Narrow focus curse: I've sliced 2018 ACA marketplace enrollment so many ways I've lost track myself and too often go rooting around this blog for some half-remembered breakout. For my own sake, then, here is an index, omitting some redundant or not particularly illuminating posts.
The main takeaway for this year is pretty obvious: huge premium hikes, largely induced by Republican sabotage, sharply reduced unsubsidized enrollment while leaving subsidized enrollment relatively stable.
A second important takeaway that I've spotlighted more than once is less obvious: among the subsidized, enrollment dropped pretty sharply for those with incomes in the 100-200% FPL range; stayed more or less flat at 200-300% FPL, and rose sharply at 300-400% FPL. A post I co-wrote with David Anderson, running in Health Affairs today, tells that story and draws conclusions about the crosswinds created by various Republican actions.
13* Ways of looking at enrollment 2018
* Okay, a few more than 13. Poetic license and all that.
National enrollment
Small enrollment shifts are not so small - 8/25/18
For example, a 1% shift in the percentage of all enrollees on hc.gov who are unsubsidized masks a 10% drop in enrollment among the unsubsidized -- exacerbated by heavy attrition in February.
GAO highlights the silver load offset to HHS sabotage - 8/24/18
The GAO report on HHS actions that depressed marketplace enrollment also shows a key effect of silver loading: average premiums at each metal level. This post matches that with shifts in metal level choice at different income levels, e.g. a massive shift out of silver at 200-400% FPL.
Silver loading vs. sabotage in non-expansion states - 8/14/18
Compares 2018 enrollment gains and losses by income group in states that refused to expand Medicaid with those recorded for healthcare.gov as a whole and in California
Unsubsidized on-exchange enrollment is also shrinking fast - 8/8/18
An unsurprising effect of massive premium hikes
Unsubsidized, but in subsidy range, in the ACA marketplace - 8/5/18
85% of enrollees via healthcare.gov were subsidized, but 90% have incomes in the 100-400% FPL range. Why the gap?
Shifts in the enrollment population in the ACA marketplace in 2018 - 8/2/18
Subsidized enrollees on average are a bit more affluent and a bit older than in past years.
A CMS misinformation byte is getting into the woodwork - 7/31/18
CMS shorted effectuated enrollment in 2017 so they could tout first-month attrition. This year, they flipped the script and used last year's undercount to claim a nonexistent net increase in 2018.
Covered California's silver-loading enrollment boost mirrors HealthCare.gov's - 7/26/18
The corroboration that enabled today's Health Affairs post
Some CMS-y data for the ACA marketplace - 7/12/18
Flagging an error in California data, confirmed to me in this post, and fixed three weeks later
Unsubsidized ACA marketplace enrollees drop out early - 7/5/18
It's not just this year: first-quarter attrition among the unsubsidized has been sharp since 2016.
Hispanic enrollment on HealthCare.gov up 8% in 2018 - 6/29/18
Kind of counterintuitive, no? Is it statistical noise?
ACA marketplace enrollment 2018: Answers and questions - 6/25/18
Why was enrollment down among those eligible for strong CSR?
Actuarial value in the ACA marketplace: Down a bit in 2018 - 6/24/18
Mainly an effect of a drop in enrollment at 100-200% FPL
Trump's CSR cutoff boosted ACA enrollment at 300-400% FPL - 5/27/18
More people in this income bracket are subsidy-eligible than in past years, and silver loading increased the value of those subsidies.
Will Trump's CSR cutoff boost enrollment by 2-3 million, per CBO? - 5/5/18
I peg this year's gain from silver loading at somewhere north of 342,000.
If Seema Verma bans silver loading, how many marketplace enrollees will suffer? - 4/12/18
Spoiler: a bit less than 2 million. A precursor of my share of a prior Health Affairs post.
"Strong" CSR takeup dropped only slightly on HealthCare.gov in 2018 - 4/3/18
A first look at CMS's full breakout of 2018 enrollment
State snapshots
Kansas
Silver loading yields some gold dividens in Kansas - 5/1/18
Pennsylvania
Rational choice in the ACA marketplace, Pennsylvania edition - 4/26/18
A free silver plan with a $0 deductible - what's not to like? (PA) - 4/24/18
Maryland
How Trump's cutoff of CSR funding affected Maryland enrollment (3/31/18)
A downside to silver loading: CSR takeup drops in Maryland (3/28/18)
Who'd be hurt by restored federal CSR funding? A snapshot from Maryland (3/18/18)
Choosing a metal level in the CSR-addled Maryland marketplace (1/12/18)
Subsidized ACA marketplace enrollment rose 2% in Maryland in 2018 (1/11/18)
Maryland ACA enrollment spotlights effects of Trump's CSR sabotage (1/8/18)
The main takeaway for this year is pretty obvious: huge premium hikes, largely induced by Republican sabotage, sharply reduced unsubsidized enrollment while leaving subsidized enrollment relatively stable.
