Maryland

OK, not exactly a shocker or particularly relevant until after Monday (unless they're gonna be foolish enough to try and switch over to the new system during the deadline weekend frenzy), but worth noting:

Maryland officials are set to replace the state’s online health-insurance exchange with technology from Connecticut’s insurance marketplace, according to two people familiar with the decision, an acknowledgment that a system that has cost at least $125.5 million is broken beyond repair.

Final report before the official 3/31 deadline...exchange QHPs are up to 49,293 from 44,836 (up 4,457), while Medicaid is up to  220,043, which includes 124,154 regular enrollments (up from 107,505) and 96K auto-transfers.

The impact on the projection chart is slight but positive; MD's increase over the February rate has gone from 50% to 66%.

Through March 22, 49,293 Marylanders have chosen to enroll in private health plans through Maryland Health Connection. As of March 25, 220,043 have gained Medicaid coverage in 2014 and remain active in Medicaid....This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage. 

For some reason Maryland's thru-dates are different for QHPs and Medicaid; not sure why. Anyway, they're up to 44,836 QHPs (up over 4,100 from 40,693 on 3/08) and Medicaid enrollments are up to 107,505 from 97,781 on 3/11 (up 9,700).

From October 1, 2013, through March 15, 2014, there have been more than a million unique visitors to the Maryland Health Connection website. 197,818 Marylanders have created identity- verified accounts. Through March 15, 44,836 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

As of March 18, 203,394 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage.

On the March Surge side, Maryland is ramping up from 116% of their February rate the first week of March to 150% when you include the second week.

OK, the cutesy title is kind of a misnomer; my two previous entries didn't use that title originally...but they should have, and do now.

March 31st is supposed to be the final day to enroll in QHPs via the exchanges...but it's looking more and more as though that won't quite be the case in not two, not three...but possibly up to seven states now, including a couple whose websites have been working smooth as silk??

On March 7th I pointed out that due to Massachusetts having some 154,000 people stuck in health insurance limbo, they've been granted some sort of temporary extension, twice...out to as far as June 30th in some cases...

A couple of weeks ago I pointed out that at least two states, Massachusetts and Oregon, may end up extending their enrollment period beyond the official March 31st "deadline" due to their exchange websites still being partially or completely hosed.

In Massachusetts' case, there's about 219,000 people currently stuck in coverage limbo; the HHS Dept. has granted an extension of some sort to as far out as June 30th to get these people squared away, although I'm pretty sure the extension only applies to those folks, not anyone who's just trying to enroll now...but that's still a hell of a lot of people.

Hmm...Last week Maryland finally reported their Paid/Unpaid numbers (54% paid); this week they didn't for whatever reason. Anyway, their total QHPs are up from 38,070 to 40,693, an increase of 2,623 since March 1st.

On the Medicaid side, they've decided to bundle together the 96K PAC transferees with the "normal" new Medicaid enrollees for whatever reason. Subtracting out the PAC number gives 97,781 through March 11th, a very impressive 37% (26,332) gain since Feb. 25th.

From October 1, 2013, through March 8, 2014, there have been more than a million unique visitors to the Maryland Health Connection website. 186,268 Marylanders have created identity- verified accounts. Through March 8, 40,693 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

As of March 11, 193,670 individuals have gained Medicaid coverage in 2014 and remain active in Medicaid. This includes the 95,889 PAC enrollees who were automatically converted on January 1, 2014 to full Medicaid coverage.

OK, as noted a little earlier, I underestimated the February HHS Report for Exchange-based Private QHP enrollment by about 4.2%:

  • My Projection: 902,800 (4.202 million total)
  • Actual Enrollments: 942,833 (4.242 million total)

I'm perfectly happy to have underestimated. As for where the extra 40,000 enrollments came from, my initial guess would be that California, in particular, started ramping up their big March blitz a bit earlier and more successfully than I figured, which, again, I'm absolutely fine with. Update: Nope, actually, California's numbers plummetted in the 2nd half of Feb due to that ugly technical outage; see below for details.

