Colorado

Last month I wrote an extensive piece about Colorado's Amendment 69 initiative, aka "ColoradoCare", which would be the latest attempt to achieve a state-level single payer healthcare system (or at least near-single payer; if enacted, it would replace all current healthcare coverage except for Medicare, the VA/TriCare and the Indian Health Service).

While I was generally supportive of the idea overall, I also concluded that:

For me, however, ColoradoCare addresses many of the criticisms I've had of Bernie's plan. I'm not necessarily "endorsing" it (I still have a lot more to learn about the details and the criticisms before I can do so), but the bottom line is that it's more realistic and far better thought out than Bernie's national plan is. This is the best opportunity for achieving single payer that you're likely to see anytime soon.

As I've noted the past few times that I've posted Colorado enrollment report updates, the way they report their numbers can be very confusing...which is doubly frustrating since the reports are also chock full of useful data as well.

Anyway, according to their latest report, when you add up the "effectuated enrollments WITH and WITHOUT APTC/CSR" (medical only), it totals 143,430 people as of June 9th, 2016...a slight drop from the 146,000 figure as of the end of April. As I noted last month, however:

Over 150,000 Colorado residents selected QHPs via Connect for Health Colorado during open enrollment this year, and the total CO individual market was well over 270,000 in 2014; as of today, it's supposedly up to a whopping 450,000 people, which sounds awfully high to me (nationally the indy market has grown by around 25% over the past 2 years, so 66% is an outlier):

In addition, Anthem has decided not to offer its PPO (Preferred Provider Organization) individual plans in 2017. In all, the Colorado Division of Insurance said Monday around 92,000 people with individual plans from Anthem, UnitedHealth, Humana, and Rocky Mountain Health Plans will have to find other coverage during open enrollment in the fall.

Many single payer advocates have been either confused or angry with me (to put it mildly) for not being a fan of Bernie Sanders's proposed national SP plan.

I've explained repeatedly that while I am a SP proponent, I just don't see it happening at the national level all at once. There are too many barricades and too many logistical, economic and political problems in doing so to make it remotely feasible to bring SP to the country in this fashion. In addition, I have major problems with the utter lack of detail in Bernie's plan.

HOWEVER, I've also repeatedly stated that I do strongly support getting the ball rolling at a smaller level first--either by partially expanding existing SP programs such as (Medicare, Medicaid, CHIP); consolidating existing private systems into larger risk pools (ie, merging the risk pools of the individual & small group markets, as a few states have done already); and/or by getting SP enacted at the state level, then using that as a model for other states and/or as a national model if it works out.

Thanks to Louise Norris for the heads up:

UnitedHealthcare / Humana Insurance

For 2017, UnitedHealthcare, along with most of its subsidiaries, is discontinuing its participation in the individual market in Colorado, both on and off the exchange.  However, Golden Rule Insurance, a subsidiary of UnitedHealthcare, will continue to offer its individual plans in Colorado off of the exchange.  UnitedHealthcare will also continue its small and large group business in the state.

Humana will continue in the small group market for 2017 off the exchange, while exiting the individual market for both Humana Health Plans and Humana Insurance Company.  

OK, so UnitedHealthcare is out except for off-exchange Golden Rule; this is actually an improvement over the prior United news, since it was assumed they were pulling out of the state completely.

A week or so ago, I reported that Connect for Health Colorado's monthly enrollment report contained some very confusing numbers:

Last month I noted that, assuming I was reading Connect for Health Colorado's monthly dashboard report correctly, they were down to 115,890 effectuated exchange enrollees as of 3/31/16, or a whopping 23.1% lower than the official APTC report tally of 150,769 QHP selections as of the end of Open Enrollment.

...The 121,962 number at the top seems to be the one I want...except that it also includes SHOP and standalone Dental enrollments (I think).

...OK, so 121,962 includes SHOP, which has a maximum tally of 2,897, which means that the effectuated number as of 4/30/16 could be as low as 119,065...except that "Individual" could also potentially include standalone dental plans, confusing the issue further. Even worse, it says that this "Includes those who effectuated in the current plan year and later terminated a policy".

I can't tell whether that means that those who terminated their policies have been subtracted from the total (accounted for) or if they're included in the total (cumulative).

Last month I noted that, assuming I was reading Connect for Health Colorado's monthly dashboard report correctly, they were down to 115,890 effectuated exchange enrollees as of 3/31/16, or a whopping 23.1% lower than the official APTC report tally of 150,769 QHP selections as of the end of Open Enrollment.

Over the weekend, they released their April dashboard report, and the numbers are actually up slightly...which means that while the net drop compared to the OE3 number is still steep, it's also spread out over a 3 month period instead of 2:

In a classic case of missing the forest for the trees, I posted two very wonky, detailed entries over the past couple of days about Minnesota and Connecticut's latest enrollment numbers...but completely missed one crucially important data point.