A second important takeaway that I've spotlighted more than once is less obvious: among the subsidized, enrollment dropped pretty sharply for those with incomes in the 100-200% FPL range; stayed more or less flat at 200-300% FPL, and rose sharply at 300-400% FPL. A post I co-wrote with David Anderson, running in Health Affairs today, tells that story and draws conclusions about the crosswinds created by various Republican actions.
13* Ways of looking at enrollment 2018
* Okay, a few more than 13. Poetic license and all that.
National enrollment
Small enrollment shifts are not so small - 8/25/18
For example, a 1% shift in the percentage of all enrollees on hc.gov who are unsubsidized masks a 10% drop in enrollment among the unsubsidized -- exacerbated by heavy attrition in February.
GAO highlights the silver load offset to HHS sabotage - 8/24/18
The GAO report on HHS actions that depressed marketplace enrollment also shows a key effect of silver loading: average premiums at each metal level. This post matches that with shifts in metal level choice at different income levels, e.g. a massive shift out of silver at 200-400% FPL.
Silver loading vs. sabotage in non-expansion states - 8/14/18
Compares 2018 enrollment gains and losses by income group in states that refused to expand Medicaid with those recorded for healthcare.gov as a whole and in California
Unsubsidized on-exchange enrollment is also shrinking fast - 8/8/18
An unsurprising effect of massive premium hikes
Unsubsidized, but in subsidy range, in the ACA marketplace - 8/5/18
85% of enrollees via healthcare.gov were subsidized, but 90% have incomes in the 100-400% FPL range. Why the gap?
Shifts in the enrollment population in the ACA marketplace in 2018 - 8/2/18
Subsidized enrollees on average are a bit more affluent and a bit older than in past years.
A CMS misinformation byte is getting into the woodwork - 7/31/18
CMS shorted effectuated enrollment in 2017 so they could tout first-month attrition. This year, they flipped the script and used last year's undercount to claim a nonexistent net increase in 2018.
Covered California's silver-loading enrollment boost mirrors HealthCare.gov's - 7/26/18
The corroboration that enabled today's Health Affairs post
Some CMS-y data for the ACA marketplace - 7/12/18
Flagging an error in California data, confirmed to me in this post, and fixed three weeks later
Unsubsidized ACA marketplace enrollees drop out early - 7/5/18
It's not just this year: first-quarter attrition among the unsubsidized has been sharp since 2016.
Hispanic enrollment on HealthCare.gov up 8% in 2018 - 6/29/18
Kind of counterintuitive, no? Is it statistical noise?
ACA marketplace enrollment 2018: Answers and questions - 6/25/18
Why was enrollment down among those eligible for strong CSR?
Actuarial value in the ACA marketplace: Down a bit in 2018 - 6/24/18
Mainly an effect of a drop in enrollment at 100-200% FPL
Trump's CSR cutoff boosted ACA enrollment at 300-400% FPL - 5/27/18
More people in this income bracket are subsidy-eligible than in past years, and silver loading increased the value of those subsidies.
Will Trump's CSR cutoff boost enrollment by 2-3 million, per CBO? - 5/5/18
I peg this year's gain from silver loading at somewhere north of 342,000.
If Seema Verma bans silver loading, how many marketplace enrollees will suffer? - 4/12/18
Spoiler: a bit less than 2 million. A precursor of my share of a prior Health Affairs post.
"Strong" CSR takeup dropped only slightly on HealthCare.gov in 2018 - 4/3/18
A first look at CMS's full breakout of 2018 enrollment
State snapshots
Kansas
Silver loading yields some gold dividens in Kansas - 5/1/18
Pennsylvania
Rational choice in the ACA marketplace, Pennsylvania edition - 4/26/18
A free silver plan with a $0 deductible - what's not to like? (PA) - 4/24/18
Maryland
How Trump's cutoff of CSR funding affected Maryland enrollment (3/31/18)
A downside to silver loading: CSR takeup drops in Maryland (3/28/18)
Who'd be hurt by restored federal CSR funding? A snapshot from Maryland (3/18/18)
Choosing a metal level in the CSR-addled Maryland marketplace (1/12/18)
Subsidized ACA marketplace enrollment rose 2% in Maryland in 2018 (1/11/18)
Maryland ACA enrollment spotlights effects of Trump's CSR sabotage (1/8/18)
No comments:
Post a Comment