Tuesday, March 31, 2015

According to a recent survey of healthcare professionals:

  • 86% think that health apps will increase their knowledge of patients’ conditions
  • 72% think that health apps will encourage patients to take more responsibility for their own health
  • 46% say that they will introduce mobile apps to their practice in the next five years

Source: "Are mobile medical apps good for our health? A new study by Research Now reveals that doctors and patients say yes," Research Now Press Release, March 17, 2015, http://www.researchnow.com/en-US/PressAndEvents/News/2015/march/research-now-study-are-mobile-medical-apps-good-for-our-health-infographic.aspx

Monday, March 30, 2015

According to a recent survey

53% of respondents said they have never heard of the Supreme Court case, King v Burwell, that could eliminate subsidies for health insurance purchased on the federal exchange; another 25% said they had heard only a little.

Source: "Most Americans Unaware Obamacare Subsidies Are At Risk," Kaiser Health News, March 19, 2015, http://kaiserhealthnews.org/news/most-americans-unaware-obamacare-subsidies-are-at-risk/

Health Insurance Policy Cancellations Uncommon in 2014

According to a Health Reform Monitoring Survey, nearly all of those with ESI reported that they did not receive a letter about changes to their plan in 2015 or received a letter. Key findings include:

Nongroup coverage (directly purchased)

  • 5.6% - received letter stating the plan was cancelled because it did not meet new coverage requirements or because of an unknown reason.
  • 2.2% - received letter stating the plan was cancelled because it did not meet coverage requirements.
  • 3.4% - received letter stating the plan was cancelled, but recipient does not know why.

Employer Sponsored Coverage (ESI)

  • 0.6% - received letter stating the plan was cancelled because it did not meet new coverage requirements or because of an unknown reason.
  • 0.3% - received letter stating the plan was cancelled because it did not meet coverage requirements.
  • 0.3% - received letter stating the plan was cancelled, but recipient does not know why.
Source: Health Reform Monitoring Survey

According to a recent analysis of data from the 2009-2010 National Hospital Ambulatory Medical Care Survey

  • The emergency departments (EDs) that patients visited were located an average of 6.8 miles from the patient’s home, although the nearest ED was an average of 3.9 miles from the home
  • 43.8% of all ED visits occurred at the ED closest to the patient's home
  • Only 37.2% of ED visits within metropolitan areas took place at the closest ED, compared with 70.1% of visits outside of metropolitan areas
  • In metropolitan areas, the average wait time for being seen (by a physician, physician’s assistant, or nurse practitioner) at the ED closest to a patient’s home was 52.3 minutes, compared withan average wait time of 62.3 minutes for visits to EDs that were farther away

Source: "Emergency Department Visits and Proximity to Patients’ Residences, 2009–2010," Centers for Disease Control and Prevention, NCHS Data Brief Number 192, March 2015, http://www.cdc.gov/nchs/data/databriefs/db192.htm

A Quarter of Healthcare Workers Don't Have Email Encryption Capabilities

DataMotion recently announced results of its third annual survey on corporate email and file transfer habits, revealing significant security risks. Here are some key findings from their healthcare respondents:

  • Nearly a quarter of respondents reported they don't have the capability to encrypt email.
  • 8% said they're permitted to use mobile devices for email
  • Of those, 31.3% cannot send and receive encrypted email from their mobile client.
  • Almost 42% said they're unaware of Direct (the secure, email-like protocol developed for healthcare).
  • Of those who are aware of Direct, 42% say their organization is not using the alternative to email encryption.
Source: DataMotion, March 11, 2015

According to a government report,

...based on estimated gains in health insurance coverage in 2014, the estimated unreimbursed cost of the care provided by hospitals to people who are uninsured or underinsured was $27.3 billion in 2014, $7.4 billion lower than it would have been if coverage had continued at its 2013 level, at $34.7 billion.

Source: "INSURANCE EXPANSION, HOSPITAL UNCOMPENSATED CARE, AND THE AFFORDABLE CARE ACT," U.S. Department of Health and Human Services, March 23, 2015, http://aspe.hhs.gov/health/reports/2015/MedicaidExpansion/ib_UncompensatedCare.pdf   

Tuesday, March 24, 2015

Patients Account for Disproportionate Share of Health Care Spending

According to a new study by UHC:

  •  The sickest 10% of Americans spent an average of $26,851 in health care costs per person.
  • The healthiest 50% spent less than $250 per person.
  • 42% of all health care spending among the commercially insured population arose from unpredictable and largely unavoidable single events such as appendectomies or injuries.
  • Another 31% of total spending was incurred by the small subset of the population that suffers from advanced chronic and complex illnesses such as congestive heart failure or cancer.
Source: United Healthcare (UHC)

Monday, March 23, 2015

A recent analysis used Medicare fee-for-service data to compare

... the rate of growth in Emergency Department (ED) payments per beneficiary for patient-centered medical homes (PCMHs) versus non–PCMH practices. According to the study, the rate of growth in ED payments per beneficiary for PCMHs was $54 less for 2009 and $48 less for 2010, relative to non–PCMH practices.

