As I've noted before, Connecticut has an unusual policy for reporting 2017 QHP selections. Instead of reporting the number of renewing enrollees + new additions, they start out by assuming every current enrollee will be renewed for the upcoming year, add the new additions and the subtract those who actively choose not to renew their policy. Technically, this makes it look like Connecticut has already broken 100,000 enrollees for 2017--over 80% of their enrollment target number--even though we're only 4 weeks into the enrollment period. As a result, I can't really give an accurate "enrolled for 2017" number until the third week of December, when every state has officially entered their autorenewed enrollees into the system.
Last year I took a shot at predicting not only total Open Enrollment QHP selections nationally, but also on a state-by-state basis. Seeing how I ended up overestimating by a whopping 2 million people nationally (projection: 14.7 million; actual: 12.7 million...about a 16% difference), it shouldn't be surprising that I was also way off on most of the individual states.
Of the 50 states +DC, I was within +/- 5% in only 13 states. 6 states overperformed my projections by more than 5 points (MA, UT, MD, SD, MN and TN)...but 32 states underperformed by more than 5 points, and 17 states came in more than 15% lower than I was expecting. Ouch.
I was therefore understandably hesitant to put my neck out there again this year...and after the unexpected results of the Presidential election, all bets seemed to be off. However, seeing how the first couple of weeks of OE4 seem to be holding pretty closely to my national projections so far, I've decided to go ahead and post my state-level calls after all.
MIAMI — Dalia Carmeli, who drives a trolley in downtown Miami, voted for Donald J. Trump on Election Day. A week later, she stopped in to see the enrollment counselor who will help her sign up for another year of health insurance under the Affordable Care Act.
“I hope it still stays the same,” said Ms. Carmeli, 64, who has Crohn’s disease and relies on her insurance to cover frequent doctor’s appointments and an array of medications.
Mr. Trump and Republicans in Congress are vowing to repeal much or all of the health law, a target of their party’s contempt since the day it passed with only Democratic votes in 2010. If they succeed, they will set in motion an extraordinary dismantling of a major social program in the United States.
As of this writing, Hillary Clinton's national popular vote tally stands at exactly 64,478,925 to Donald Trump's 62,352,480, with an additional 7,169,272 people having voted for other candidates (Gary Johnson, Jill Stein, various other 3rd party candidates and a smattering of write-in votes). That means Clinton is ahead of Trump by over 2.1 million votes, and I understand there's still up to 1.5 million more left to count, mostly in California. By the time the dust settles, it's conceivable that she could lose the electoral college--and therefore the Presidency--while having beaten Trump by as many as 2.6 million votes.
IF the amount of excessive profit going into the kitty was greater than the amount of excessive losses, the federal government would have paid out what was owed and keep the difference, in which case it was conceivable that the feds would actually profit off of the program.
IF, instead, the profit was less than the loss, the government would have to pay out the difference.
Unfortunately, as it happens, the second scenario is how things played out in 2014...as well as in 2015, and, most likely, 2016 as well.
When I last checked in on Colorado, they were reporting 2017 enrollments at a rate 30% faster than last year (16,305 in 13 days vs. 12,496 in the first 13 days last year).
Today they didn't issue an official update, but did give enough to piece together an estimate via an email to their enrollees:
Dear Connect for Health Colorado Stakeholders,
As we approach the Thanksgiving holiday, we’re busy as ever enrolling customers. In fact, enrollments are outpacing our numbers by more than 25 percent over this time last year, with our biggest day falling the day after the election. And, this is a trend we’re seeing nationally.
While the recent election has raised a lot of questions about the future of healthcare, what remains constant and true is the importance of protecting the health and financial future of our customers. Broken bones, disease and other chronic conditions aren’t political, but can happen at any time and in some cases, are preventable with access to care and health insurance. Our dedication to helping customers remains as strong as ever.
Two months before President-elect Donald Trump begins his attempt to repeal the Affordable Care Act, the Obama administration and its allies are making an aggressive final push to sign-up some of the program’s most reluctant customers -- young people.
Healthy and new to the workforce, the “young invincibles” -- people aged 25 to 34 -- represent the highest uninsured rate of Americans, according to a survey released in November by the Centers for Disease Control and Prevention. While coverage of people in that range has grown under Obamacare, the group has for the last five years had the highest rates of uninsurance compared to other age bands.
It's a good story, but there's one section in particular with a line which will make anyone with the slightest idea about how insurance works wince:
On the one hand, starting in January, the Republican Party will have complete control over both the U.S. House and Senate, Donald Trump will be sworn in as President, and the entire lot have promised repeatedly to kill the Affordable Care Act, aka "Obamacare".
On the other hand, the GOP hasn't managed to figure out what the hell they plan on actually replacing the ACA with (if anything), even though they've had over 6 years to come up with something and have voted to repeal it dozens of times. They insist that the ACA is a complete disaster; for years they refused to admit that it helped anyone; more recently they've grudgingly admitted that it helps some people, although they still claim that it hurts more than it helps.
In light of this, the Center for American Progress Action Fund has whipped up a simple website, ACAWorks.org, in which they ask people who have been helped by the ACA to let them know what Obamacare has meant to them.
So, the day after the election, I noted that on top of the rest of the awful, there's another fun tidbit: Due to the nature and timing of the ongoing House vs. Burwell lawsuit, it's conceivable that President-elect Donald Trump (See? I'm starting to get used to typing that!) could effectively wipe out most of the ACA immediately upon taking office by simply giving up on fighting the lawsuit and stopping Cost Sharing Reduction subsidies as early as February 1st.
This, in turn, would not only cause havoc across the individual insurance industry, it would also trigger an "escape clause" among the carriers, potentially (subject to whatever the state laws allow) letting them immediately cancel their policies. As in, the currently-in-effect policies which people had just had go into effect a month earlier. And this would have nothing to do with any action taken on the part of the Republican-held Congress.
How many people could potentially see their policies yanked out from under them?
Just another update: I'm fairly certain that QHP selections via HealthCare.Gov (covering 39 states) has broken 1.7 million people, with an additional 500,000 having enrolled via the 12 state-based exchanges for a total of around 2.2 million as of tonight.
The confirmed tally stands at just over 1.4 million thanks to a small update out of Minnesota.
I expect things to slow down significantly over the holiday weekend (Thursday - Sunday) before ramping back up again next week.
UPDATE: As of Wednesday night (11/23/16), I estimate the grand total is now up to around 2.4 million nationally, 1.8 million via HC.gov.
