Charles Gaba's blog

And now we enter the Bonus Round!

That's right, Medicaid Expansion finally came to Michigan starting today, April 1st, 2014:

Enrollment began Tuesday for Healthy Michigan, which extends Medicaid eligibility to adults making up to 133 percent of the federal poverty level, or about $16,000 for an individual and $33,000 for a family of four.

By 4 p.m. Tuesday, 11,848 applications had been received, and 4,152 had been automatically approved, according to the Department of Community Health. The state expects 320,000 residents to sign up in the first 12 months. The number could grow as high as 470,000 over time.

I actually have Michigan down as having up to 500,000 people qualifying for expansion, but whatever. I'm not entering this into the spreadsheet or anything yet; I really want to lock down the March numbers before I start up with the April ones. However, it was at least worth mentioning, especially since this is my home state and all... :)

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.

Without the final day's numbers, this update is both helpful and frustrating, because it's so close yet so far away. The QHP number is actually somewhat lower than I had thought a few days ago (not that I'm complaining; HC.gov more than took up the slack, and CA was going nuts on the final day anyway...which is why I'm so anxious to get the data from the 31st):

Consumer interest in Covered California has been strong, with 1,209,791 Californians signing up as of 2 a.m. March 31. From March 24 through 2 a.m. March 31, 155,988 individuals signed up for coverage. During the same week, 389,840 accounts were started — including 123,787 on Saturday and Sunday, as consumers hurried to meet the deadline.

“We’ve set records on accounts created five of the past six days,” Lee said.

Maryland's exchange may be a mess, but this article gives solid, no-nonsense totals: 60K QHPs and 232K Medicaid through 3/31.

Sharfstein provided updated enrollment numbers on Tuesday. He said the state enrolled 60,003 people into private health plans. The state initially hoped to have 150,000 enrolled in private plans. O’Malley has tried to offset the disappointing private plan enrollments by highlighting a higher numbers of Medicaid enrollments through the federal Affordable Care Act. Sharfstein said Tuesday that 232,025 have been enrolled in Medicaid. The state’s goal of total enrollments was 260,000.

Excellent find by contributor deaconblues; HighMark is one of the few major insurance companies which has been very open about their off-exchange QHP enrollments. This press release contains some great updates for 3 different states, including a total exchange QHP update for West Virginia (since HighMark is the only insurance company operating on the exchange there anyway):

Highmark's total enrollment* for individuals who have purchased Affordable Care Act-compliant plans both on the federal marketplace exchange and through Highmark directly:

Pennsylvania: 148,003 total with 104,324 on-exchange and 43,679 off-exchange
West Virginia: 20,131 total with 14,839 on-exchange and 5,292 off-exchange
Delaware: 13,010 total with 9,187 on-exchange and 3,823 off-exchange

Through both on- and off-exchange purchases, Highmark had a noteworthy percentage of new members, which are likely those who were previously uninsured or had insurance with a competitor.

Pennsylvania: 53 percent new members
West Virginia: 63 percent new members
Delaware: 67 percent new members

Not exactly a glowing review of Hawaii's performance, but the final 3/31 number is higher than before, anyway (I'm going with 7,990 as "under 8,000" for now)...no Medicaid news here, however:

April 01--As of Monday, the deadline for signing up for Obamacare coverage, fewer than 8,000 Hawaii residents had successfully enrolled, among the lowest in the nation.

...The Connector said it had 22,000 apply as of March 22. Those who applied but did not finish the process have the opportunity to complete their applications even though the deadline has passed.

...Kataria said there are more than 11,000 Connector applicants being held up because of the problem with DHS.

...DHS said it only agreed to collect information necessary to make a Medicaid determination and isn't required to collect additional data for the Connector.

OK, the kind folks at KynectKY have helpfully cleared up their final 3/31 numbers:

Kynectky Here is what I have. This is as of 7:00AM 04-01-14.Total QHP Enrollments: 77,044; Total MCO Enrollments: 294,221.