Source: "Emergency department and inpatient hospital use by medicare beneficiaries in patient-centered medical homes," Annals of Emergency Medicine, abstract only, March 11, 2015 http://www.annemergmed.com/article/S0196-0644(15)00003-7/abstract

The Affordable Care Act's Impact on Quality of Care

1.    Expanded Access to Care

2.    Preventive Services

3.    Changes in Payment Systems

4.    Electronic Health Records (EHRs)

5.    The Patient-Centered Outcomes Research Institute (PCORI)

Source: "The Affordable Care Act at Age Five: Quality of Care," The Huffington Post, 17 March 2015.

5 Mechanisms of Acquiring Health Insurance Coverage Under The ACA

1.    Medicaid- Eligibility expanded in 28 states and (D.C.)

2.    Marketplaces- Shop for private plans with different cost sharing

3.    Direct Enrollment- Buy coverage directly from insurers with new consumer protections

4.    Parent- Young adults through 25 years of age can enroll in a parent's health plan

5.    Employers- Most large companies offer health benefits

Source: The Commonwealth Fund/Time

73% of Healthcare Workers Report Security Policy Violations

DataMotion recently announced results of its third annual survey on corporate email and file transfer habits, revealing significant security risks. Here are some key findings from their healthcare respondents:

  • 36% said within their entity, security and compliance policies are at most only moderately enforced.
  • When asked if they thought employees fully understood these types of policies, over a third said no.
  • Almost three quarters said employees/co-workers either occasionally or routinely violate these policies.
  • 18.2% said policies were intentionally violated by employees to get their job done.
Source: DataMotion, March 11, 2015

Today's Datapoint

35% is the reduction in the U.S.'s uninsured population as a result of the Affordable Care Act, according to HHS, which said the percentage of Americans without health coverage has fallen from 20.3% to 13.2%.

Quote of the Day

"To tell you the truth, there are a lot of plans that have not even started to put pen to paper to price out what a finding for the plaintiffs [in King v. Burwell] would be. I think they know it would mean a lot higher premiums. They might have to revise pricing but there are so many difficult actuarial assumptions that flow through that pricing they would need more time to do a revision...."

— Greg Scott, national leader of Deloitte Consulting LLP's health plan practice, told AIS's Health Plan Week

Friday, March 20, 2015

45 Days in February, March and April: ’Tis the Season for Lobbying on MA

By James Gutman - March 18, 2015

It seems to happen every year, and 2015 looks like no exception. From the time CMS releases in late February its draft Medicare Advantage plan payment notice and MA and Part D Call Letter for the following year, and until the final document comes out the first Monday in April, there’s a battle of press releases and lobbyists seeking to change or retain provisions in the draft document. And some of the back-and-forth rhetoric can get quite heated — and interesting.

Consider what already has occurred since CMS released the 2016 draft notice and Call Letter Feb. 20. On Feb. 25, the America’s Health Insurance Plans (AHIP) trade group came out with an actuarial study from Oliver Wyman finding the net 2016 pay cut for MA proposed in the initial notice would reduce MA payments by more than CMS had predicted (1.2% versus 0.9%). Just for good measure, AHIP on March 17 supplemented this with a state-by-state analysis by Wyman showing how big the impact would be in dollar terms. “Seniors cannot afford another cut to their Medicare Advantage coverage,” said AHIP President and CEO Karen Ignagni in a prepared statement accompanying the March 17 study.

Republican party officials saw an opportunity to capitalize on the controversy surrounding the rate-cut proposal and came out with their own tailored version of the impact of proposed MA cuts. Not surprising they blamed it all on the Affordable Care Act and the Democrats who passed the statute. “Now that those cuts are starting to negatively impact Medicare Advantage and the 15 million seniors covered by the program, it’s important for voters to remember it is the Democrats that are solely responsible,” National Republican Congressional Committee spokesperson Ian Prior told The Washington Post.

