Josh Archambault on Forbes has the most damming analysis yet of how access to health insurance is changing under the Affordable Care Act.
Thousands of people are getting cancellation notices from insurance companies. In only three states, Archambault puts this number at 500,000. As of Thursday morning when Archambault wrote this post, only 476,000 applications have been filed through an exchange in all 50 states. Even if you trust the new number of applicants — 700,000 — that the administration has since published, that may be artificially high due to double counting. Archambault writes:
As I have tracked enrollment by states, many are reporting out both Medicaid and exchange enrollment at the same time.
Therefore the 476,000 number is misleading. My best guess is that for the 17 states that have reported out some data, the number is closer to 193,818 applications (once you pull out the Medicaid applications that have been reported on). Of course, this number is also still too high as it is compromised by the jointly reported data.
What becomes clear, is that the federal exchanges in 34 states are accounting for a single digit percentage of the accounts being filed.
Dan Diamond at the Advisory Board has a different set of calculations around enrollment through state exchanges. His total is 115,060 signups through state exchanges. His data backs up the Forbes post:
1) Lots of people are getting coverage through the 15 state-based exchanges. 2) Most of them (so far) are signing up for Medicaid.
The President is getting well-deserved criticism for his “If you like your coverage, you can keep it” promise, but these numbers are what will kill the Affordable Care Act if they don’t start balancing out soon.
I have spoken with two people who have received a cancellation notice. I expected these letters would include an upsell from a insurance company: “We’re replacing this (cheaper) product with this (more expensive) one,” or at least a little advice: “Go to healthcare.gov (and good luck to you).” Both people I spoke with said the letters were very brief and unhelpful.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Obama and HHS can’t control messaging from insurance companies that are cancelling policies, but they can control healthcare.gov. If they don’t fix the web site soon, there will more uninsured people in 2014 than there were in 2009.
