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Cross-posted at ACA Signups
Hawaii: Boom! Medicaid Expansion cuts HI's uninsured population in half

Hawaii's private QHP exchange may still be a mess, but there's great news out of the Medicaid side: Over 48,000 new enrollees since October 1st. The article specifies that these are a combination of "strict expansion" and "woodworkers", though it doesn't break the total out between those two, which would have been nice to have, but so be it. Based on existing data, I'll assume roughly 25% woodworkers to 75% strict expansion for now, or 12K / 36K.

Hawaii has seen a spike in Medicaid enrollment since eligibility was expanded under the federal Affordable Care Act, with more than 48,000 new enrollees since October.

“The expansion (to 138 percent of the federal poverty level) meant Hawaii was expecting about 48,000 additional beneficiaries because of the mandate that you have to have insurance,” said Kayla Rosenfeld, spokeswoman for the Hawaii Department of Human Services, who noted that enrollment has exceeded that benchmark to date. Increasing enrollment is also due to greater awareness rallying Medicaid-eligible individuals “out of the woodwork.”

That means about half of the estimated 100,000 uninsured that the Hawaii Health Connector has been targeting since October are Medicaid eligible.

It's actually even better than that. According to the Kaiser Family Foundation, Hawaii has around 102,000 uninsured residents total. However, of these, around 10,000 are undocumented immigrants who are therefore not eligible for either Medicaid or QHP subsidies, bringing the potential total down to around 93,000.

Of those 93,000 people, Kaiser estimates roughly 58,000 are eligible for Medicaid (either via expansion or pre-expansion rules), which means that Hawaii has already enrolled around 83% of their potential Medicaid recipients since October.

The other 35,000 people are eligible to enroll in private QHPs; obviously Hawaii has had a tougher job on that front due to their messed-up exchange, only adding 4,661 people (plus another 4,000 via SHOP or off-exchange enrollments).

Below the fold, more updates out of Oregon, Minnesota, Maryland and a heck of a development in Oregon and Massachusetts:

Minnesota: Another 1,000 since yesterday, no QHP/Med breakout??

On the one hand, it's nice to see Minnesota post 3 enrollment updates in a single week. On the other hand, for some reason they didn't include the exact number or the QHP/Medicaid breakdown this time. Not sure why...it's already known that their private QHPs have been making up around 30% of the total until now, and the exact tally through 3/1 will be out next week sometime anyway; no point in trying to mask low numbers. Strange.

Anyway, I'm still assuming a 30/70 split, which would be another 300 QHPs and 700 Medicaid/CHIP on the pile, for a total of 34,000 / 79,001.

ST. PAUL, Minn. —  Today, MNsure announced more than 113,000 Minnesotans have enrolled in comprehensive, affordable health insurance coverage through the state’s new health insurance marketplace.
Maryland: Private QHPs up 2,400 in last week of February

Maryland's private QHPs went up 2,434 in the last week of February. More noteworthy, Maryland's exchange seems to be getting a lot of pressure to explain their "paid/unpaid" data; this is the most extensive explanation I've seen from any state about the subject (except for one Vermont report last month). They're up to 38,070 total, of which 20,439 are paid up.

Medicaid numbers are the same, since they're still through 2/25.

Through March 1, 38,070 Marylanders have chosen to enroll in private health plans through Maryland Health Connection.

Carriers are receiving first premium payments from new enrollees and notifying Maryland Health Connection on a rolling basis. Payment deadlines have not yet passed for many of those individuals who have chosen plans through Maryland Health Connection.  According to data received so far from carriers, 20,439 individuals who chose plans through Maryland Health Connection have paid the first premium for their policies. Based on information reported nationally, the rate of premium payment in Maryland appears to be similar to other areas.

95,889 Marylanders signed up through the Primary Adult Care (PAC) program were automatically enrolled in Medicaid coverage on January 1, 2014, and now have full Medicaid coverage. As of February 25, 2014, an additional 71,449 individuals were newly enrolled in Medicaid effective January 1.

Oregon: QHPs up 3,500 & Medicaid up 7,100...QHP rate TRIPLE Feb. for 1st week of March

Well, Oregon's website may still be a complete disaster, but their manual enrollment process seems to be chugging along fairly well. Private QHPs are up 3,500 from 38,806 a week earlier, while Medicaid enrollments are up another 7,100 from 84,991.

Note that they've finally stopped including the "Fast Track" Medicaid numbers, presumably because they've already enrolled everyone they could find via that route:

March 7, 2014

Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Total: 134,412

Private insurance: 42,325

Oregon Health Plan: 92,087

Something else very interesting about Oregon's situation. Take a look at their QHP enrollment history:

—12/28: 18,337—02/01: 33,808 (15,471 in 35 days, or 442 per day)<!--EndFragment-->—02/28: 38,806 (4,998 in 27 days, or just 185 per day...a 58% drop per day, ouch!)
However, today they announced the number, as of (I presume) yesterday, the 6th, as:

—03/06: 42,325 (3,519 in 6 days...or 586 per day)

That's right...in the first month of March, even with their website still being mostly useless, Oregon has managed to more than triple their February rate.

Don't get me wrong; this could simply be a clerical error from the 12/28 or 2/28 update, or even from todays, and there might have been some special one-time batch enrollment thing that was pushed through. Even if all of the data and dates are accurate, six days from a single state is way too early to even begin to make any projections.

Having said that, this is still certainly a positive start to the March home stretch.

So much for me getting some sleep in April...

Last month there was news out of Massachusetts of some sort of extension being granted to "bring the state’s health care system in line" with ACA regulations. At the time I didn't pay much attention to it, thinking that it only related to administrative procedures or somesuch.

However, it turns out that there's actually 154,000 people who are currently enrolled in a sort of healthcare batter's box, being placed on hold until MA's screwed-up exchange is able to absorb them into the system via proper ACA-compliant QHPs (or Medicaid/CHIP...not sure about that yet):

Unable to immediately enroll applicants in new, private plans under the Affordable Care Act, state officials extended existing state coverage for about 124,000 individuals, and granted temporary state coverage to about 30,000 new applicants. Those individuals were supposed to move onto new plans by March. 31; the federal waiver gives officials another three months to do that.
So why am I bringing this up today, 3 weeks after that story broke? Because a contributor called my attention to this story out of Oregon:
House Bill 4154 would extend whistleblower protections to Cover Oregon employees and allow the governor to remove all Cover Oregon board members in a single year. It would also direct Cover Oregon to seek a federal waiver to extend the enrollment deadline by a month to April 30, and to seek federal tax credits for small businesses.

The bill passed the House 56 to 2 and heads to the Senate.

Yes, that's right. If the Oregon bill passes the state Senate, is signed into law and the waiver is approved by the HHS Department, it appears that Oregon will have an extra month before they hit their enrollment deadline.

Meanwhile, Massachusetts has already been OK'd to extend theirs until the end of June...although from what I can tell, it looks like that extension may only apply to those 154,000 people specifically, although that doesn't change much considering that MA has only enrolled about 11,000 people in QHPs so far anyway.

Both of these developments are on top of my previously noted point that some enrollees may not have actually paid until sometime in May, since anyone signing up between March 16 - March 31st (which is expected to be quite a few) won't have their coverage kick in until May 1st.

In any event, it looks like I'll have to keep this site up and running for a wee bit longer than I had planned to...(sigh)

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