The impending King v. Burwell Supreme Court decision will cast an even larger shadow over the ACA over the next 2 months (the decision is expected to be announced in June), as exchanges in 6 of the 14 states running their own (State-Based Marketplaces, or SBMs) are at risk of either being abandoned, dissolved or otherwise moved over to the federally-run Healthcare.Gov exchange:
The federal government is threatening to take over Hawaii's health insurance exchange within months and has restricted grant money to support operations of the Hawaii Health Connector.
Jeff Kissel, the Connector's executive director, told lawmakers at a briefing Thursday that if the exchange created by the Affordable Care Act does not get state funding soon, the federal government will abolish Hawaii's marketplace and run it directly.
Now that the King v. Burwell Supreme Court oral arguments are out of the way (with radio silence expected until they announce the decision sometime in June) , the next Big Development to keep an eye on ACA-wise is...Tax Season! There will be plenty of stories about how many people have to pay back some/all of their 2014 tax credits, how many will receive additional tax credits...and, most germane to this site, how many additional people enroll via the exchanges to avoid having to pay (most) of the higher tax penalty next year for not being covered in 2015 during the Tax Filing Season Special Enrollment Period (SEP), or #ACATaxTime as I prefer to call it.
This isn't an exact apples-to-apples comparison, since the Massachusetts number includes the "overtime" extension period while the other 5 states only run through 2/15/15, but I thought it would be useful to see how the 6 exchanges which had widespread technical issues last year fared this time around. Obviously other states like Washington and California had some snafus, but these are the ones which were seriously hosed last year to the point of requiring massive overhauls or which were completely scrapped in favor of a new platform (I'm not including HC.gov itself here since everyone already knows what massive technical improvements they've made).
The chart below refers specifically to QHP selections only (whether paid or not), and compares the 2015 open enrollment period (11/15/14 - 2/15/15...or 2/26 in the case of MA) against the 2014 open enrollment period (10/1/13 - 4/19/14). I've also included some notes for context.
WIth the DC and Vermont updates this evening, there are now only 4 states which haven't brought their enrollment data up through the end of open enrollment: CO, CT, ID and KY:
Vermont Health Connect Open Enrollment and Renewal Update
The following numbers are up-to-date as of 11:59pm Sunday, February 15, 2015.
New Vermont Health Connect Customers
15,422 individuals have checked out a 2015 health plan. This includes 6,211 individuals in Qualified Health Plans (private health insurance) and 9,211 individuals in Medicaid or Dr. Dynasaur plans.
After a new customer checks out a plan, they must make an initial premium payment and have their selection processed before they have an active health plan. Of the 15,422 individuals who checked out, 11,704 have completed the enrollment process and have an active health plan (i.e., effectuated enrollment). Of those who completed the process, 3,471 are on a Qualified Health Plan and 8,233 are on Medicaid or Dr. Dynasaur.
I'm not at all surprised that the exchanges are starting to announce "tax season" enrollment periods already. The only thing I'm surprised by is the length of these special periods. I figured they'd do something like April 1st - 15th...instead, all 3 (Washington, Minnesota and now Vermont) are going for 2-month periods or even longer:
WA: 2/17 - 4/17 (effectively just extending the enrollment period by 2 months)
MN: 3/01 - 4/30
VT: 2/16 - 5/31 (a full 3 1/2 months...with the caveat that it has to be "within 60 days of discovering" that they have to pay the fee, which isn't exactly the sort of thing that one can prove one way or the other, y'know?)
Again, it's important to keep in mind that there are 3 main reasons for having a deadline/cut-off at all: First, prevents people from gaming the system by waiting until they're sick to enroll. Secondly, it allows the insurance companies ample time for their actuaries to crunch the numbers for the next year. Finally, it acts as a great motivator, as evidenced by the huge surges in December and again last week (even if the 2nd surge wasn't quite as large as I was expecting).
