District of Columbia

The DC exchange doesn't post updates often, but when they do it's simple, to the point data...and as a bonus, they're one of the few exchanges to include SHOP data (probably because they're one of the few where SHOP enrollments are above 4 figures, thanks to the weird ACA rule requiring Congressional staffers to enroll using it).

From October 1, 2013 to January 11, 2015, over 74,100 people have enrolled in health insurance coverage through DC Health Link in private health plans and Medicaid:

These numbers are pretty good for DC...except that there's an important caveat: They're all cumulative numbers since October 1st, 2013, making it trickier to parse out:

More Than 71,000 People Enrolled in Health Coverage Through DC Health Link

Wednesday, December 24, 2014


From October 1, 2013 to December 21, 2014, over 71,500 people have enrolled in health insurance coverage through DC Health Link in private health plans or Medicaid:

 18,773 people, including new customers from the 2nd Open Enrollment Period , have enrolled in private health plans through the DC Health Link individual and family marketplace;
 37,457 people were determined eligible for Medicaid coverage through DC Health Link; and
 15,284 people enrolled through the DC Health Link small business marketplace and members and staff from US Congress.

Fortunately, I have most of the 2014 data as well so we can break this out:

Ah, here we go:

Nearly 15,000 people signed up for coverage through D.C. Health Link to begin by Jan. 1, officials announced this week.

The D.C. Health Benefit Exchange Authority reported 1,886 new enrollees and 13,100 people who have re-enrolled in private health insurance plans so far in this second open enrollment period under the Affordable Care Act. Earlier this month,officials said there could be up to 500 applications that weren't completed by the first deadline to obtain health coverage by Jan. 1 because of a glitch in the system's new features. Officials said all of those impacted enrollees would have coverage by Jan. 1.

Between Nov. 15 and Dec. 21, the D.C. Health Link website had 56,318 visitors with 109,058 visits. It fielded 25,667 calls to its customer service center.

OK, that's 14,986 total for DC, and this gets another chunk of renewals off the books.

OK, that's more like it...about 500 people in DC are being contacted by exchange personnel regarding technical issues, but over 2,600 made it through under the wire:

D.C. Health Exchange Director Mila Kofman said as many as 500 applications were left in limbo at 9 p.m. Monday, the cutoff for selecting coverage that would take effect on Jan. 1.

Kofman said 2,631 people enrolled successfully.

Employees at the exchange, known as D.C. Health Link, will spend the next several days contacting each applicant by phone or e-mail to walk them through a follow-up process to ensure unfinished applications are processed and those residents can begin receiving coverage beginning next month as planned, Kofman said.

DC had around 10,000 enrollees to start with; presumably the 2,631 figure is a mix of renewals and new additions.

Short & sweet:

District of Columbia: DC Health Link has enrolled 1,413 people, both new and renewed applications, according to data collected by last week Kaiser Health News.

Grammar aside, I'll assume "last week" means "through Friday the 12th".

Just a few things to note...

MASSACHUSETTS: The MA Health Connector allows for online premium payments (and in fact, payments have to be made to the exchange, not to the insurance company itself). The good news is that the website & billing system appear to be working properly this year, a vast improvement over last year's disaster. The bad news (or, odd news anyway) is that for some reason the system requires you to pay using only direct electronic fund transfers or a written check--it does not accept credit card payments!

I don't know if this is for technical reasons (which I doubt) or policy reasons (avoiding the 2.5% transaction fees or whatever), but it seems very odd to me.

HAWAII: Not only hasn't the HI Health Connector provided any enrollment updates since open enrollment started again on November 15th, they haven't even updated their enrollment report section since July 26th! Guys, either post an update or at least remove the link entirely; keeping it as is, locked in on 7/26 is just embarrassing.

A nice, detailed but to-the-point update out of DC (which supersedes my earlier post):

Meanwhile, as of Monday, D.C. Health Link had a little more than 9,000 visits to its website from about 6,300 visitors. The exchange had 708 total applications and 212 plan selections for 249 covered lives. Officials said they were off to a strong start toward their enrollment goals this year, though they've declined to disclose specific numbers.

This also shows the importance of using the correct number:

9,000 visits > 6,300 unique visitors > 708 applications > 249 covered lives (from 212 policies) in 3 days.

From a state exchange roundup report; I've already reported on every data point they have except for this one out of DC:

By the end of the day Saturday the District of Columbia enrolled 66 people at an event downtown. DC Health Link upgraded this year, including features like providing more information about each health plan. More than 15,000 people enrolled in private plans last year and nearly the same number enrolled on the small business exchange. Health care premiums for 2015 will increase by 11 percent.

