Confirmed 2015 QHPs: 8,300,264 as of 1/23/15
Estimated: 9.79M (7.36M via HCgov) as of 1/23/15

state-level targets
Estimated 2015 ACA Policy Enrollment:
8.6M Paid Exchange QHPs + 13.0M Medicaid/CHIP  + ??? Off-Exchange/SHOP


FINAL 2014 QHPs (as of 11/14/14): 6.7M Current / 8.4M PAID / 9.6M Total
TOTAL: 6.7M Exchange QHPs, 8.0M Off-Exchange QHPs, 10.7M Medicaid/CHIP, 2.0M assorted

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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.

I debated whether to put the "Off Topic" header in the title since this isn't about the ACA or healthcare, but this is most definitely not off topic.

Trust me, just watch this; it's about 9 minutes long. I actually cheered out loud several times.

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:

LEGISLATURE: Bills would create Texas' own health benefit exchange

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.

Talk about a fast turnaround!

Just yesterday I posted this story:

Not Cool, Guys.

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.

Hot off the presses...

As of Jan. 22 @ 3:30: 75,760 individuals have renewed QHP enrollments > 17,126 are newly enrolled in QHPs > and 38,547 are Medicaid. #kynect

— kynectky (@kynectky) January 23, 2015

OK, that's 92,886 QHPs total, or 208/day since the December 15th deadline. At that rate, they'll likely add a minimum of 5,000 more by 2/15 if there's no mid-February surge; more likely they'll add between 10-15K more, for a total of perhaps 108K at the outside, just barely hitting the HHS Dept's target (107K), but coming up short of mine (130K)...but we'll have to see...

Latest Enrollment Numbers

January 23, 2015*

MNsure will release 2015 enrollment metrics weekly, and will present a more robust metrics summary to the MNsure Board of Directors at each regularly-scheduled board meeting. During weeks that MNsure is closed on Friday, the enrollment metrics update will be released earlier in the week.

Health Coverage Type Cumulative Enrollments
Medical Assistance 44,308
MinnesotaCare 17,506
Qualified Health Plan (QHP) 44,130
TOTAL 105,944

* (actually as of 1/22)

OK, let's see here...that's exactly 400 more QHP enrollees since 1/19, or 133/day, although they've averaged 194/day since New Year's Eve.

At that rate (with no mid-February bump), they'll add another 4,600 by 2/15, or 49K, well short of their target of 67K. However, it's more likely to be more like double or even triple that when you include the final surge, for a total of perhaps 58,000 or so. Reaching their internal target may still be feasible; reaching mine (75K) seems very unlikely at this point, but anything's possible.

A week or so ago, Maryland broke the official HHS target for 2015 (88K) with 91,137 QHP enrollments. Today, they're reporting:

As of Jan. 22, 185,199 Marylanders have enrolled in quality, affordable health coverage for calendar year 2015, since the 90-day open enrollment period began Nov. 15. That includes 93,806 people enrolled in private Qualified Health Plans (QHP) and 91,393 people enrolled in Medicaid.

As of Jan. 21, the total number of Medicaid and MCHP enrollment is 1,281,999. Compared to Dec. 31, 2013, the net change in Medicaid enrollment as of Jan. 21, 2015 is +241,337. This figure takes into account that individuals lose Medicaid coverage because of changes in household, age and income, as well as redeterminations.

OK, that's 2,669 in 11 days, or 242/day. This is down substantially from the prior week or so, but it includes the days leading up to and following the 1/15 deadline for February coverage (when they'd drop off again), so that doesn't really mean much.

This is an incredibly depressing post for me to write. Last month I received word that CoOportunity Health, one of the 23 co-ops set up as part of the ACA to offer competition with the Big Boys, had run into serious financial trouble and was being yanked off of Healthcare.Gov (they were operating in Iowa and Nebraska, both of which are on the federal exchange).

This surprised me because from everything I had heard, CoOportunity was doing quite well, with upwards of 120,000 QHP enrollees last year. I've written about them several times in the past, and have kind of a special fondness for them because they were one of the first sources I had for solid OFF-exchange QHP enrollment data.

Anyway, as of December 10th, my contact at CoOportunity was unaware of any issues; they reported that everything was going great. On Christmas Eve, I was tipped off about CMS dropping CoOportunity from the exchange completely, but there wasn't a whole lot of detail given as to what had gone wrong beyond vague references to quarterly financial statements, cash flow and annual audits.

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