Massachusetts

OK, in addition to the appx. 7.041 million enrollments on the Federal exchange (HC.gov), I've brought CO, CT, DC, HI, KY, MD, MN, NY, RI and WA completely up to date, with all QHP data through midnight on 3/31 (some of the Medicaid/CHIP data is still missing, but that's a lesser concern at the moment).

However, I'm still missing the following exchange QHP data:

  • California: 22 hours (that's right...the current tally runs thru 2am on 3/31)
  • Massachusetts: 3 days (current is thru 3/28)
  • Nevada: 2 days (current is thru 3/29)
  • Oregon: 3 days (current is thru 3/28)
  • Vermont: 1 day (current is thru 3/30)

I can't tell you how frustrating it is to be this close to full data while still missing it.

So, how much is actually missing? Well, if these states were running at their prior average March daily rate, it would be

  • CA: 11,754
  • MA: 512 x 3 = 1,536
  • NV: 427 x 2 = 854
  • OR: 502 x 3 = 1,506
  • VT: 775
  • Total: 16,425

However, this obviously doesn't apply since the final weekend and especially yesterday were insane.

A small update from Massachusetts...still not sure what the heck they're gonna do with a couple hundred thousand people who got caught in "limbo status" but that's for another day...

As of Friday, Connector spokesman Jason Lefferts said the site saw 26,793 people sign up with new federal Affordable Care Act-compliant plans since the Oct. 1, 2013 start date.

Residents seeking unsubsidized coverage had until Monday to buy insurance, but because of problems with the website, those having trouble applying now have until April 15 to apply.

As usual with Massachusetts, there's a lot of weird numbers flying around in this article (and therefore, no new hard enrollment numbers to add at the moment), but there's some other important stuff right in the lede:

BOSTON -- Massachusetts residents who have had difficulty signing up through the Health Connector for unsubsidized health insurance coverage will be given an extra two weeks to enroll under an extension plan to be presented Thursday, two days after President Barack Obama announced a similar reprieve for frustrated consumers on the national level.

...Residents who have had trouble completing enrollment to due technical problems with the website will be allowed to shop online for unsubsidized plans through April 15, with payment due April 23 for coverage starting on May 1.

OK, first, there's the standard "you get until 4/15 as long as you started by 3/31" bit which is all the rage (seriously, I think Connecticut is the only state not extending enrollment in one way or another at this point, while Rhode Island nor Hawaii are the only other states not to chime in one way or another...which is insane in the case of Hawaii).

Eureka! Finally, some serious progress on the Massachusetts Mess front. Apparently the backlog of manual payment enrollments is seeing serious progress as people mail in their checks. As a result, MA's 15,140 exchange QHPs as of 3/19 have shot up to 25K. And yes, these all appear to be QHPs, not Medicaid (under any of the dozen Medicaid categores that Massachusetts seems to have), as all of those numbers are far, far higher than 25K.

I should further note that MA only reports enrollments to HHS if the first premium is paid.

In one shot, Massachusetts has gone from running 30% behind their February QHP rate to of three times higher, and my overall 3/31 projection has moved up from 6.26 million to 6.30 million.

Lefferts said some 25,000 people have enrolled in Affordable Care Act plans, with the bulk of those being former Commonwealth Choice enrollees, along with a small number of subsidized individuals from Commonwealth Care and about 2,000 people for new dental coverage.

Contributor deaconblues brings a very nice find. Massachusetts continues to be one hell of a mess, but this latest official briefing helps bring some clarity to the situation, while raising some more questions. Rather than restate it all myself, here's deaconblues summary, and the chart in question:

A bit of an update out of Massachusetts; the article is another rundown of the MA Mess, but there's actually small enrollment update included as well: Exchange QHPs have gone up from 12,965 on 3/01 to 15,140 as of "this week" (I'll call it Wednesday the 19th).

As of this week, only 740 Massachusetts residents have been able to enroll in newly subsidized plans under the act, Health Connector Authority spokesman Jason Lefferts said.

He said 14,400 people were able to enroll in unsubsidized plans on the private market by using the connector's website. Their success rate is tied to not needing to go through the income eligibility process, Lefferts said.

However, here's the actual good news: It turns out that Massachusetts only includes paid enrollees in their reports. From a CNBC article a week ago:

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.

Thanks to contributor deaconblues for sending me this story out of Massachusetts, which puts a bit of a downer spin on the otherwise fantastic one-two punch of hitting 1M QHPs in CA and 5M nationally. The short version? MA fired CGI, won't hit their own twice-extended deadline, and has tens of thousands of people stuck in a weird healthcare coverage holding pattern for...no one seems to know exactly how long:

Massachusetts has chosen to toss out CGICorp., the architect of the troubled Health Connector website, amid an ObamaCare enrollment crisis that threatens to spill into 2015....

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!

Last month there was news out of Massachusetts of some sort of extension being granted to "bring the state’s health care system in line" with ACA regulations. At the time I didn't pay much attention to it, thinking that it only related to administrative procedures or somesuch.

However, it turns out that there's actually 154,000 people who are currently enrolled in a sort of healthcare batter's box, being placed on hold until MA's screwed-up exchange is able to absorb them into the system via proper ACA-compliant QHPs (or Medicaid/CHIP...not sure about that yet):

Unable to immediately enroll applicants in new, private plans under the Affordable Care Act, state officials extended existing state coverage for about 124,000 individuals, and granted temporary state coverage to about 30,000 new applicants. Those individuals were supposed to move onto new plans by March. 31; the federal waiver gives officials another three months to do that.

So why am I bringing this up today, 3 weeks after that story broke? Because a contributor called my attention to this story out of Oregon:

Massachusett's ACA exchange website is still undergoing massive technical problems, but there's been significant progress made in processing a mountain of paper applications. The immediate impact isn't that significant (11,000 total enrollments = only 2,861 more than the Feb. 1st tally), but the article suggests that another 50,000 applications should be getting pushed through the system any day now... 

Officials running the state’s troubled health insurance marketplace reported progress on Friday toward addressing its most immediate problem -- a massive backlog in processing applications...

As a result, people were urged to file paper applications instead, both to replace expiring policies and to enroll for the first time. The nearest-term problem has been simply processing 72,000 applications, many of which come from uninsured residents....

Overall, a spokesman for the marketplace said that there have been about 11,000 people who have newly enrolled successfully for coverage since October, almost all in unsubsidized coverage.

As contributor deaconblues put it, "First mention I've heard of 30K new people being enrolled into Medicaid (in addition to the 130K transitioned from the CommonwealthCare plans)."

Before delving into the website issues, Patrick said Massachusetts still has the highest coverage rate in the nation at 97 percent and faced unique challenges to implementing the ACA because of past health reform efforts. He noted that on Jan. 1 130,000 subscribers to coverage through the Connector were successfully transitioned to new plans under the expansion of MassHealth and 30,000 new adults and children were enrolled in the Medicaid program.

For Massachusetts Health Connector’s Board of Directors, which is meeting today, the key question is: How bad do things have to be – and for how long – before the consequence is a brutal decision?

We know that MITRE, a private contractor, was hired to do a technical review of the flawed website of the Massachusetts state insurance exchange. MITRE is the same company that pointed out certain vulnerabilities in HealthCare.gov that have later been fixed.

CGI, which has been responsible for development, failed to deliver a working website. Worse than that: after three months, there is still no indication that CGI has the competency required to fix the website.

Pages