First, as noted this morning, California has tacked on an extra 2 days to their "In Line by Midnight" period (previously ending on 2/20; now extended to 2/22)
Second, Vermont, which didn't appear to be allowing for any extra time beyond postmarking a paper application as of Tuesday, has apparently decided to go ahead and allow an "In Line by Midnight" exception thorugh February 23rd:
But by February 18, the exchange was offering an extension to people who tried to enroll by February 15 but were unable to do so by the deadline. This has not been published on the exchange website, but an exchange representative confirmed that the extension runs through February 23, and that the call center (855-899-9600) will help enrollees complete the process between now and then.
D'oh! OK, one more late-breaking number today, out of Vermont:
Vermont Health Connect Open Enrollment and Renewal Update
The following numbers are up-to-date as of 11:59pm Monday, February 9, 2015.
New Vermont Health Connect Customers
12,344 individuals have checked out a 2015 health plan. This includes 4,786 individuals in Qualified Health Plans (private health insurance) and 7,558 individuals in Medicaid or Dr. Dynasaur plans.
After a new customer checks out a plan, they must make an initial premium payment and have their selection processed before they have an active health plan. Of the 12,344 individuals who checked out, 10,678 have completed the enrollment process and have an active health plan (i.e., effectuated enrollment). Of those who completed the process, 3,293 are on a Qualified Health Plan and 7,385 are on Medicaid or Dr. Dynasaur.
The following numbers are up-to-date as of 11:59pm Monday, January 26, 2015.
New Vermont Health Connect Customers
10,399 individuals have checked out a 2015 health plan. This includes 4,098 individuals in Qualified Health Plans (private health insurance) and 6,301 individuals in Medicaid or Dr. Dynasaur plans.
After a new customer checks out a plan, they must make an initial premium payment and have their selection processed before they have an active health plan. Of the 10,399 individuals who checked out, 8,853 have completed the enrollment process and have an active health plan (i.e., effectuated enrollment). Of those who completed the process, 2,713 are on a Qualified Health Plan and 6,140 are on Medicaid or Dr. Dynasaur.
Renewing 2014 Vermont Health Connect Plans
Unless a customer requested otherwise, all individuals who had an active health plan through the end of 2014 currently have health insurance coverage through Blue Cross Blue Shield of Vermont, MVP Health Care, Medicaid or Dr. Dynasaur. The insurance issuers have their information in their systems and ID cards remain active.
A few days ago I posted an article about how Rhode Island is having trouble scraping together the $19 million or so that they need to operate HealthSource RI, now that the federal funds have pretty much dried up and the exchange has to pull its own weight. Some exchanges were set up with a funding mechanism in place (generally by charging either the insurance companies operating on the exchange, or the enrollees themselves, some sort of tax or fee), but others, like Rhode Island, were funded with federal dollars but never got around to setting up a way to pay for themselves after that funding stopped.
Anyway, a Republican state legislator in RI came up with an ingenious solution: Dump the exchange, even though it's functioning perfectly well. The reasoning is that the federal exchange, Healthcare.Gov, is operating more efficiently, so why not just do what Oregon and Nevada had to do this year (due to technical problems) and add themselves to the pile of 3 dozen states already being run through HC.gov?
9,454 individuals have checked out a 2015 health plan. This includes 3,791 individuals in Qualified Health Plans (private health insurance) and 5,663 individuals in Medicaid or Dr. Dynasaur plans.
After a new customer checks out a plan, they must make an initial premium payment and have their selection processed before they have an active health plan. Of the 9,454 individuals who checked out, 7,981 have completed the enrollment process and have an active health plan (i.e., effectuated enrollment). Of those who completed the process, 2,506 are on a Qualified Health Plan and 5,475 are on Medicaid or Dr. Dynasaur.
Renewing 2014 Vermont Health Connect Plans
Unless a customer requested otherwise, all individuals who had an active health plan through the end of 2014 currently have health insurance coverage through Blue Cross Blue Shield of Vermont, MVP Health Care, Medicaid or Dr. Dynasaur. The insurance issuers have their information in their systems and ID cards remain active.
