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Whenever I post about King v. Burwell, I have a tendency to lump all 34 states together into collective numbers (around 6.5 million losing their tax credits, plus another couple million being priced out of the market due to the resulting premium spikes, plus another 4-5 million having to pay through the nose to keep theirs).

However, I decided to break this out by individual state. First, I used the HHS Dept's. official ASPE report from March 10th. This includes all people who selected a QHP via HC.gov as of 2/22/15.

Next, I assume my standard 88% payment rate. Ironically, the higher this percentage is, the more people who could actually get royally shafted by a King plaintiff win.

Then, I estimate how many people will be enrolled in effectuated policies as of July 1st. That's important because of the churn factor--people are constantly enrolling and dropping their policies for unrelated reasons, even during the off season. I estimate that as of July, this will likely be around 2% fewer than the number who paid up (normal attrition would be more like 4% but that was partially cancelled out by the 147,000 people who enrolled via the Tax Filing Season special enrollment period via HC.gov). That brings the grand total down to around 7.4 million.

Next, we have to look at what percentage of enrollees are actually receiving federal tax credits in each of these states. The overall percentage is around 87%, but that varies from as low as 70% in New Hampshire to as high as 93% in Florida and Mississippi. That brings it down to around 6.43 million without NV/NM/OR or 6.63 million with them included.

With all that done, here's the state-by-state breakdown of how many people I expect will be receiving federal tax credits for their ACA exchange-purchased healthcare policy as of July 1st, 2015:

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Two weeks ago I posted a diary about an attorney named Chad Boonswang who appeared to have pulled a pretty tacky ambulance-chasing stunt by sending tasteless notes to the families of the victims of the Amtrak crash in Philadelphia.

Boonswang claimed to be innocent, but a week went by without him providing any sort of explanation as to what might have happened.

So, a few days ago I posted a follow-up in which I explained why this incident had struck such a nerve with me personally, even though I have no connection to any of the victims or their families.

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Some Guy, early December:

In other words, every one of the following states--along with the other 2 dozen not already running their own exchanges--should be running, not walking towards at least getting their ducks in a row in case SCOTUS lowers the boom...and instead, every damned one of them appears to have decided to twiddle their thumbs for the next 6 months or so.
Some Guy, late January:
Anyway, let's suppose that #1 and #2 are squared away. Against all odds, the Republican governors and legislators of these states get their heads out of their asses and actually approve all of the above.

That leaves #3: Time. Even if everything was streamlined and fast-tracked (and lord knows that's unlikely), it would still take substantial amounts of time to do all of this.

According to consulting firm Leavitt Partners (via the Center for American Progress), it would take up to 18 months for a state to set up their own "full" exchange (website/platform et al). Using the "HC.gov piggyback" method which I'd imagine most states would go for (again, assuming it's allowed), it might take less time--perhaps 6 months or so from the point that such legislation is passed and signed.

And that's the problem. Again, as the CAP notes:

A ruling in June would be only months before open enrollment for 2016 begins in October, leaving little time for states to act.

Of the states that would lose tax credits, only eight have legislative sessions that extend beyond June. Because states need to have the legal authority to set up a marketplace—and because most governors do not have the statutory authority to act on their own—state legislatures would need to act.

In other words, even if the various state legislatures and/or Governors wanted to go ahead and slap something together, almost all of them would have to do so BEFORE the Supreme Court ruling.

That is, they'd have to start RIGHT NOW...and even then it would be awfully tough timing.

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Last week, I noted that the number of ACA exchange-based QHP selections has officially passed the 12 million mark nationally. I also mentioned that:

Of course, when you throw in the missing tax season SEP / off-season enrollments, the actual total should be closer to 12.4 million or higher, and should finally reach my personal Open Enrollment Period target of 12.5 million by the end of May.
Well, it's a week later, and I'm feeling confident enough (especially with the support of new data out of California) to state that the actual total number should indeed have passed the 12.5 million mark nationally sometime over Memorial Day weekend (or today at the latest, since most exchanges were closed for the holiday).

On the one hand, this is yet another milestone to celebrate, and holds special meaning for me personally, since 12.5 million was my official projection for the 2015 Open Enrollment Period last fall/winter. I can't feel too smug about this, of course, since it ended up taking 3 months longer to reach this number than I was expecting...

On the other hand, this likely doesn't really impact the number of effectuated enrollees, since most of the new additions are likely being cancelled out by an equal number of enrollees dropping their policies for similar reasons. The actual number of people enrolled via ACA exchange-purchased policies at any given moment is likely to be holding steady at around 10.1 million or so for most of the summer and fall at this point, although it might be up to half a million or so higher if I was interpreting the payment rate for Covered California properly last week (and if that CA data is representative of most other states as well).

I should also note that assuming at least an 88% payment rate (similar to last year), this means that another milestone should now be achieved: At least 11 million paid QHP enrollments (including those currently effectuated as well as those who paid have already dropped coverage since February).

In any event, here's what The Graph looks like today...and I've added a special shaded area for the 2nd half of the year to reflect the uncertainty regarding the impending King v. Burwell Supreme Court decision.

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IMPORTANT: SEE UPDATE ON THIS STORY FROM 5/27/15
About a week ago, I posted an off-topic entry called "Attorney Chad" is about to have a really bad weekend.

