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Cross-posted at
After the massive spike in enrollments seen in mid- to late December, regular site visitors might be a bit disappointed at the relative dearth of increases since New Year's. There have actually been quite a few updates, including several impressive percentage increases, but the actual numbers involved have been relatively small compared to the massive jumps seen just a few weeks ago. In short, you're probably wondering why the total number of private enrollments which shot up to 2.1 million in late December only seems to have gone up about 80,000 more since then.

There are three reasons for this:

First, obviously there was a tremendous sense of urgency for people to enroll in time for January 1st coverage. A drop-off after Christmas has long been expected, although this has been a bit fuzzy as the actual enrollment deadline bounced around, from 12/15 to 12/23, then 12/24 (for most states), then 12/27 or 12/31 for a handful, and finally as late as 01/06/14 for Oregon.

Secondly, I'm sure a lot of people who didn't absolutely need to enroll for Jan. 1 are in sort of a holding pattern while they wait to see how the exchange-purchased plans work out in real life. There's a big difference between being told that you'll have coverage starting on a certain date and actually hitting that date and beyond, as this article out from the L.A. Times demonstrates. In many ways, I suspect this is sort of like the early November situation, where people were watching & waiting before dipping their toes onto the website after all the technical issues they had heard about (or experienced) in the chaotic days of October.

However, the third reason is a simple one: I haven't found any new reliable numbers out of California since 12/23 or New York since 12/30. Texas, Florida, Illinois, Pennsylvania, Ohio, Georgia, Michigan, N. Carolina, New Jersey and Virginia are all run via the Federal Exchange. Since HHS itself hasn't released the data since 11/30, that means the largest-population state that I have data for is #13, Washington...which was updated 3 days ago.

After that, the next-largest state running it's own exchange is Massachusetts (an utter mess), followed by #19. At this point we're into states with less than 6 million people each, which means that enrollment increases which are impressive on a state level are only making a small dent in the overall national numbers. In other words, it's not that the number of enrollments have necessarily dropped off that much, it's just that the states representing about 85% of the country have been maintaining radio silence for a couple of weeks now.

Now for the good news: New York should be releasing their latest tally at any time. California should be just about done sorting out the deluge of last-minute partially-completed enrollments that they've been sorting through for the past 2 weeks. Most of all, the official HHS Dept. report for December should (based on the release dates of the October and November reports) be released sometime today or over the weekend.

The official HHS report should finally answer the question of just how full of beans my own numbers have been over the past crazy month. And perhaps we'll finally find out what the hell is going on in the District of Columbia (HHS had no official data for them through November!) and Hawaii (they had a small number for private enrollments but zilch for Medicaid expansion).

Anyway, I've also tweaked the spreadsheet itself a bit more; I've added 2 new columns which show the states that 1) have agreed to Medicaid Expansion and 2) have agreed to allow their insurance companies to extend the old, non-ACA compliant plans by 1 year. Note that even if the state allows this it doesn't necessarily mean that all of the companies in that state are doing so; some are, some aren't, some are only extending plans by 3 months and so on. Messy.

ArcticStones and I ae also working on a  separate issue which I hope to have news on soon...but until then, everyone will have to sit tight.

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Comment Preferences

  •  Just Waiting for the Next Round of Numbers (2+ / 0-)
    Recommended by:
    WisVoter, Oh Mary Oh

    Personally, the numbers that you have reported have generally looked pretty good when you compare them to expected performance for the states being reported.  However, there have been a fairly small number of fairly small states reporting giving the impression of limited progress.  

    Am very interested to see the next round of big numbers out of California, New York, and the federal government.  Those should offer the first glimmer of how those two big states and the states covered by the federal government are performing after our December deadline dates from which we might begin to extrapolate expected performance going into January and February.

  •  Here's the DC update you've been dreaming about (10+ / 0-)

    "The top line talking point: More than 20,000 people have secured medical coverage.
    But nearly 60 percent, or 11,967, enrolled through the small business side of the exchange"


    "1.) 3,646 people are enrolled in commercial health plans as individuals or families (about 1,000 of those are enrolled in plans that won't take effect until Feb. 1, the rest were covered as of Jan. 1.) We don't know the rate of enrollment because past data dumps weren't as comprehensive, but the exchange says enrollment doubled in the last week before the Dec. 23 deadline.
    "Our experience in the last two weeks of December shows that consumers are deadline driven," Executive Director Mila Kofman said."


    •  Thanks for the link, with the interesting (3+ / 0-)
      Recommended by:
      Brainwrap, bear83, ArcticStones

      information that many enrollees in exchange plans may have been Congressional staffers. The reporter asked the source: "how many of the nearly 12,000 small-group members are from Congress...they haven't gotten back to me yet. But it seems reasonable to think a high percentage of them are from Capitol Hill, because nearly 10,000 staffers are required by law to use the exchange while it remains voluntary for most District companies."

      More info from the link:

      2.) The demographic breakdown is looking positive for the exchange, too. Thirty-seven percent of the individual commercial plan buyers are between 26-34, and another 20 percent are between 35 and 44. This is a very promising development for proponents of the law, whose plans depend on young, generally healthy people buying insurance to cover expenses likely generated by older users.