UPDATE: I've been so busy plugging these numbers into the spreadsheet that I haven't had a chance to see what the true impact is...and in Kentucky, it's nothing short of amazing:

Obamacare has cut Kentucky's uninsured population by more than 40 percent, signing up roughly 360,000 residents since enrollment opened up on Oct. 1, according to the Louisville Courier-Journal.

Some 75 percent of them -- 270,000 -- were previously uninsured. That means Kentucky's uninsured population of 640,000 has come down by 42 percent.

UPDATE: (sigh) OK, another very slight update:

Washington State gives the official 3/31 total (except for Medicaid, which is still missing a few days):

Enrollments Completed

Qualified Health Plans: 146,497

Medicaid Newly Eligible Adults (through March 27): 268,367

Medicaid Previously Eligible but not Enrolled (through March 27): 135,485

Medicaid Redeterminations (Previously Covered - through March 27): 408,086

Total: 958,435

*Note: These numbers reflect enrollments and applications through March 31.

Connecticut reports their 3/31 totals...just shy of their 200K upgraded goal, but still very impressive:

A total of 197,878 residents secured a policy through the system, including 76,597 with a private carrier and 121,281 in Medicaid. Since open enrollment began last October, Access Health CT logged 801,509 unique website visitors. 

New York joins the 3/31 Final club ("9am" appears to include enrollments through midnight the night before, which makes sense...takes awhile to fully process/etc...) 

Just out from @NYStateofHealth: As of 9 a.m. today, Total enrollments: 865,487 Medicaid: 453,386 Private: 412,101 cc @charles_gaba

— Charles Ornstein (@charlesornstein) April 1, 2014

So far, I've entered the final 3/31 Exchange QHP data for Colorado, the District of Columbia, Minnesota and Rhode Island. I also have inexact final numbers for Kentucky.

I still need to update the final numbers for California, Connecticut, Hawaii, Maryland, Massachusetts, Nevada, New York, Oregon, Vermont and Washington State.

I'm sure all of these will come in later today or so. In the meantime, I'm taking a few minutes to actually breathe :)

Wow, a personal response from the KynectKY Facebook Page:

Kynectky Charles Gaba Total QHP Enrollments = 73,080; Total MCO Enrollments = 286,222.

I don't think this is the final 3/31 total, however, since this adds up to 359,302, which was posted as of around 4pm yesterday.

However, they've also just announced another 12K "processed through 8:30am today", so I'm not sure whether those are counted as part of the 3/31 total or not. I'm going to assume that they were entered last night and just took a few hours to actually process fully...therefore they count towards the 3/31 tally (unless they clarify otherwise), using a 20/80 ratio of 2,400 QHPs to 9,600 Medicaid:

No final numbers or Medicaid, but it's something for the moment:

According to preliminary numbers, approximately 140,000 people had purchased insurance plans through the state by the end of the weekend, said Michael Marchand spokesman for the Washington Healthplanfinder exchange. That’s a bump of about 9,000 people over four days.

The third state-based exchange (well...technically not a state) to release their 3/31 total is the District of Columbia. Fortunately, they specifically separate out the SHOP numbers:

The DC Health Benefit Exchange Authority today released new data showing strong enrollment activity through DCHealthLink.com as of March 31st.  Since the marketplace opened for business on October 1, DC Health Link has enrolled 40,234 people. This includes District residents who enrolled in private health plans and in Medicaid, as well as people with coverage through their employers.  In the final week alone, more than 2,000 people enrolled through the individual and family marketplace -- accounting for over 21% of all individual enrollments in private coverage. 

Enrollment

As of March 31, 2014, 40,234 people have enrolled through DC Health Link in private health plans or Medicaid:

 9,838 people enrolled in private health plans through the DC Health Link individual and family marketplace;
 17,489 people were determined eligible for Medicaid coverage through DC Health Link; and
 12,907 people enrolled through the DC Health Link small business marketplace.

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