Colorado

Colorado is one of the few ACA exchanges issuing monthly reports during the off-season. Until now, these reports, while chock full of data, have made it rather confusing to separate out the key number which I'm looking for: The cumulative number of 2015 QHP selections and the currently effectuated QHPs, because of their tendency to mix SHOP and Dental policies into the mix.

In any event, CO's official QHP selection total as of 2/21/15 was 140,327, and as of the end of April, it was up to 146,506...of which 129,055 were actually effectuated as of 4/30.

Louise Norris has provided some valuable information about 2016 individual market rate change requests in her home state of Colorado:

For 2015, Colorado HealthOP cut premiums aggressively, and ended up with the lowest-cost plans in eight of the state’s nine rating areas.  Unsurprisingly, that resulted in the CO-OP garnering the highest market share in the exchange during the 2015 open enrollment period, with nearly 40% of exchange enrollees selecting Colorado HealthOP coverage (among our own clients, Colorado HealthOP was even more popular, including among those who selected off-exchange coverage).

...In 2015, Colorado HealthOP got almost 40% of the exchange’s market share, and Kaiser was a close second with 35%; the two non-profits accounted for three-quarters of all the private plan enrollees in Connect for Health Colorado this year.

Colorado just released an updated enrollment report bringing things all the way up through April 30th...and as always, CO's report is both extremely comprehensive and extremely confusing at the same time.

Here's the relevant section:

The numbers, as I noted last time, need to be parsed quite a bit, since some of the numbers mix in SHOP (small business) enrollees while others mix in Dental coverage (which we all know is a big no-no!!)

If I'm reading/understanding this correctly, it looks like it breaks out to:

OK, this isn't a huge thing, but it's noteworthy.

Historically, Medicaid (and to a lesser extent, the CHIP program for children) has carried a certain stigma, since it's traditionally been reserved for the very poor. Many people enrolled the program have been embarrassed/ashamed to admit that they needed the assistance, and many who qualified for the program even under the pre-ACA rules never actually signed up based on the "shame" factor (still others didn't enroll because they simply didn't know that they qualified or didn't understand the procedure/paperwork for doing so).

With that Affordable Care Act, that all changed (well, in the states which expanded Medicaid, anyway). Yes, it's still limited to the poor, but there's a difference between being "dirt poor" and "working poor" (and yes, I understand that many "dirt poor" people work their butts off...I'm talking about general societal perception here). Suddenly, millions of people who considered themselves "lower middle class" (or otherwise "not poor", anyway) found themselves being able to enroll in Medicaid alongside the "dirt poor".

In my post about today's official ASPE ACA Enrollment Report, there weren't too many surprises....but there were a few notable items. As I noted:

  • HAWAII: I was assured 8 ways from Sunday that Hawaii's23,000 enrollee figure was specifically for 2015 enrollment. This made no sense to me given their tiny enrollment last year, but I was assured of it. Well, apparently my original instincts were correct, because they're showing up with only 12,625 in the end.
  • IDAHO: This is the only state which hasn't given their own enrollment update in forever. According to the prior ASPE report, they were at around 90.5K as of January 17th...yet somehow they only managed to rack up another 6,500 enrollees over the entire final month of Open Enrollment?? I was expecting upwards of 30K or so. This makes zero sense to me...am I missing something here?

In addition, there are a few states where their most recent official enrollment reports had some confusing data, which the ASPE report pretty much trumps regardless of anything else (at least, this is the official number which will be tossed around no matter what anyway):

The Colorado ACA exchange has just released their latest official enrollment report, and while it's chock full of useful data, it's also bit hard to read (physically...it's a low-res version, will swap it out with a higher-res PDF once they post it), and the numbers also require a bit of parsing...and are a bit confusing.