      3.) 4,677 people have enrolled in Medicaid through the exchange.

      The spirit of liberty is the spirit which is not too sure that it is right. -- Judge Learned Hand, May 21, 1944

      by ybruti on Fri Jan 10, 2014 at 12:33:53 PM PST

      [ Parent ]

    •  THANK YOU!! (4+ / 0-)

      Awesome find. And of course, it just figured that would show up right after I post a whiny screed about a lack of updates lol...

      Updating now, will give you full credit for the find, thanks!

  •  Thanks for all your updates! These are great and (1+ / 0-)
    Recommended by:

    are needed!

    Funny Stuff at

    by poopdogcomedy on Fri Jan 10, 2014 at 12:22:12 PM PST

  •  Here's another wrinkle... (6+ / 0-)

    There are people waiting until they get their W-2s before applying for Obamacare so that they will have accurate current income information--especially if they have unpredictable income flows.

    50 states, 210 media market, 435 Congressional Districts, 3080 counties, 192,480 precincts

    by TarheelDem on Fri Jan 10, 2014 at 12:43:26 PM PST

  •  I expect that your numbers are conservative (1+ / 0-)
    Recommended by:

    and that the releases for December are going to look great - and still be incomplete.

    I know the major insurer in my state continues to struggle with the volume of payments that have been sent in by mail since mid-December and that continue to flow in. Just getting the mail opened is a challenge, and then add the complication that 10-20% of them have problems - incomplete information, wrong payment amounts, etc. - that have to be researched one by one.

    Filibuster reform, 2013 - woulda, coulda, shoulda.

    by bear83 on Fri Jan 10, 2014 at 02:01:59 PM PST

  •  NC Insurers extend Jan payment deadline (3+ / 0-)
    Recommended by:
    itskevin, IM, Brainwrap
    Blue Cross Blue Shield of North Carolina and Coventry Health Care of the Carolinas, the two insurers offering health plans in North Carolina through the exchange, said Friday that they have extended the deadline for people to pay. Premiums were supposed to be paid by Friday in order for coverage to become effective.

    Blue Cross customers have until Jan. 24 to pay their first premium, while Coventry customers must make their payment by Jan. 17.
    Blue Cross and Coventry are among numerous insurers nationwide giving customers additional time to pay for subsidized coverage amid continuing reliability issues with the federal insurance marketplace.

    “It has to do with the challenges associated with the rollout of the Affordable Care Act,” said Blue Cross spokesman Lew Borman.

    What's unsaid here it that they just gave themselves 2 more weeks to catch up with the overwhelming number of payments that have come in through the mail.

    Filibuster reform, 2013 - woulda, coulda, shoulda.

    by bear83 on Fri Jan 10, 2014 at 03:38:19 PM PST

    •  Your last point... (1+ / 0-)
      Recommended by:

      What's unsaid here it that they just gave themselves 2 more weeks to catch up with the overwhelming number of payments that have come in through the mail.

      You’re spot on! The payment extensions that insurance companies are granting, are as much if not more in their own interest as the customers’. Many if not most companies have done an abominable job preparing for the deluge.

      “The meaning of life is to find it.”

      by ArcticStones on Sat Jan 11, 2014 at 03:01:47 AM PST

      [ Parent ]

  •  AZ update (3+ / 0-)
    Recommended by:
    bear83, philipmerrill, riverlover

    AZ expanded medicaid but did not establish an exchange.

    As of this week AZ finally admitted what many of us thought. All applications submitted before Dec 31 were reviewed under the OLD guidelines: in other words ,if you are an adult without dependents your application was automatically denied. You were also denied on the basis of income using the old standard, not the new ACA .

    so they denied everyone flat out and are just now announcing they will begin reviewing those applications again, using the new standards. the word, from a local office was that, to the best of their knowledge, a 'special team' was preparing to review all the applications that came into the department between October 1 and Dec 31,2013..i.e all the ones they just rejected.

     One other problem on the state DES website is that they have no real guidelines what constitutes proof of income. on the website they just say 'submit proof of income', using different time periods and measures than ACA marketplace, but not specifying what constituted a valid proof. As a small businessperson, i submitted a statement, with numbers from 2012 tax return and estimates for 2013 based on my best estimate (i applied in Nov, before 2013 was even over). they did not even ask about estimates for 2014.  

    in my case, I received 2 denials this week, one for having no dependents , the other for excessive income (anything over $958 dollars per month is too much). Actually my income is below that number BUT
    the problem I noticed was that in my case, a self employed sole proprietor with business expenses, they  used my schedule C GROSS RECEIPTS rather than my ADJUSTED GROSS INCOME as the measure, which is insane.(ACA uses adjusted gross income)

    I file totally legit schedule C 1040 returns and no one ever uses gross receipts as a measure of income.

    So, no numbers from Arizona expanded medicaid have come in yet and judging from the state's DES total lack of transparency and communication ,( impossible to get through to an actual person),   i'm not feeling very confident about  the way they are going about this, or the outcome.

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