Investor's Business Daily's Jed Graham picked up on some of my work for his post today, including the enrollment data for both Minnesota and Connecticut...but in addition to that extra data point (which I'll come back to in a moment), he also nabbed the latest number out of a third state, Oklahoma, from one of Adam Cancryn's updates on what I'm calling the UnitedHealthcare Disenrollment Odometer:

When I reported on Colorado's monthly enrollment report a week or so ago, I noted that they had added around 15,000 QHP selections via off season SEPs, mainly due to the meltdown of their state Co-Op last fall. However, like I did with Minnesota (I'm slipping!), I forgot to note the effectuated enrollment number as of 3/31...and if I'm reading this correctly, it's not pretty:

There's a bunch of different numbers there, but as far as I can tell, the one I'm looking for is "Effectuated Enrollments with APTC/CSR (medical)" combined with "Effectuated Enrollments Without APTC/CSR (medical)". That's 69,519 + 46,371 = 115,890 effectuated, individual, medical QHP enrollees as of 3/31/16.

When the dust settled on the official 2016 Open Enrollment Period, Connect for Health Colorado reported enrolling 153,583 people in exchange-based Qualified Health Plans. However, as I noted at the time:

Colorado lost their Co-Op...and CO is also one of only two states (Oregon is the other one) to drop their "transitional" policies as of the end of 2015. As a result, Colorado has a lot of people who could still potentially enroll by the end of February thanks to the 60-day Loss of Coverage Special Enrollment Period provision.

Louise Norris noted that there were around 39,000 ex-Co-Op members in Colorado (along with some others) who could still potentially enroll during February via the SEP option; I spitballed anywhere from 10,000 - 20,000 more Coloradoans might yet be added. There are also the normal SEPs for things like getting married, giving birth and so forth.

The last Colorado update, which ran through January 15th, had their numbers at 139,579 private policies (QHPs), 23,017 standalone dental plans, 45,100 in Medicaid and 2,771 in the SCHIP program.

I've just learned that Colorado's final tally as of the January 31st deadline stands at 153,583 QHPs, 25,604 dental, 54,447 Medicaid and 3,549 SCHIP, which means they added just over 14,000 in the final 16 days.

Here's Connect for Health Colorado's latest enrollment update:

DENVER — Between Nov.1 and Jan. 15, more than 190,000 Coloradans enrolled in health coverage for 2016, either in private health insurance purchased through the state health insurance Marketplace or in Medicaid, or Child Health Plan Plus (CHP+), according to new data released today by Connect for Health Colorado® and the Colorado Department of Health Care Policy and Financing.

“These enrollment figures show strong growth during this open enrollment period,” said Connect for Health Colorado® CEO Kevin Patterson.  “But we are now only days away from this year’s enrollment deadline for many. I strongly urge everyone who does not have health insurance provided through their employer to act right now to provide financial security for their families and to avoid a penalty that experts estimate will average nearly $1,000 per household. The final deadline for 2016 coverage for many Coloradans is Jan. 31.”

Connect for Health Colorado just issued their official monthly enrollment update:

Connect for Health Colorado® and Colorado Medicaid Report Enrollment Gains of More Than 169,000

January 5, 2016

DENVER — Between Nov.1 and Dec. 31, more than 169,000 Coloradans enrolled in health coverage for 2016, either in private health insurance purchased through the state health insurance Marketplace or in Medicaid, or Child Health Plan Plus (CHP+), according to new data released today by Connect for Health Colorado® and the Colorado Department of Health Care Policy and Financing.

“We are very happy with the enrollment growth during the first two months of this open enrollment period,” said Connect for Health Colorado® CEO Kevin Patterson. “But I want to urge everyone who does not have health insurance provided through their employer to act now to provide financial security for their families and to avoid a penalty of nearly $695 or more. The final deadline for 2016 coverage –Jan. 31 – is fast approaching.”

A very welcome, if unofficial, update from Connect for Health Colorado:

DENVER (AP) – A new insurance-matching tool similar to Uber car sharing is helping Colorado’s health insurance exchange meet demand during the open enrollment period for people who need to sign up for health coverage , an exchange official said Thursday.

And an extended deadline didn’t hurt.

Open enrollment ends in January for Connect For Health Colorado. But Thursday was the deadline for shoppers to have coverage in effect by Jan. 1.

More than 117,000 people had signed up, though exact figures weren’t available, said Connect For Health spokesman Luke Clarke.

Connect for Health wants to see 217,000 people signed up by next summer. Clarke said the exchange is ahead of last year’s pace, when 113,000 had signed up by the December deadline.

The article doesn't specify what the "thru date" for the 117K figure is, but I'm assuming that it was as of 12/15 since that was the original deadline for January coverage and the story ran today.

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