ACA Private Enrollments Pass 228,000; over 950,000 with Medicaid/SCHIP

Since the day that the ACA (aka Obamacare) health insurance exchanges launched on October 1st, I’ve been tracking the number of applications, enrollments and Medicaid/SCHIP expansion signups at ACASignups.net. Obviously the first few weeks were, shall we say, rocky. In addition to the now infamous website problems, reporting on the numbers was all over the map as well, with many “serious” journalists confusing “accounts created” with “applications started”, “applications completed”, “plans selected” and so on.

In addition, many sources confused private exchange enrollments with Medicaid/SCHIP expansion enrollments. Both numbers are important, of course, because each represents people who either didn’t have any healthcare coverage before at all or had crappy coverage (in a few cases, such as myself, they have a decent plan but one which needs a few tweaks to be compliant with the law).

In any event, just as the Healthcare.Gov website has been majorly modified and improved, so too has ACASignups.net (aka ObamacareSignups.net, if you’d prefer). All numbers since the first official HHS report was released (which gave the true numbers through 11/2/13) are fully sourced are now separated out by actual private exchange enrollments and Medicaid/SCHIP enrollments for the individual states.

In addition, I’ve added graphical charts showing both the ACA Private Exchange enrollments as well as a comparison against the Massachusetts enrollment pattern of 2007.

Finally (and this is brand new this week), I’ve added the actual official HHS Dept. Per-State Goals for the 6-month enrollment period! This answers the question about where the mystical “7 million” figure came from, broken down by state (more about this below the fold).

As far as I can tell, 2 of the other websites (the Advisory Board Company and Aaron Strauss) which were tracking ACA enrollments have abandoned the project. However, EnrollMaven.com is still keeping at it. I was highly skeptical of EnrollMaven at first, as they have an openly anti-ACA/Obamacare mission statement, but their methodology seems to be sound. Many of my sources have turned out to be identical to theirs, so I’ve grown pretty comfortable with using them as a cross-check on my own numbers.

However, there’s still a few important differences between their site and mine:  They don’t bother listing Medicaid/SCHIP at all; their site is poorly laid out and doesn’t let you easily compare data; they don’t include historical data, and so on. Plus, since I’m using a Google Docs spreadsheet, you can easily export the data to Excel/etc for further analysis.

Having said all of that, here’s the latest figures as of Monday, Nov. 25:

Total Exchange ENROLLMENTS: 228,578
Total Medicaid/SCHIP Expansion: 728,210
Total Combined: 956,788

aca_chart

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See ACASignups.net for details, including direct links to cited sources.

As for the newly-added “State-by-state Goals” column, if you look closely, there’s some interesting things to note:

–In Texas (6.3 million uninsured, 630,000 target) they only expect to have 10% of their uninsured covered by then. Texas only had 0.5% enrolled as of 11/2; hardly surprising given how anti-ACA the Texas GOP is.

–In California, they’re targeting 1.3 million people, or about 3.4% of the total population, or about 17% of the total uncovered population. They’re up to 6.2% of their target so far.

–Kentucky, which has rightly received tons of praise for their state exchange, actually isn’t looking all that impressive in terms of their % of goal attained (4.9% so far)…but that’s mainly because the goal for the state is so high to begin with (220,000 people, or a full 1/3 of the state’s total uninsured).

–Vermont is very interesting. Vermont has about 9% of their population uninsured, or about 57,000 people out of 626,000…and the target is 57,000.

In other words, the HHS Dept. has been hoping that Vermont will have EVERYONE without coverage signed up by 3/31/14. Given that it’s deep blue and moving towards single payer anyway, this makes sense. Unfortunately, so far they’ve only achieved about 4.4% of their target.

However, the most noteworthy state, to me, is actually…Connecticut.

–In Connecticut, the official projection is only 33,000 out of 360,000 uninsured in the first 6-month enrollment period, or about 0.9% of the states total population.

Here’s the thing, though: While Kentucky, Washington and California are getting all the attention for running their exchanges properly, Connecticut is actually leading the way in terms of percent of GOAL attained. Take a look–8,000 people covered means they’re already 24% of the way there.

