Estimated Exchange QHPs as of 7/14/14: 7.85M PAID (8.87M Total)

Estimated Total, all sources: (24 Million - 29 Million)

Exchange + Off-Exchange QHPs: 15.7M  •  Medicaid/CHIP (7.1M - 9.9M)

ESIs (156K confirmed; up to 8M more possible)  •  Sub26ers (1.6M - 3.1M)

Note: Anyone who donates $20 or more will receive an account to remove the ads thru 2/15/15.
(the ads generate a small amount relative to the work involved; donations are still appreciated)

When I posted my dumb-simple solution/workaround to resolve the Halbig decision back on July 2nd (assuming that it's upheld, which is by no means guaranteed), I meant it seriously, but figured that no one else would. I mean, really...the salvation of the most important healthcare law of the past 50 years and the single most important accomplishment of the Obama administration could end up being as simple as registering 3 dozen domain names and putting up a splashpage?

After yesterday's flood of updates, I'm taking a moment to give a shout-out to Chris Savage. He's currently running a fundraiser to help support Eclectablog, the Michigan-centric political site which deserves far more attention than this one. Eclectablog isn't primarily healthcare-related (although there are occasional ACA-related pieces by Amy Lynn Smith and LOLGOP from time to time), but it would mean a lot to me if readers of this site would lend a hand to that one.

Full disclosure: Not only is Chris a friend and colleague, he also happens to be one of my hosting clients, so in that sense this may be a bit self-serving.

Some of the various state-run exchanges continue to experience assorted technical issues, ranging from minor to serious. I may be rooting for the ACA to work, but as a website developer and a member of the Reality-Based Community, I do need to fully acknowledge that it's not all sweetness & light on the tech side these days. These issues will be resolved eventually, but you can't just ignore them either. So, without further ado...

VermontVPR (Vermont NPR), 07/23/14: Lawmakers Angered By Continuing Problems At Health Exchange

 Snowballing technological problems at Vermont’s online insurance exchange are drawing new scrutiny. And advocates warn that the situation for many customers who bought plans through Vermont Health Connect is becoming increasingly dire.

Washington State: Union Bulletin, 07/22/14: Washington state health-care exchange sounds alarm

OK, with all the fuss about the Halbig decision, people have been flooding me with a bunch of stories about both that as well as other ACA-related topics. I can't address them all fully, so here they are in bite-sized format:

Tara Culp-Ressler, Think Progress, 07/24/14: Obamacare Has Helped Americans Save Nearly $2 Billion On Their Insurance Premiums

Millions of Americans can expect to get a refund from their insurance companies this year, at an average of about $80 dollars per family, thanks to a little-known Obamacare provision that’s helping people save money on their premiums. According to a new report released by the Health and Human Services Department on Thursday, Americans across the country have received a total of $1.9 billion dollars in rebates since this provision first took effect in 2011.

Amy Fried, Bangor Daily News, 07/24/14: Supreme Court already said DC Court was wrong on Obamacare subsidies

Normally this would be a lengthy entry, but given that there have already been 4 other major national surveys saying the same thing, the latest news is just locking things down.

The New England Journal of Medicine just published a new report which concludes (shocker) that there's been a net reduction in the number of uninsured U.S. adults by around 10.3 million since the ACA exchanges went into effect:

As compared with the baseline trend, the uninsured rate declined by 5.2 percentage points by the second quarter of 2014, a 26% relative decline from the 2012–2013 period. Combined with 2014 Census estimates of 198 million adults 18 to 64 years of age,19 this corresponds to 10.3 million adults gaining coverage, although depending on the model and confidence intervals, our sensitivity analyses imply a wide range from 7.3 to 17.2 million adults.

OK, I've had a chance to download the actual Excel file with the raw data and a handy graph already set up; I've cleaned up and color-coded the graph, and it's fascinating to look at, both during open enrollment as well as since it ended The things which stand out the most:

  • The obvious dead zone in October and most of November, finally coming to live around Thanksgiving time
  • The gradual rise in December, culminating in a large spike on Christmas Eve (the "official" deadline for January 1st coverage, although that varied in some states)
  • The massive spike in late March, culminating in a nearly off-the-chart peak on the "official" open enrollment deadline of March 31st, which saw over 200,000 transactions by itself

Yes, I'm quoted in this breaking story; Mr. Ornstein contacted me earlier today to ask my thoughts on his scoop, and I agreed to keep mum until it went public:

For months, journalists and politicians fixated on the number of people signing up for health insurance through the federal exchange created as part of the Affordable Care Act. It turned out that more than 5 million people signed up using Healthcare.gov by April 19, the end of the open-enrollment period.

But perhaps more surprising is that, according to federal data released Wednesday to ProPublica, there have been nearly 1 million transactions on the exchange since then. People are allowed to sign up and switch plans after certain life events, such as job changes, moves, the birth of a baby, marriages and divorces.

Now, before everyone jumps on the "1 million" figure, a few important things:

Pages