Minnesota's "first-come-first-serve" enrollment cap system caused a massive surge in early QHP selections...so much so that they kicked things off by signing people up at a pace twelve times faster than last year in the first few days.
With more than four weeks of open enrollment in the books, more than 57 percent of Minnesotans enrolling in a private health insurance plan through MNsure are qualifying for financial help available only through the state-based health insurance marketplace. The average tax credit amount going to MNsure customers will be more than three times higher in 2017 than it was in 2016.
As I understand it, the trend in the individual market has been moving away from wide-network PPOs and towards narrower-network HMOs for some time now...and while the ACA has certainly accelerated this trend, it had already started before the ACA came around.
Anyway, as I've noted before, my own family was among those who received the Scary Cancellation Notices® back in October 2013 letting us know that our pre-ACA Blue Cross Blue Shield of Michigan policy was being terminated for not complying with full ACA requirements (I think it was mostly the lack of mental health coverage, but there might've been other stuff as well).
We managed to work our way through HealthCare.Gov (this was after the worst HC.gov technical problems had been resolved, but while the system was still pretty buggy) and ended up enrolling in the closest equivalent ACA-compliant policy: A BCBSMI Gold PPO plan.
Today, the Connect for Health Colorado Finance & Operations Committee had a meeting with the following slideshow...showing that they're doing even better than that: 29,045 QHP selections in those same 22 days.
However, there's also another important tidbit here (last slide below): While the average unsubsidized premium rates for Colorado exchange enrollees officially went up 16.9%, the final premium cost to the enrollees is actually dropping by 1.9%(from $214/month to $210/month):
In Colorado, the typical consumer who has already used Affordable Care Act subsidies to buy exchange plan coverage for 2017 is on track to spend less on premiums next year.
If President-elect Donald J. Trump wanted a cabinet secretary who could help him dismantle and replace President Obama’s health care law, he could not have found anyone more prepared than Representative Tom Price, who has been studying how to accomplish that goal for more than six years.
Mr. Price, an orthopedic surgeon who represents many of the northern suburbs of Atlanta, speaks with the self-assurance of a doctor about to perform another joint-replacement procedure. He knows the task and will proceed with brisk efficiency.
Mr. Trump has selected Mr. Price, a six-term Republican congressman, to be secretary of health and human services, according to a transition team official.
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.