UPDATE: OK, I've found the actual high-res Dashboard report and have swapped out the low-res one below.

the grand total of "submitted enrollments" is just shy of 154,000. However, that appears to include 3,716 SHOP enrollees (the precise SHOP number is a bit fuzzy due to the footnote regarding this being "currently covered lives, regardless of date of enrollment").

So, separate SHOP out and you have 150,229 QHP selections.

OK, strike that...Colorado has released their newest data as well as DC and Vermont, leaving just 3 states to go (Connecticut (data since 2/13), Kentucky (data since 2/12) and Idaho, which hasn't posted any updates since way back on January 17th...over a month ago.

Anyway, here's Colorado:

DENVER, CO – Between Nov. 15 and Feb. 15, nearly 220,000 Coloradans enrolled in healthcare coverage for 2015, either in private plans purchased through the health insurance Marketplace, or with 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.

During the three-month open enrollment period, 139,652 people enrolled in private coverage through Connect for Health Colorado; another 76,194 in Medicaid and 3,720 in CHP+.  Connect for Health Colorado also enrolled 24,884 individuals in dental plans.

There's one very interesting tidbit, however:

I've confirmed that Rhode Island's weather-induced enrollment extension is indeed state-wide and is of the "full" variety (ie, people can start the application process, not just finish it), through February 23rd. This is exactly the same policy that the Massachusetts exchange announced the other day.

Also, a late-breaking extension announced from Maryland.

11:45pm: OK, add the DC exchange to the pile.

9:00am 2/16/15: OK, HHS/CMS has clarified the specifics for the 37 Healthcare.Gov states.

11:50am 2/16/15: Idaho's policy took some work to decipher...

2:24pm 2/16/15: ...and Minnesota...

The last official update out of Connect for Health Colorado had the QHP tally at 125,378 as of 1/31.

Yesterday (Friday, 2/13), CBS Denver reported:

As of last Monday, Colorado reported 128,000 enrollments in 2015. About three-fourths of those are returning customers , with about a fourth being new customers.

OK, so that's an increase of around 2,622. However, the "...as of last Monday" bit is confusing. To me, saying "last Monday" on a Friday refers to the prior Monday (ie, 2/02 in this case). However, that would suggest that CO enrolled over 1,300 per day for 2 days in a row. The state was only averaging 233/day over the prior couple of weeks, which means they'd have to have ramped up over 5.5x, which is possible (a few other states have pulled this off).

Connect for Health Colorado has released their end-of-month enrollment update. Since the 1/15 deadline for February coverage, they've added another 3,728 QHP enrollees, or 233/day. At that rate they'd only add another 3,500 by 2/15, or less than 130K total (vs. their target of 194K or mine of 208K). Of course, that's an extremely unfair comparison, as 1/16 - 1/31 covers the slowest portion of the open enrollment period (immediately after a monthly deadline).

Even so, there's no realistic way that CO can hit their target at this point--they'd have to average 4,600/day just to hit theirs (and over 5,500 to hit mine). For comparison, last year Colorado averaged 627 enrollees per day throughout the entire open enrollment period (and that included the huge surges in December and March). This year they've averaged 1,607/day, and that includes all of the renewals from 2014. Even with a massive final surge, I just don't see any way of CO hitting more than 160,000 QHPs at this point, although I'll obviously be happy to be proven wrong.

Hot off the presses...

During the first eight weeks of open enrollment, 121,650 people enrolled in private coverage through Connect for Health Colorado and 47,724 in Medicaid and 2,272 in CHP+.  Connect for Health Colorado also enrolled 20,580 individuals in dental plans.
 
“The enrollments in Medicaid and Connect for Health Colorado show that Coloradans are attuned to the importance of having health insurance coverage,” said Susan Birch, Executive Director of the Colorado Department of Health Care Policy and Financing. “Whether Coloradans have health insurance coverage through private insurance or through Medicaid, health coverage is the first step to better health.”  