Democrats and patient-advocacy and provider groups, though, also have been active. The Medicare Rights Center coordinated a letter from 21 such groups, for instance, sent to CMS March 6 and focusing not on the MA payment rates but instead on what’s wrong with MA and Part D now. The letter praised provisions of the Call Letter, saying, “Like CMS, we are deeply concerned by the findings of the agency’s recent audits of plan sponsors, which revealed significant challenges related to organization/coverage determinations, appeals and grievances as well as formulary and benefits administration.”

And the Center for Public Integrity (CPI) news organization, which last year disseminated a widely used series of articles alleging a pattern of upcoding in MA, on March 13 came out with a new article. It referred to an unpublished 2009 study commissioned by CMS but never released showing risk scores for MA enrollees grew twice as fast between 2004 and 2008 as they would have if the same persons had stayed in fee-for-service Medicare. The study, according to CPI, found it was “extremely unlikely” that the people in the MA plans were so much sicker as to warrant such coding differences.

What do you think about these documents and the lobbying occurring between the draft and final notices? Are they likely to influence what’s in CMS’s final document April 6? Are they raising MA-related issues that need discussion at the right time to discuss them? Or are they, like so many things in Washington these days, just more examples of how a seemingly technical process gets caught up in rhetoric and partisan rangling?

Quote of the Day

"Our current programs [across the U.S. health care landscape] are not sustainable. There's not enough money being printed in the treasury, in any state, or by any employer or by any individual to afford this."

— Cigna Corp. CEO David Cordani, speaking at a National Business Group on Health conference on March 4.

Today's Datapoint

26,500 full-time employees of Starwood Hotels & Resorts Worldwide, Inc. will move to OneExchange, a private multi-carrier exchange operated by Towers Watson, the consulting firm announced on March 16.

Thursday, March 19, 2015

According to a recent study of health insurance policy cancellations, as of December 2014:

Adults with nongroup health insurance coverage reported:

  • 91.8% either did not receive a letter about their health plan and any changes that will happen in 2015, or received a letter but it was not a cancellation notice
  •  2.2% said their plan was canceled for 2015 because it did not meet new coverage requirements
  •  3.4% received a letter saying that their plan was canceled but they did not know why.

Adults with employer sponsored insurance reported:

  • 98.1% either did not receive a letter about changes to their plan in 2015, or received a letter but it was not a cancellation notice
  • 0.3% received a letter saying that their plan was canceled for 2015 because it didn't meet new coverage requirements
  • 0.3% received a letter saying that their plan was canceled, but they did not know why.

Source: "QuickTake: Health Insurance Policy Cancellations Were Uncommon in 2014," Urban Institute Health Policy Center, March 12, 2015, http://hrms.urban.org/quicktakes/Health-Insurance-Policy-Cancellations-Were-Uncommon-in-2014.html

Variation in Survival Rates for High-Risk Procedures

According to a new analysis by The Leapfrog Group and Castlight Health, there is a significant variation in survival rates for high-risk procedures. Key findings include:

  •  Pancreatectomy: This surgery to remove all or part of the pancreas has a significant variance in survival rate by hospital, at 19% from 81 to 100%.
  • Esophagectomy: An esophagectomy removes all or part of the esophagus. The average survival rate is 90% with a variation by hospital of 88 to 98%.
  • Abdominal aortic aneurism (AAA) repair: A surgery to treat an enlarged abdominal aorta has a 13%variation in predicted survival rates from 85.7 to 98.9%.
  • Aortic valve replacements (AVR): This heart surgery treats problems with the heart's aortic valve, and only 15% of hospitals fully met Leapfrog's standard.
Source: The Leapfrog Group

Quote of the Day

"Everybody is under margin pressure, I would say, but [the not-for-profit insurers have some advantages]. They don't have to meet earnings expectations, etc. Our impression is that the nonprofits are probably willing to give up some margin and ... especially in this ACA environment they want to grow enrollment and kind of meet their goals, which is to basically provide health care, and perhaps not worry about the profitability of any new business they are taking on."

— Mark Rouck, senior director for Fitch Ratings, Inc., told AIS's Health Plan Week

Today's Datapoint

More than 1 million BCBS of Massachusetts members will be eligible to receive the insurer's Alternative Quality Contract, a P4P program that was formerly available to 680,000 HMO members and will now be available to PPO members as well, according to The Boston Globe.

Impact of Proposed Medicare Advantage cuts on enrollees


Wednesday, March 18, 2015

Eating our own: How compliance confusion cannibalizes common sense

Feb 18, 2015 | By John Sullivan

An advisor once told us about a charity golf tournament he organized. He wanted to put the name of his firm and the name of his broker-dealer on the golf balls he was planning to give each player. He approached his broker-dealer who dutifully ran it through their compliance department. The compliance department approved the tournament with one caveat; the golf balls needed to include the required disclaimer—all of the required disclaimer.