VERMONT: Federal Law Raises Questions About Who Can Bid For IT Projects That Support The Exchange

A provision of the Affordable Care Act precluding health insurers or companies in the “same controlled group of corporations” as a health insurer from holding exchange contracts raises questions about Optum working on Vermont Health Connect.

Concerns regarding Optum were raised at the federal level by Sens. Orrin Hatch, R-Utah, and Chuck Grassley, R-Iowa, the ranking members of the Finance and Judiciary committees respectively.

IDAHO: Your Health Idaho to launch sign-up system

Basically just an overview of the new Idaho ACA exchange; ID is the only state moving from HC.gov to their own website for the 2nd year, giving them a unique perspective. Most interesting to me is that they're spinning the "autonomy/states-rights" angle, which was the whole reason for pushing states to set up their own exchanges in the first place:

A nice, simple, no-nonsense enrollment update from the DC exchange:

From October 1, 2013 to October 7, 2014, 60,771 people have enrolled through DC Health Link in private health plans or Medicaid:

  •  15,110 people enrolled in private health plans through the DC Health Link individual and family marketplace.
  •  14,486 people enrolled through the DC Health Link small business marketplace.
  •  31,175 people were determined eligible for Medicaid coverage through DC Health Link.

That's an increase of 708 QHPs, 627 in SHOP policies and 1,983 in Medicaid.

Thanks to top contributor deaconblues for jumping back into the game and providing me with a whole batch of updates this evening. First up, the DC exchange, which posted their first update in 2 months:

From October 1, 2013 to September 9, 201457,883 people have enrolled through DC Health Link in private health plans or Medicaid:

 14,402 people enrolled in private health plans through the DC Health Link individual and family marketplace.
 14,289 people enrolled through the DC Health Link small business marketplace.
 29,192 people were determined eligible for Medicaid coverage through DC Health Link.

That's an increase of 1,872 QHPs, 510 new SHOP enrollees and 4,472 more Medicaid additions to date.

Unfortunately, I don't know the market share breakdown, so I can't do a weighted average, but the DC Health Link exchange rates for 2015 have been released, and the unweighted average is only a 2.3% increase for the individual market. For the SHOP (small business) exchange the news is even better...a decrease of over 2% (again, unweighted). The SHOP rates carry a lot more heft in DC than in most states due to the unique rules in place there (like Vermont, all individual enrollment has to be done via the ACA exchange, and all Congressional staffers are required to enroll via the DC SHOP system):

The D.C. Department of Insurance, Securities and Banking today announced the approved health insurance plan rates for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2015.

Eight carriers through four major insurance companies – Aetna, CareFirst BlueCross BlueShield, Kaiser Permanente and UnitedHealthcare – will have plan offerings for individuals, families and small businesses on DC Health Link when enrollment opens Nov. 15, 2014.

Between my son being sick for the past 4 days (he's better now, thanks!), losing my internet connection for 2 days (it's back up now, thanks!) and just generally being swamped with work, I don't have time to give these stories the attention they deserve, but they're all worth checking out:

D.C.’s health exchange is still hampered by delays, glitches 11 months after launch

While Democratic partisans tout the latest conventional wisdom that Obamacare is finally going strong, the experience of many ordinary people who apply for it says otherwise.

The ongoing delays and irritation that consumers endure while navigating the District’s health insurance exchange offer a window into the reality on the street.

More health insurance options increase choice — and possibly confusion

Three ACA-related stories which are all interesting but which I don't have a whole lot to add to:

The trouble with trying to sign people up for health insurance when care is already free

It’s hard work trying to get people to sign up for health insurance when their care is mostly free to them. Andrea Thomas is working to get Alaska Natives in Sitka, Alaska, to do just that. She’s the outreach and enrollment manager at SouthEast Alaska Regional Health Consortium (SEARHC), and it’s her job to sign people up for health insurance coverage through exchanges created as a result of the Affordable Care Act.

To get a sense of just how uphill Thomas’s battle is, consider this: Of the more than 100,000 people who live in Alaska and self-identify as Alaska Native or American Indian, only 115 had signed up for health insurance through an Affordable Care Act exchange as of March 31.  Alaska Natives and American Indians are exempt from tax penalties for not signing up for health insurance.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

MARYLAND: An Amazing Healthcare Revolution Is Happening In Maryland — And Almost No One's Talking About It

The Maryland ACA exchange has been one of the "middle-tier" models in my view; not an utter disaster like the ones in Oregon or Massachusetts, but still riddled with technical problems like the ones in Minnesota & Vermont. However, the state has apparently had a different healthcare-related initiative which has been a huge success so far:

Through innovative methods and a data-centric approach, Western Maryland Regional Medical Center, has become the cornerstone in Democratic Gov. Martin O'Malley's ambitious makeover of the state's healthcare programs.