Estimated Exchange QHPs as of 7/28/14: 7.90M PAID (8.92M Total)

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

Exchange + Off-Exchange QHPs: 15.9M  •  Medicaid/CHIP (7.0M - 9.9M)

ESIs (157K confirmed; up to 8M more possible)  •  Sub26ers (1.6M - 3.1M)

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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?

OK, I've proven time and time again that overall, roughly 90% of ACA exchange QHP enrollees do eventually pay their first month's premiums, although it may take a bit longer for some of them to do so. The problem with the exchanges (or individual insurance companies, or the state insurance commissioners or whomever) releasing a flat "XX% have paid as of such-and-such date" is that it's misleading, since anyone who has enrolled within the past 2 weeks likely won't have their policy actually start for up to a month or longer, and even those who enrolled more than 2 weeks ago may just be starting their coverage now. In other words, it's a rolling average, which increases as time goes on for the earlier enrollees, but drops as time goes on for the newest enrollees.

The Vermont update which I just published is a perfect demonstration of this. As of July 22nd:

Finally, a solid update out of Vermont; thanks to Morgan True of VT Digger for pointing me towards the most recent Vermont Health Connect report as of just a week or so ago:

There's a lot going on in the table above. For one thing, this demonstrates, again, how stupid it was to hyperventilate about "How many have PAID???" back in February or March, when a good 40% or more of the people who would eventually enroll wouldn't even have their policies kick in for weeks or even months yet. Note that of those whose policies started between January 1 - May 1st, over 95% have paid their first premiums by now:

There's been a recent batch of insurance rate change requests reported across various states which has gotten a lot of press. However, as I noted a couple of weeks ago, there can be a big difference between what the insurance companies ask for and what the state insurance commissioner approves. This is one of the most important (and least-written about) aspects of the ACA: Insurance companies can no longer just jack up their prices however much they feel like; those rates have to be approved by the insurance commissioner for the state they're operating in if they want to sell their wares on the exchange.

Yesterday I posted an article in which I attempted to coin the term "Halbig Conspiracy!!®" (complete with not one, but two exclamation points). However, others including Kevin Drum of Mother Jones and Brian Beutler of the New Republic prefer the term "Halbig Truthers®", which I have to admit rolls off the tongue better, so I'll go with that instead.

In any event, last night Drum made a (tongue-in-cheek?) offer to give $10 to anyone who:

...can point out a conservative who so much as suspected that subsidies were limited to state exchanges prior to March 2010. Surely that's incentive enough? Let's start digging up evidence, people.

This led to a brief Twitter exchange in which Vox's Adrianna McIntyre offered to match Drum's $10, and I upped the ante (um...sort of) by offering up my collection of mint-condition official Todd McFarlane "Spawn" promotional action figures to sweeten the pot (I was a movie theater manager in a prior life and these were left over after the live action movie bombed in 1997).

Thanks to Paul Mullen for this find: A rare update out of North Dakota. Lots of useful data, but kind of frustrating because of the apples/oranges comparisons:

As of July 6, 9,953 North Dakota residents were covered by private insurance plans obtained through the federal marketplace, up from 8,374 reported at the committee’s last meeting May 14, according to Insurance Department figures.

That’s still lower than the 10,597 enrollment figure cited by the Obama administration in April, in part because the state counts only those who have actually paid their first month’s premium. Either way, enrollment fell short of the administration’s projection that 11,000 North Dakotans would enroll in private plans through the marketplace during its first six months.

Greg Sargent over at the Washington Post has done an excellent job of looking at the reality behind what I'm terming the "Halbig Conspiracy!!®" (note: if you choose to re-post this, I ask you to include both exclamation marks), by looking at the actual history of the federal exchange in the earlier drafts of the ACA bill:

...But documents from the Senate committees that worked on versions of the bill in 2009 — combined with a close look at the history of the phrase itself, and interviews with staffers directly involved in the drafting of the statutes — strongly undercut the argument that the law did not intend or provide subsidies to those on the federal exchange.

...1) The first Senate version of the health law to be passed in 2009 — by the Health, Education, Labor and Pensions Committee — explicitly stated that subsides would go to people on the federally-established exchange. A committee memo describing the bill circulated at the time spelled this out with total clarity.

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