(sigh) OK, after doing this for Michigan earlier today, I said that I wasn't gonna do this for every state, and I'm not...but the irony is that the 19 non-expansion states are actually easier to compile this data for than the expansion states...because you can't rip away healthcare from someone you never provided it to in the first place. Anyway, someone requested that I do a county-level estimate of how many people would likely lose their healthcare coverage in Texas under a full repeal of the Affordable Care Act, so here it is.
Regular readers (and Twitter followers) know that for the past month I've been heavily pushing my state-by-state analysis projecting how many people I expect to lose their healthcare coverage if/when the Republican-held Congress follows through on their promise to repeal the Affordable Care Act. As noted in that post and the various links within it, part of the projection is very specific and confirmed (ie, the exact number of Medicaid expansion enrollees), while the rest is more speculative. For one thing, I don't know exactly how many people will have enrolled in ACA exchange plans, because we're still in the middle of the open enrollment period; even then, the percentage of those enrollees who will be receiving APTC assistance is still unknown as well...and even then, not all of those folks will be receiving substantial subsidy assistance which would make or break their ability to keep their policy.
It's New Year's Day, so I figured I should indulge in a little year-end navel-gazing by looking back and seeing which posts generated the most traffic throughout the year. There's a good chance that this site won't survive the new year anyway, so what the heck.
Below is a daily traffic graph showing the days with the biggest traffic spikes, along with the specific stories driving those spikes. I hope you don't mind, but I'd rather not post the actual numbers involved publicly.
As you can see, in 2016, there were 5 stories in particular which captured tons of traffic:
Every month I post an entry about the official CMS Medicaid enrollment report, documenting the increase in Medicaid enrollment since ACA expansion went into effect. The numbers were increasing dramatically every month for nearly two years, but started slowing down last fall as most of the expansion states started maxing out on their eligible enrollees. I wrote about the August 2016 report back on 11/20, and normally would be writing about the September report today. Instead, however, I'm skipping right past September, because the preliminary report for October was just released today:
UPDATE: Denis Byron, in the comments below, claims that Ryan Cooper's story (and therefore, mine) is "incredibly deceptive" and that I should be "ashamed" of myself for basing this entry on it. I've contacted Cooper about Byron's claims and will update the article if Cooper responds. Byron is correct that I am by no means a Medicare expert, so I'll leave it at that for the moment.
UPDATE 12/31: A few folks in the comments have noted that a) pre-existing condition denials aren't an issue for most group policies even without the ACA and b) some of the professions listed below don't appear to belong on the list since those groups should be guaranteed coverage anyway (ie, the VA/TriCare for those in the military; members of police/firefighter unions and so on). Both KFF and I have already addressed the first point (yes, they're covered now but if they lose their job for any reason they'd likely be screwed; thus, the "...if they were to lose their current coverage" caveat). As for the second one, I've asked Larry Levitt & Cynthia Cox of the KFF to clarify.
Update 12/31: I've received clarification from Larry Levitt re. the 2nd criticism: "I suspect insurers were mostly being overly cautious just in case. Active duty military would be covered otherwise. Police and fire generally would, but possibly not in small towns or volunteer firefighters."
Remember, the ACA's Medical Loss Ratio rule (80% of all premiums have to go towards actual healthcare, leaving only a 20% maximum margin for administrative/operational costs) already does a pretty good job of keeping carriers from outright gouging enrollees...although that only comes into play when the carriers would otherwise be spending less than 80% on healthcare claims. In cases where they're already spending more than 80%, it's kind of moot...and for the past couple of years, many carriers are at 100% or higher, which is the main reason some of them are pulling out of the market next year in the first place.
In other words, unlike other "retail" markets where more competition is generally considered to automatically help keep prices down, there's only so much that more players can do in the individual health insurance market. If everyone is already losing money, adding one more to the mix isn't gonna make anyone else drop their rates further.
I just noted this morning that Rhode Island's enrollment numbers for 2017 are coming up significantly short of not only my own admittedly unrealistic hopes (I was hoping RI would buck the national trend and beef up enrollment by 15% this year), but is likely to actually come up lower than last year's 33.9K by several thousand people.
Fortunately, the opposite is proving to be the case in Massachusetts:
Through yesterday, we had 240,745 enrolled in January 2017 coverage...these are people who paid their bill. There are an additional 11,803 people who selected a plan but haven't paid for it yet. That's a total of 252,548.
That's, 252,548 QHP selections as of 12/28/16, of which over 95% have actually paid their first monthly premium (well above the 90% payment national average).