“It would have completely covered the ball and looked ridiculous,” the advisor recalled. “But they said if we hit it into the woods and someone found it, even if it was 10 years later, it would constitute an offer to sell.”

We wish it were the only time we heard of such a thing, but another advisor at a different broker-dealer had a similar story. His annual client appreciation dinner was to feature a minor celebrity who would give a speech and take questions afterwards. The advisor wanted his name and the name of his broker-dealer on the pens they handed out so people could write down their questions beforehand. The broker-dealer wanted a disclaimer on the pens, which once again would have covered them entirely, with little or no room for anything else.

Of course, both advisors opted against using their name or the name of the broker-dealer, and for good reason. Doing so would have needlessly raised questions that needn’t be raised. And that’s the point. Each bit of added paper makes the client wonder what they’re signing, why they’re signing it and what prompted regulators to require it in the first place. As much as the advisor might explain, it eventually becomes white noise, and clients’ eyes glaze over as they robotically sign and initial where instructed. It was a common complaint when The Patriot Act first passed. If every client transaction has to be accompanied by reassurances that the advisor won’t launder money to fund insurgent activities—well, the terrorists have won.

In other words, it gets clients wondering, and engenders less trust, not more; which is the exact opposite of what it was intended to do. It is said that the road to hell is paved with good intentions, which relates to “The Folly of Accountabalism,” one of the breakthrough ideas in 2007 that was featured in Harvard Business Review. This is a critically important concept.

Every ethical person wants to be held accountable for doing the right thing, but how do you successfully institutionalize something so opaque? It’s a question regulators, legislators and corporate America seems unable to answer. As a result, they go overboard, and the outcome is the hyper-regulated and litigated environment in which we now find ourselves. It gives rise to what marketing consultant David Weinberger coined as accountabalism, examples of which are the golf balls and client appreciation pens with which we opened.

Accountabalism manifests itself in four interrelated beliefs and practices. They are: 

1). Accountabalism assumes perfection—if anything goes wrong, it’s a sign that the system is broken. But as Weinberger rightly notes, “Social systems are incapable of anything close to perfection, so if something goes wrong in one, it need not mean the system is broken. If an employee cheats on expenses by filling in taxi receipts for himself, the organization doesn’t have to ‘fix’ the expense-reporting system by requiring that everyone travel with a notary public.

2). Accountabalism is blind to human nature. For example, “it assumes that if we know we’re being watched, we won’t do wrong—which seriously underestimates the twistiness of human minds and motivations. We are capable of astounding degrees of self-delusion regarding the likelihood of our being caught.”

3). Accountabalism bureaucratizes and atomizes responsibility. “While claiming to increase individual responsibility, it drives out human judgment. When a sign-off is required for every step in the work flow, those closest to a process lack the leeway to optimize or rectify it.”

4). Accountabalism tries to squeeze centuries of thought about how to entice people toward good behavior and dissuade them from bad into simple rules by which individuals can be measured and disciplined. It would react to a car crash by putting stop signs at every corner.

In other words, accountabalism claims to increase accountably while in actuality decreasing it. Any efficiencies sacrificed in the process are therefore all for naught. Common sense practices and documentation measures should be a core practice of any ethical business, advisors included. Just be sure it serves its purpose, and that accountability doesn’t become accountabalism.


Private Exchanges: When Will Employer Adoption Catch Up to the Industry Buzz?

Reprinted from INSIDE HEALTH INSURANCE EXCHANGES, a hard-hitting newsletter with news and strategic insights on the development and operation of public and private exchanges.

By Steve Davis, Managing Editor

March 2015 Volume 5 Issue 3

Last June, technology firm Accenture predicted 9 million people would select benefits through private health insurance exchanges in 2015 — triple the number in 2014 — and 40 million would participate by 2018. Despite a sustained buzz around private exchanges over the past few years, employer adoption is lower than expected. Industry observers, however, remain optimistic that participation will continue to increase among employers.

“The predictions were overly ambitious,” says Paul Fronstin, Ph.D., director of the Employee Benefit Research Institute’s (EBRI) Health Research & Education Program. EBRI estimates just shy of 3 million active employees participate in multi-carrier exchanges offered by the “big four” — Mercer, Towers Watson, Aon Hewitt and Buck Consultants. Another 3 million collectively enrolled in coverage through other private exchanges.

One explanation for the slow take-up rate could be the improving job market. Five years ago, unemployment topped 10% and some employers eyed private exchanges and defined contribution as a way to stabilize coverage costs. Now that unemployment has dropped to 5.5%, employers are leery of any change that could impact their ability to attract and retain workers, Fronstin says.