Colorado's last update ran through New Year's Eve, totalling 113,864 QHP enrollees, or 362 per day since the 12/15 deadline. That gives a nice apples-to-apples comparison to the new number (7,786 higher), which averages 519 per day...up over 40% per day since the holiday period.

This Just In...

Connect for Health Colorado® and Colorado Medicaid Report Enrollment Gains

Posted on Tuesday, January 6, 2015

Curtis Hubbard, curtis@onsightpublicaffairs.com, 303-908-2378 (Connect for Health Colorado)
Marc Williams, Marc.Williams@state.co.us,  303-866-3144  (Colorado Medicaid)

DENVER, CO – Between Nov. 15 and Dec. 31, more than 151,000 Coloradans enrolled in healthcare coverage for 2015, either in Medicaid, Child Health Plan Plus (CHP+) or in private health insurance purchased through the state health insurance Marketplace, according to new data released today by Connect for Health Colorado® and the Colorado Department of Health Care Policy and Financing.

 

...The initial six weeks of open enrollment saw a total of 113,864 enrollments in private coverage through Connect for Health Colorado (20,790 people new  to the Marketplace and 93,074 re-enrollments from 2014); 35,981 in Medicaid; and 1,517 in CHP+.  Connect for Health Colorado also enrolled 19,068 individuals in dental plans.

A nice, no-BS, pretty comprehensive enrollment update out of Colorado:

DENVER, CO – In the first month of Open Enrollment, 136,315 Coloradans enrolled in healthcare coverage for 2015, either in Medicaid, Child Health Plan Plus (CHP+) or in commercial health insurance purchased through the state health insurance Marketplace, according to new data released today by Connect for Health Colorado® and the Colorado Department of Health Care Policy and Financing.

“These initial sign-ups during this first month were consistent with our projections and culminated with a single-day record of 12,600 enrollments on December 15th,” said Connect for Health Colorado Interim CEO Gary Drews. “It’s also important to remember that it’s not too late for people to purchase health insurance for 2015. Open enrollment continues until February 15th.”

Dec. 15 was the deadline for individuals and families to select plans for coverage to begin on Jan. 1. Connect for Health Colorado will continue working with those who started their application by Dec. 15 to help finish it so they can be covered by the New Year. Customers also have to take the last step to ensure their coverage: make the first payment on time.

As you can see from the graphic I posted yesterday (and had to revise several times throughout the day), the official enrollment deadline for private policies starting on January 1st, 2015 has now passed for all 37 states operating via HealthCare.Gov, as well as residents of DC, Hawaii and Kentucky. It's certainly possible that any or all of these will announce some sort of "special circumstances" allowance for those who didn't make the midnight cut-off (10pm in Alaska), but I'm assuming those would be done strictly on a case-by-case basis.

OK, so what about the remaining 11 states?

Well, 4 of them (MD, MA, RI & WA) had later deadlines for January coverage all along: Maryland on 12/18 (Thursday) and the other 3 on 12/23 (next Tuesday).

New York and Idaho bumped their deadlines out from yesterday until 12/20 (Saturday), although Idaho had previously claimed that their deadline was 12/23, but are now claiming that it was originally 12/15. I still don't understand what happened there, but so be it: 12/20 it is for ID.

Until now, I've relied on states like Maryland, Massachusetts and Vermont, which have given out frequent 2015 enrollment updates, to point out how impressive the enrollment stats have been this time around; Maryland and Vermont are currently running at nearly 5x their 2014 pace, while Massachusetts is adding people at an astonishing 10x their 2014 rate.

However, these are pretty misleading, because all 3 of those states had such Godawful websites last year that it didn't take much to outperform this year.

Instead, consider states whose exchanges were already doing pretty well out of the gate last year, such as Colorado:

On the surface, this looks pretty good, but nothing jaw-dropping. 24,811 in 27 days is 919/day, or about a 50% improvement over 2014's 627/day.

However, break it out between the first 16 days and the next 11 and it's a different story:

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