s premium. 

The wording of this makes it hard to tell whether "all enrollees" means all of them or only those through Jan. 31, but this CoveredCA Tweet clarifies:

#CoveredCA health insurance companies are reporting that 80% of all enrollees have paid their first month's premium.

— Covered California (@CoveredCA) February 19, 2014

OK, so this really does mean all enrollees. Fair enough. The downside is that I have to move 165,272 people over to the "Unpaid" category. The upside is that the "How many have PAID???" question just became about 12% cleaner.

Well THAT just figures! In the words of Emily Litella..."Never mind..."

Hot off the presses: California has released their first-half of February enrollment data: 100,228 people have enrolled in Private QHPs in "the first 2 weeks" of February (actually February 2 - 15, I assume, since the 728K number includes Feb. 1st). This breaks down to 7,159/day:

Nearly half of those covered [through 2/01] — 728,410 Californians — selected a Covered California health insurance plan. This strong enrollment trend is extending into February, where in the first two weeks more than 100,000 individuals enrolled in Covered California, increasing the cumulative total enrollment in Covered California to 828,638.

California's January enrollment rate was (728,410 - 498,794) = 229,616 / 35 days = 6,560/day, which means that their February enrollment rate is actually increased from that of January, by over 9%!

So, how does this impact the "February Drop-Off" factor? MASSIVELY! Take a look:

Pages