I'm busily plugging the new enrollment numbers into the spreadsheet even as I type this, and will be updating with various notes and observations, so keep checking in.

OK, I've entered the QHP data; a couple of things to note:

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!

Maryland's private QHPs went up 2,434 in the last week of February. More noteworthy, Maryland's exchange seems to be getting a lot of pressure to explain their "paid/unpaid" data; this is the most extensive explanation I've seen from any state about the subject (except for one Vermont report last month). They're up to 38,070 total, of which 20,439 are paid up.

Medicaid numbers are the same, since they're still through 2/25.

Through March 1, 38,070 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

Yeesh! Another crazy day...a third update today, this time for Maryland. The numbers aren't anything exciting (QHPs up about 2,400, Medicaid up a more impressive 10.7K), but every bit helps. The more noteworthy bit of news, however, is shown below--Maryland is finally jumping on the "How many are PAID???" bandwagon and joining 6 other states in breaking out their payment numbers.

While the percentage doesn't look good on the surface (only 54% of the total), the press release is careful to make the same point that I've been making for weeks now: If a big chunk of the unpaid enrollments aren't even due yet, it's rather silly to wring your hands about people not having paid their premiums yet.

Maryland continues to creep along, adding 2,139 to their QHP tally (about 7%) and another 8,581 to their Medicaid enrollments (a bit under 6%).

Through February 15, 33,251 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

95,889 Marylanders signed up through the Primary Adult Care (PAC) program were automatically enrolled in Medicaid coverage on January 1, 2014, and now have full Medicaid coverage. As of February 18, 2014, an additional 60,672 individuals were newly enrolled in Medicaid effective January 1. 

Maryland's Private QHP enrollment is up to 31,112 (up from 29,059 on 2/01), and their Medicaid/CHIP enrollment has increased to 52,091 people plus another 95,889 transfees from the Primary Adult Care program; this is up from 44,592 Medicaid + 95,824 PAC transfers a week earlier.

Through February 8, 31,112 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

95,889 Marylanders signed up through the Primary Adult Care (PAC) program were automatically enrolled in Medicaid coverage on January 1, 2014, and now have full Medicaid coverage. As of February 11, 2014, an additional 52,091 individuals were newly enrolled in Medicaid effective January 1.  

Maryland had another few thousand people enroll in the in both Private QHPs and Medicaid over the past week: Private enrollments are up over 8% to 29,059, while Medicaid/CHIP enrollments have increased by 5%, to 44,592. The number of automatic transfers from the Primary Adult Care program also went up a few hundred to 95,824.

 Through February 1, 29,059 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

95,824 Marylanders signed up through the Primary Adult Care (PAC) program were automatically converted to Medicaid coverage effective on January 1, 2014, and now have full Medicaid coverage.  As of February 4, an additional 44,592 individuals were newly enrolled in Medicaid effective January 1.

Maryland continues to move along...

Through January 25, 26,832 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

95,318 Marylanders signed up through the Primary Adult Care (PAC) program were automatically converted to Medicaid coverage effective on January 1, 2014, and now have full Medicaid coverage. As of January 28, an additional 42,302 individuals were newly enrolled in Medicaid effective January 1.

Hmmm...the same article uses 2 slightly different numbers (368 and 370)...I'll split the difference for the moment :)

New Mexico is also noteworthy in that while their individual ACA market is being handled by the federal exchange (HC.gov) for the first 2 years, they're already running their own small business (SHOP) market themselves.

Meanwhile, I've been informed that Washington State only has their SHOP program running in 2 counties, while Maryland's won't be operational until April (SHOP enrollments are open year-round, while individual/family enrollments are only available through 3/31).

As of Jan. 15, 368 people had purchased insurance through New Mexico’s SHOP (Small Business Health Options Program) exchange for small businesses. 

...So far, 370 people have enrolled in insurance plans on the SHOP exchange, according to the NMHIX. A total of 1,542 employers have set up accounts on the exchange and they represent 3,962 employees.

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