(sigh) I might as well get this out of the way now.
I've been promising for some time to write a post explaining the difference between the CBO's "13 Million QHPs" projection, the HHS Dept's "9.1 million" projection and my own "12.5 Million" projection. I've alluded to this here and there, but a lot of people are still confused, so it behooves me to dedicate a full post to the topic (which I can then add to the menu for quick access).
I was planning on waiting another week or so before writing this, but with the CBO issuing their latest 10-year Budget Outlook, which quietly reduces their "13 million" figure down to 12 million, it seems like now is the time. I'm already anticipating people thinking that this means that my own projection is now higher than the CBO's...which it isn't.
In a nutshell, here's what the different numbers mean:
For the past few months, the estimates of the reduction in the uninsured people in the U.S. has ranged from as low as 8-9 million to as high as 10-11 million, depending on the survey source (Gallup, Urban Institute, the Census Bureau, etc), when it was done (a lot has changed over just the past few months), whether it includes children under 18 or not, whether it includes undocumented immigrants or not and so on.
However, the official number which has been tossed around by both the White House as well as the mainstream media has pretty much settled on an even 10 million of late. It's been used in various press releases and as a talking point in Sunday morning talk shows, and President Obama even used the 10 million figure in the State of the Union.
Last Friday's weekly report for the MA Health Connector had the official QHP selection tally up to 108,051 as of January 22nd. Since then, there have been another 4,751 QHP determinations, of which around 2,100 or more should have actually selected a policy.
Note the huge gap between last Friday (3,440) and the following two days (1,311 combined). This is partly due to the weekend drop-off, but is mostly because Friday was the enrollment deadline for February coverage. Anyone enrolling on Saturday or Sunday won't have their policy start until March 1st anyway, thus the massive drop-off.
Anyway, this should mean that Massachusett's QHP total is now up to at least 110K, while Medicaid (MassHealth) enrollment are now above 200K, at 206,063.
Meanwhile, the MA exchange has also announced that due to the massive blizzard/snowstorm rolling into the area later on today, they're extending the payment deadline for people who enrolled by the 1/23 deadline out to this Friday, January 30th:
If you get sick, America, the Republican health care plan is this: "Die quickly." That’s right. The Republicans want you to die quickly if you get sick."
...Consider this question: Should society have as its goal that the government prevents all deaths from any health-related ailment other than natural causes associated with ripe old age? The notion is absurd — to both conservatives and liberals. There are limits to the proper amount of scarce resources, funded by taxpayers, that Washington should redirect toward health care.
After the one-two punches of both Rhode Island and Vermont moving in exactly the wrong direction (at least before the King v. Burwell SCOTUS decision is announced this summer), my jaw nearly dropped when I read this story out of Texas, of all states:
AUSTIN -- On Wednesday, State Rep. Chris Turner (HD 101-Grand Prairie) filed two bills, HB 818 and HB 817, both creating a state health benefit exchange.
Health Connector Executive Director Maydad Cohen released the updated numbers Friday, the day Gov. Charlie Baker announced he was extending through Jan. 28 the deadline for people to sign up and pay for insurance plans that take effect Feb. 1. The deadline originally was Friday.
Gov. Charlie Baker appointed Louis Gutierrez, a veteran of the last three Republican administrations, to lead the Massachusetts Health Connector.
Gutierrez will replaceJean Yang, who was executive director of the state's health insurance exchange under former Democratic Governor Deval Patrick. Baker, a Republican, was widely expected to bring in his own appointee to head the organization, which has had a difficult year.
The last 4 weekly HC.gov reports saw 96K (Christmas), 103K (New Year's), 163K (nothing significant) and 400K (the February coverage deadline for most states) on the federal exchange.
With the 1/15 deadline out of the way, the past week (and the next two) should come in somewhere between the last two: Fairly quiet, but steady and not completely dead. I'm assuming roughly 30K/day on HC.gov (around 40K/day nationally), which should have brought the total on HealthCare.Gov up to around 7.36 million as of Friday, January 23rd (around 210K for the week).
Now, here's the thing: We're 1/3 of the way through what should be a fairly consistent 3-week period before the final rush kicks in around February 9th/10th. My guess is that whatever the tally was this past week should stay pretty close for the next 2 weeks as well...so if the past week turns out to be higher (say, 250K), the following 2 weeks should each hit that number or higher as well. I'm estimating that the national total should reach the HHS's target (10.4 million) around February 6th.
No, I'm not gonna go into a "Dental Gate"-style rant against the HHS Dept. about this. Without knowing more details about the information in question or how it's being used, this may be another "nontroversy". Even so, it strikes me as being a bit of an unforced error on the part of the administration:
The government's health insurance website is quietly sending consumers' personal data to private companies that specialize in advertising and analyzing Internet data for performance and marketing,The Associated Press has learned.
The scope of what is disclosed or how it might be used was not immediately clear, but it can include age, income, ZIP code, whether a person smokes, and if a person is pregnant. It can include a computer's Internet address, which can identify a person's name or address when combined with other information collected by sophisticated online marketing or advertising firms.
A few days ago, I posted an article over at healthinsurance.org which delved into the mysterious world of OFF-exchange QHPs...ie, people who just enroll in a private, individual/family healthcare policy the old-fashioned way, by contacting Blue Cross, Aetna, UnitedHealthCare or whoever directly instead of going through one of the ACA exchange websites.
I also posted an accompanying piece here which noted how hard it is to lock down these enrollment numbers, since the carriers aren't generally required to provide that information publicly except in a general sort of way (and even then, usually only once a year or so). Only Oregon and Washington State really post off-exchange data with any sort of frequency, and only Oregon is doing so weekly.
