END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

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Charles Gaba's blog

Last week I noted that Maine Republican Senator Susan Collins' proposal to "solve" the problems created by repealing the ACA's individual mandate (passing the Alexander-Murray CSR bill and her own Collins-Nelson reinsurance bill) would only mitigate a small portion of the damage caused by such a mandate repeal.

As I had previously noted, the Alexander-Murray bill would simply restore CSR funding into place which was already assumed to be there when the CBO made their "13 million losing coverage/10% rate hike" projection earlier, making passing it kind of a non-factor when it comes to the impact of repealing the mandate. That just left the reinsurance bill. Collins original proposal was a mere $2.25 billion/year (and only for two years at that)...which I estimated would fall short by a factor of anywhere from 3x to 7x, depending on which back-of-the-envelope math you use:

 

So one of the Big Deals on Twitter this morning was this tweet by Republican (correction: Former Republican) MSNBC talking head Joe Scarborough:

.@SenOrrinHatch talking about children's health care: “I have a rough time wanting to spend billions and billions and trillions of dollars to help people who won’t help themselves – won’t lift a finger – and expect the federal government to do everything.”

— Joe Scarborough (@JoeNBC) December 3, 2017

...which caused an immediate and understandable backlash uproar, including my own tweet (since deleted),

Holy crap. They're CHILDREN. Plus...didn't he used to brag about helping CREATE the CHIP program in the first place?

I hadn't actually seen the full clip at the time. My own tweet went semi-viral, with several hundred RTs and a bunch of Likes within a couple of hours.

However, shortly after that, Bloomberg reporter Steven Dennis correctly noted that...

 

Welp. There you have it.

It's not over yet, since the House of Representatives still has to vote on the bill again (either as is, or after hashing out the differences between the House and Senate versions of the bill), but assuming the final version of the bill includes mandate repeal and is indeed signed into law, this is what the ACA's 3-legged stool would look like when the dust settles.

Obviously I'll have much more to say about what happened last night soon, but for the moment I'll leave it at this.

Thanks to "Andy the Dog" for the heads up:

Kelly said about 90,000 people were insured through the exchange at any given time this year. (People could enroll or cancel during the year.) And at the end of last year’s open-enrollment period, more than 100,000 were signed up for coverage.

This month, the exchange has renewed 86,300 customers for 2018 plans. The new sign-ups are much lower, in the hundreds. Kelly said total enrollment so far — 2017 customers being rolled over into 2018, plus the new sign-ups — exceeds 87,000.

“That number has grown every day in the last several weeks,” he said.

Less than 10 percent of people who were auto-renewed for 2018 plans have canceled so far, he said. More people could cancel by the deadline, though; last year, almost 30 percent of auto-renewed plans had been canceled when the dust settled on the enrollment period.

Access Health CT has just posted their full November enrollment numbers: 90,428 QHP selections thru 11/30, of which 13% are new enrollees.

For comparison, last year they enrolled 111.5K people, so they've hit 81% of their 2017 number and 78% of their 2016 number.

They've also done something interesting: They're listing the 11,055 current enrollees who haven't actively re-enrolled as of yet. If every one of them did so (they won't), that would bring the grand total up to 101.4K.

This just in...

Connect for Health Colorado® Reports Increase in 2018 Medical Plan Selections

DENVER —  More than 43,000 Coloradans selected healthcare coverage for 2018 through the state health insurance Marketplace in November, a rate 29 percent ahead of signups one year ago, according to new data released today by Connect for Health Colorado®.

“With only two weeks left to enroll for January coverage, I am pleased with the pace of plan selections,” said Connect for Health Colorado CEO Kevin Patterson.  “I know people are busy this time of year but I encourage everyone who buys their own health insurance to check to see if they qualify for financial assistance, review the available plans, and complete an enrollment before the last-minute rush. Many will be surprised that they qualify for financial help.”

...well, not a whole lot, to be perfectly frank.

Vermont has been pretty much on radio silence for the past two years. They issued fairly regular enrollment data reports in 2014 and 2015, but last year there was nary a peep; the only mid-season enrollment report with Vermont data was the official one released by CMS in early January.

I was, therefore, pretty happy to see a link to their "2018 Open Enrollment Update" posted earlier this afternoon.

Unfortunately...

