HHS reports 8,019,763 Exchange signups up to April 19.
The estimate from brainwrap was 8.03 million by April 15 (off by only about 10,000), and 8.14 million by April 30. There will be another report covering all of April, and there will be a continuous further trickle of enrollments for various reasons that we have explained many times.
HHS also pointed out that the Republican House committee nonsense on how many have paid is nonsense. (Statement below) No, duh!
It took three posts to report on the whole report, starting from the announcement of the announcement, then the announcement in a group phone call including questions from reporters, then the PDF of the full report. The numbers are in brainwrap's spreadsheet. He is still on limited duty while he recovers from his illness, but says he can work for a few hours a day now.
CMS reports on Medicaid expansion are chronically late. There was some hope from brainwrap that the two reports would come out on the same day, but no. On past form, we might get their April report in early June. We should also hear definitively in about three weeks from many more insurance companies about how many enrollees have paid after those payments have actually come due.
…presumably there will be a follow-up report in another week or so with the "mop-up" enrollments from the final 11 days.That's what a real surge in enemy territory looks like.
TEXAS: Was 295K as of 3/01; 734K as of 4/19
FLORIDA: Was 442K as of 3/01; 984K as of 4/19
GEORGIA: Was 139K as of 3/01; 317K as of 4/19
Kathleen Sebelius led off, and others added further information. These are the highlights.
- 5.4M Fed, 2.6M via state exchanges
- More than 8M total, can't be denied coverage for gender/pre-existing, etc
- in addition to 3M+ sub36ers
- 4.8M ADDITIONAL Medicaid/CHIP as of end of March
- Hoping non-expansion states will expand
- Huge outreach/enrollment effort
- State/Local in-person assistance via a whole mess of organizations (NAACP, Planned Parenthood, Hispanic Access Foundation, etc etc)
- navigators/assistors/state & local Media, social media, Spanish language media, etc.
- Race/Ethnicity: 10.7% Latino, 16.7% African American, 8% Asian Pacific Islanders
- QHPs Doubled in over a dozen states since end of Feb (Texas, Georgia, etc.)
- 70K+ enrollment activities (going over ethnic outreach events, etc)
- 28K in-person assistors
During the reporters' Q&A, more information came out.
2.2 million (28 percent) of the people who selected a Marketplace plan during the initial open enrollment period were young adults between the ages of 18 and 34. A total of 2.7 million (34 percent) were between the ages of 0 and 34 (including additional SEP activity reported through Saturday, April 19th).The insurers and the government had a target of 35% young healthy people. In the last month, it was 38% young people, ages 0-34, bringing the total to the 34% cited above.
We're good, and that's another pre-debunked Teapublican talking point. We do not have any figures on health of enrollees, which was not collected by design since pre-existing conditions no longer have any bearing on getting covered. Insurance companies say that they are happy with the mix they have gotten.
Women make up 54% of enrollees, and men 46%. Republicans have attempted to turn this into another pre-debunked Death Spiral talking point, and to fearmonger that the end of gender rating will cause a huge spike in premiums for men. However, even the ACA Death Spiral site admitted back in January that it isn't actually a problem.
There are three major pieces of good news for those who support the goals of the ACA.But then they reverted to type and pronounced disaster in several states. The insurance companies in those states have not agreed, and I prefer their word on the subject.
1. The overall gender distribution of enrollees, 54% female, 46% male does not appear on preliminary inspection to be sounding “red alert.” To be sure, the problem may be a little greater than would otherwise be suggested by the aggregated numbers if the middle age group is more heavily female and the oldest group of enrollees more heavily male that the aggregated numbers suggest. And Mississippi is troubling with 61% female enrollment (and for other reasons, see below). But, overall, and if they hold up, these do not appear to be the the kind of numbers that would be way beyond what insurers likely expected or that, standing by themselves, would be devastating to an insurer on an Exchange.
2. Several states have total enrollments and the age distributions that should reduce the possibility of a serious death spiral getting started. New York and California are the two big states doing better than most. Connecticut is doing very well also.