Even better, look at the *total* uninsured number: 360,000 (out of about 3.6 million total citizens). Assuming that they (along with other states that are doing well, such as Kentucky, Washington, etc.) continue to kick ass and ramp up their enrollments, it’s not at all unlikely that those states could help achieve the 7 million signup goal WITHOUT the other 40 states or so helping out.

I’m quite serious about this–look at the total uninsured numbers the states that have already hit 4% or more of their goals: CA, CO, CT, KY, NY, RI and WA (I’m not counting VT because they’re already expected to hit 100% anyway). These 7 states alone have a combined total of over 13 million uninsured people…but if you look at the *targets* for them, it’s only 2.2 million. If these states continue to ramp up and kick ass, they have a pool of up to 11 million more people that they could conceivably sign up between now and the end of March. Even if not a single additional person enrolled in any of the other 43 states, we could still theoretically hit the 7 million goal.

Obviously it’s not going to happen that way–the other states *are* continuing to sign people up (albeit at a slower pace), and those 7 states aren’t going to ramp up THAT much, but it’s still food for thought.

Also here’s how New York and Kentucky are doing on the “ramping up” thing:

New York:
10/1 – 11/2: avg. 500/day
11/3 – 11/12: 800/day
11/13 – 11/24: 1,100/day

Kentucky:
10/1 – 11/2: 170/day
11/3 – 11/14: 260/day
11/15 – 11/21: 290/day

As a final note, several people have asked me to make a prediction for total signups at the end of November. I’m going to guess the cumulative total through 11/30 at around 400K. This would still be well below the HHS original projections (they were hoping for 500K in October), but it’d be a hell of a lot closer.

UPDATE: It looks like my “over-performing state exchange” theory above may not be crazy after all; apparently New York is already on target to exceed projections by at least a bit!

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  • Brainwrap

    As a minor follow-up: It looks like there may be something to my speculation about the state exchanges not only meeting but potentially *exceeding* expectations:

    http://www.buffalonews.com/business/state-exchange-enrollment-continues-to-meet-expectations-20131126

  • bryan

    Is there a way to compare Medicaid/SCHIP enrollment in 2013 vs. previous years?

    My question goes to how the Medicaid Expansion part of the ACA is impacting enrollment. Can you tell, of the Medicaid enrollees, how many are newly eligible because of the ACA expansion?

    Good work.

    • Brainwrap

      Thanks!

      Unfortunately, I don’t have access to historical info, and I don’t think that data has been released yet; my guess is that the Medicaid/SCHIP numbers so far are a mish-mash of expansion qualifiers as well as people who were already qualified but just didn’t realize it.

  • DSMAL

    What about Michigan statistics? We just got kicked off Medicaid as of the first of the year – not based on income – based on qualifying child turning 19. We still receive food benefits and we income qualify using both methods – I went through breast cancer last year and have complications with my double mastectomy implants and neurological issues and now will not have the treatment or medications necessary – Michigan does not implement the Medicaid changes until April 2014 – complications is not treatment neither is the maintenance meds that will cost me on average $2000.00 a month that we do not have, so now I choose between my cancer and my shelter at the holidays!! Thank you!!

    • DSMAL

      My caseworker told me to stay off the exchange and stated she did not know anything about the expansion yet they were not given any information so she can not qualify me under the new rules only the old ones.

      • Brainwrap

        I have no idea why you were told to “stay off the exchange”, but as far as I know it’s working pretty smoothly these days–I’d advise you to contact Amy Lynn Smith here at Eclectablog; she’s the expert on the actual implementation, I just crunch the numbers as they come in.

      • Amy Lynn Smith

        DSMAL, I’m so sorry to hear what you’re going through. I’ve heard murmurings that there may be efforts to get Medicaid expansion running sooner than April 2014 in Michigan, but I can’t confirm that. The first step might be contacting your state Representative and Senator. They may be able to answer questions and help you cut through red tape. I don’t want to contradict your caseworker (applying for coverage might impact your Medicaid eligibility), but you might look into talking with an ACA navigator (you can find one near you at healthcare.gov). They may be able to answer Michigan-specific questions. Last, you might look into area clinics that can provide interim services. I hope this gives you some avenues to try. Best of luck to you.

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