Open Enrollment Countdown: Just 15 Days Left to Sign up for 2018 Health Coverage

Customer Support Center to Open Next Two Saturdays (9am-1pm)

Nothing official yet, but New York-based Politico healthcare reporter Dan Goldberg just tweeted this out:

@charles_gaba new ny numbers out. 46,000 new enrollees. 13 percent ahead of last year’s pace. 31,500 in essential plan. Numbers through end of November

— Dan Goldberg (@DanCGoldberg) November 30, 2017

Unfortunately, a lot of the state-based exchanges have an annoying habit of not posting renewal numbers until after the enrollment period is over (including the biggest one, California), but this is still helpful. Also handy to have the early BHP enrollment numbers.

UPDATE: Whoops...the official NY State of Health press release is out, and it looks like I misunderstood Goldberg's tweet; it's 46,000 new enrollees total including QHPs and BHPs combined:

A couple of weeks ago, a joint letter was sent to all four Congressional leaders from AHIP (America's Health Insurance Plans), the BlueCross BlueShield Association, the American Academy of Family Physicians, the AMA, the American Hospital Association and the Federation of American Hospitalsm warning them, in no uncertain terms, of what the consequences of repealing the individual mandate would be:

We join together to urge Congress to maintain the individual mandate. There will be serious consequences if Congress simply repeals the mandate while leaving the insurance reforms in place: millions more will be uninsured or face higher premiums, challenging their ability to access the care they need. Let’s work together on solutions that deliver the access, care, and coverage that the American people deserve.

A week or so ago, the American Academy of Actuaries sent a similar letter to Republican Senate Majority Leader Mitch McConnell stating pretty muc the same thing, but in more vivid detail:

The following letter was sent to Rep. Carol Shea-Porter of New Hampshire a few days ago:

Dear Representative Shea-Porter:

Thank you for your letter regarding funding for the Navigator program. I appreciate hearing from you on this issue. The Patient Protection and Affordable Care Act requires each Health Insurance Exchange (whether Federally-facilitated or state-based) to have a Navigator program to, among other things, help facilitate enrollment of individuals in qualified health plans (QHPs) through the Exchange.

She goes on to rehash everything we already knew: That CMS slashed outreach grant funding by tens of millions of dollars. She obviously tries to make it sound like a reasonable, well thought-out process, even though, as I reported exclusively back in September, the decision was actually slapped together at the last minute, literally a few hours before the formal grant notices were actually sent out.

However, that's not what I'm focusing on here; this is:

This just in from the Washington Health Benefit Exchange...

The Washington Health Benefit Exchange today announced that nearly 18,000 new customers have used Washington Healthplanfinder to select 2018 health coverage through the first four weeks of open enrollment. The number of new customers who have signed up since Nov. 1 represents a 43 percent increase over the same period last year.

In addition to the 4,500 new sign-ups received on average each week, Washington Healthplanfinder has experienced an 18 percent increase in visits to the website, with more than 423,000 visitors reviewing their coverage options on www.wahealthplanfinder.org.

Additional data revealing increased consumer interest during open enrollment:

As I noted earlier, the price Maine GOP Senator Susan Collins appears to be demanding is passage of the Alexander-Murray stabilization bill and passage of her own Collins-Nelson reinsurance bill. I addressed Alexander-Murray in my last post, but let's take a look at Collins-Nelson:

Collins' bill with Nelson would set aside $4.5 billion over two years to help states establish reinsurance programs. Reinsurance directly compensates insurance carriers for their most expensive customers.

To the best of my knowledge, that's...pretty much all it does: $2.25 billion per year for two years, and then...that's it. If there's more to the bill than that, I'll revise this post, but in the meantime, that seems to be the whole bill.

All eyes are on the Godawful Tax Scam Bill this week, which once again lies mostly in the hands of a handful of Republican Senators including the usual suspects like John McCain, Lisa Murkwoski and Susan Collins.

McCain's biggest beef this year has been about "following regular order"; it's the reason he shot down the GOP's #BCRAP bill last summer. Of coruse, current tax bill most certainly isn't following regular order either. Will he stick to his guns on the issue or cave under pressure this time? Who knows?

Murkowski was a healthcare hero last summer as well...but she may have been bought off by the addition of a "Polar Payoff" in the form of the bill allowing oil drilling in the Arctic National Wildlife Refuge (ANWR). This is the only reason I can think of that would explain her rather disingenously defensive op-ed piece in the Anchorage Daily News last week.

Me, four days ago:

FWIW: By midnight tonight, I’m estimating ~2.8M QHP selections via HC.gov (4.6M nationally). My prior estimate forgot to account for Thanksgiving weekend: https://t.co/NoZrEE3eTK #ACA #Obamacare #GetCovered pic.twitter.com/mB1wKcWwQP

— Charles GetCoveredBa (@charles_gaba) November 25, 2017

CMS, moments ago:

In week four of Open Enrollment for 2018, 504,181 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday.

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