3. The metal tier distribution is 80% for Bronze and Silver policies and only 20% in Gold and Platinum. That’s comforting for adverse selection. A higher proportion of enrollment in the more generous plans would have been a warning sign that enrollment was coming disproportionately from the sick. There’s a footnote on this point later on — we are not out of the woods — but this is definitely better news for the ACA than a distribution of, say, only 50% Bronze and Silver purchases.
CBO recently estimated that an additional 5 million people have purchased coverage outside of the Marketplace in Affordable Care Act-compliant plans. Meanwhile, the Blue Cross Blue Shield Association estimates that its plans have enrolled 1.7 million in Affordable Care Act-compliant, off-Marketplace plans.The report notes three independent sources for the declining percentage of the uninsured: Gallup, Rand, and the Urban Institute. All are in rough agreement. Gallup has the most recent numbers, a decline of 5.1% from the beginning of Open Enrollment through the first half of April, from 18.0% to 12.9%. That cannot be repeated too often, because it is the biggest debunktion of Republican pre-debunked talking points going. Also Gallup has these numbers on the difference between cooperating states (state-run exchange plus Medicaid expansion) and non-cooperating states (neither).
We all know that that represents thousands of people dying from Republican state government Death Panels every year for as long as it goes on.
This report also includes data on the characteristics of persons who have selected a Marketplace plan (by gender, age, metal level, and financial assistance status for the SBMs [State-Based Marketplaces] and FFM [Federally-Facilitated Marketplace]; and for the FFM, by gender and age, gender and metal level, financial assistance status and metal level, and metal level and age).This includes detailed state-level tables, provided in an Appendix.
Please note that for the first time, the Appendices of this report include FFM data on the race/ethnicity (Appendix C) and health insurance coverage status at the time of application (Appendix D) and of the persons who have selected a Marketplace plan through the FFM. While this information is provided for transparency purposes, its quality is low and its use should be limited.Now that we have twelve pages of published data on the question of ethnicity in Appendix C, we should look further into the ethnic makeup of the pool of enrollees. However, that is too big a topic to cover in a note within a Diary. The biggest problem we see is that Latinos "lawfully present" are seriously underrepresented at 10.7%, in spite of Spanish-language outreach efforts and the rest. However, during the surge, Latino enrollments surged even faster than others. It is not simply a matter of ethnicity, and it cannot be summed up in one table or chart. It depends on what regions of which states we are talking about, among other things. Another time, then.
Another pre-debunked Republican talking point gets its own coverage in Appendix D. How many enrollees previously had insurance? The Right claims that going from junk insurance to, say, a Marketplace Silver plan (like my son Certifiable Genius), counts for nothing. Balderdash. Deliberately evil balderdash. Obamacare saves lives, and also treasure and sanity, and allows people to retire early or pursue new careers, even for those who had some sort of insurance before. HHS cites studies from Gallup, RAND, and McKinsey, and much more data will appear over time.
Another 4.8 million were determined to be eligible for Marketplace policies, but did not complete their applications. It would be of interest to know why. Did they find a better deal elsewhere? Did they complete an application off-exchange, because they didn't qualify for subsidies and the site wasn't working? Did their circumstances change? Were they just looking, because they already had insurance? Did the process ultimately not work for them? We don't know.
There is also information on people selecting dental plans.
HHS threw cold water on a Wednesday House Energy and Commerce Committee finding only 67 percent of enrollees in the federal exchange have paid their initial premiums, with an HHS spokesperson noting the report includes only half of the participating insurers and pointing out that bills are not yet due for many enrollees.Hey! Hey!! Youse can't talk ta us like dat! BENGHAZEEEEEEE!!! (Darrell Issa just announced a subpoena for John Kerry, who wasn't at the State Dept. at the time.)
...The committee report included information from 160 FFE insurers, and broke down the percentage of paid enrollees by state.
HHS spokesperson Erin Shields Britt said in a statement that there are about 300 plans participating in the FFE, and added that the 67 percent figure "does not match up with public comments from insurance companies themselves, most of which indicate that 80 to 90 percent of the enrollees have paid their premium."