It appears that after the tragic Amtrak derailment a couple of weeks ago, a Philadelphia-based personal injury attorney named Chad Boonswang (allegedly) decided to send out hand-written "sympathy cards" to the families of not just one, but at least two different victims. The "sympathy cards" actually contain no words of sympathy, but instead are crass ads pushing his litigation services at a discounted rate. What a bargain!!

Adding insult to injury, at least one of the victims and their families happen to be Jewish, making the embossed cross on the outside of the card doubly tacky.

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Fri May 22, 2015 at 06:06 PM PDT

A Week in the Life of ACA Signups

by Brainwrap

I've been sending out these weekly digests to my mailing list for months now, but figured some here might be interested in it as well (and most of the compilation work is already done so what the heck!)

It there seems to be enough interest I'll keep posting the weekly digests here at dKos as well; let me know!

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Cross-posted at ACASignups.net
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Wow. All I can say is...good for him, seriously:

Lifelong Republican Turns On His Party, Embraces Obamacare

Luis Lang, who is currently crowdfunding for medical expenses that he can’t afford because he didn’t sign up for insurance under Obamacare, has become a viral sensation. However, the 49-year-old South Carolina resident says he doesn’t want to be the poster child for the Republican Party’s opposition to health care reform anymore.

Many people both here and over at ACASignups.net have criticized me, either for donating a few bucks ot Mr. Lang in the first place or alternately, for coming down so hard on the guy in my blog posts. Some thought it was a waste of time (and money) to help the guy out, while others thought it was an equal waste of time/breath to chastize him, figuring that it'd fall on deaf ears. Still others thought that it's inappropriate to donate money with one hand while berating him with the other. Well, guess what?
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This Just In...

After all the fuss and bother made over the #ACATaxTime Special Enrollment Period by myself and others, the final number of QHP selections was announced in the most understated way possible:

From March 15 to April 30, 147,000 consumers signed up for coverage through http://t.co/... using the tax special enrollment period.
— HealthCare.gov (@HealthCareGov) May 19, 2015
No splashy press release, charts or graphs; just a simple number. In the end, while it was still far lower than my original spitball take (600K+), it was also slightly higher than my revised estimate of 135K - 140K.

Unfortunately, there's still no state-by-state breakout. However, combined with the other off-season/tax SEP numbers reported from (most) of the state exchanges, this (including today's Minnesota update of 64K QHPs) does bring the grand total number of confirmed 2015 QHP selections up to exactly: 11,995,315.

Technically speaking, they're still about 5,000 QHPs shy of the 12 million mark, but give me a break; this number doesn't include normal Off-Season Enrollments (via life changes) in nearly every state since 2/22 or the tax season SEP enrollments from a half-dozen state-based exchanges.

Therefore, it's quite safe to call it:

2015 ACA Exchange-based QHP Selections have officially broken the 12.0 million mark, with over 9.0 million coming from HealthCare.Gov.finally reach my personal Open Enrollment Period target of 12.5 million by the end of May.

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OK, I admit this is a bit of a tease; the actual story is over at healthinsurance.org (which has exclusive rights to pieces I write specifically for them).

However, I felt that the dKos community would appreciate these tips, so here's a heads' up.

As you may have noticed, I've been posting a bunch of 2016 Rate Change Request posts over the past week or so. Last week I wrote about Oregon, Washington State, Iowa and Connecticut. This week I've added Michigan and the District of Columbia, and just this morning I added Vermont and Maryland. Other state numbers will be popping up left and right over the next couple of weeks.

To try and avoid confusion, my latest exclusive piece over at healthinsurance.org is a primer of sorts on what to be on the lookout for when you start seeing scary-sounding newspaper headlines about "massive rate hikes!" for 2016.

Spoiler: They may be accurate, or they may be full of hot air. Check it out!

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IMPORTANT: SEE UPDATE ON THIS STORY FROM 5/27/15

My friend was killed in the @Amtrak crash. Her family received this note. I think we should all give Chad a call... pic.twitter.com/CH59KJw2QK
— Rachel Lutz (@racheldaytwa) May 15, 2015

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Yesterday I posted a rather scathing entry about Mr. Luis Lang of South Carolina, followed by another one about the hundreds of almost entirely liberal / progressive-leaning donors (including myself) who have, as of this writing, ponied up over $12,000 to save him from going blind due to a combination of his own irresponsibility and his political party's decision to throw nearly 180,000 SC residents--including himself--under the bus.

Today, Mr. Lang has responded to all the hubbub...mostly (emphasis mine):

First of all I would like to thank ALL of the wonderful people that have donated to help me in my time of need. And I do mean everybody. When I started this I never meant it to became a political war. I am a honest person and I have to give a big thumbs up to the liberal side. Even though you have crucified me in your comments but you spoke with your heart with the donations. I respect everybody opinion whether I agree with you or not. That is why we live in the U.S.A. home of the free and free speech. As far as the conservative side I wish they would step up to the plate and do there part. Again thank you all and i will be posting updates with my condition.

sorry one last thing I have to hand it to the liberal side you sure do know how to get the word out when you dislike something. I say shame on the conservative bloggers for resting on there laurels.

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