More than 70% of employers are taking a wait-and-see approach when it comes to private exchanges, and just 8% plan to join in 2015 or 2016, versus 16% of employers expressing no interest in this strategy, according to a March 2 research note from Christine Arnold, an equities analyst at Cowen & Co. Interest among small employers, however, is growing — to 32% this year versus 15% last year — while large employer interest is stable at around 25%, she wrote.

During recent conference calls to discuss earnings, CEOs from Aetna Inc. and Anthem, Inc. noted limited interest in multi-carrier private insurance exchanges among large employers (HEX 2/15, p. 9).

Large employers are likely waiting to see how private exchanges — and sustainable cost growth — play out beyond the initial years “where rate guarantees and vying for market share may mean lower premiums,” says Steve Wojcik, vice president of public policy for the National Business Group on Health. “I think they are also looking to see whether the exchanges use their growing leverage to improve network performance, which they are starting to see in some exchanges.”

Fronstin notes that employers historically have been slow to embrace new trends in employee benefits. More than a decade after health savings accounts (HSAs) became available, just 20% of employees have one. In 2004, however, Mercer suggested that 74% of large employers would offer HSA-based plans by 2006, Fronstin says. “It has materialized; it just took longer than initially expected,” he says. “So why should private exchanges be any different?”

Although adoption of private exchanges has been slower than anticipated, interest remains high, notes Barbara Gniewek, a principal in PwC’s Human Resource Services health care practice. “With the initial reports of savings being very favorable, and the experience by both employers and employees being viewed as positive, adoption will begin to accelerate,” she says.

Large employers, she tells HEX, understand that the private exchange market offerings are diverse, and they are taking time to evaluate the options to see which one best meets their needs and/or is in line with their strategic objectives. “We are seeing a lot of interest in employers using an independent evaluator to help them assess the market. This process is taking longer than simply converting to an exchange,” she says. And early adopters are warning employers to spend more than six months to roll out a private exchange, she adds (see story, p. 3). To be ready for the 2016 plan year, employers will need to finalize plans by April or May.

But Gniewek says there could be a “piling on” effect if competitors are successful in switching to a private exchange. Nearly half of employers have implemented or intend to implement a private exchange for full-time active employees before 2018, according to a 2014 survey of 446 employers conducted by the Private Exchange Evaluation Collaborative, an initiative launched by PwC and four non-profit business coalitions — Employers Health Coalition, Inc. (Ohio), Midwest Business Group on Health, Northeast Business Group on Health and Pacific Business Group on Health. But 57% of employers said they’d be more inclined to consider a private exchange if a peer switched to one.

Cadillac Tax May Drive Some to Exchanges

Arnold predicts that the so-called Cadillac tax on rich employee benefits, which is slated to go into effect in 2018 as part of the Affordable Care Act, could propel private exchange momentum.

About 40% of large employers would trigger the penalty, according to an employer survey released March 5 by Towers Watson. Gniewek agrees that the Cadillac tax is driving interest in exchanges. Employers can use the tax as an excuse to change the way they provide benefits, she tells HEX. Fronstin says the Cadillac tax could be a “game changer.”

Wojcik agrees that the Cadillac tax could spur some movement in 2018 and beyond, “but it doesn’t necessarily immunize employers from the tax if the exchanges are unsuccessful in keeping trend below [the consumer price index],” he notes.

More than 25% of the 444 employer representatives surveyed for the Towers Watson report say they have “extensively analyzed private exchanges,” and 20% say they are more interested in adopting a private exchange today than they were a year ago. Employers that have completed extensive analysis of private exchanges — versus companies that have not — are twice as likely to find private exchanges a viable alternative in 2016, according to the report.

The Towers Watson study also found that the vast majority of U.S. employers (84%) expect to make changes to their full-time employee health benefit programs over the next three years, despite cost increases remaining at historically low levels.

If SCOTUS Rules for Plaintiff, What Happens Next?

By Steve Davis - March 17, 2015

For the record, I don’t think the Supreme Court will decide only state-based exchanges can distribute federal premium subsidies. The court had its chance to strike down the individual mandate in 2012 but didn’t.

But if I’m wrong, will a decision against HHS mean the end of public insurance exchanges and an unraveling of the Affordable Care Act (ACA)? Probably not. But it certainly would force Congress, state lawmakers, HHS and insurance carriers to do some serious scrambling this summer. In the absence of a stay, subsidies, which are distributed monthly to carriers, would dry up almost immediately if the court determines federally run exchanges can’t legally distribute them. If the verdict comes out in late June, as expected, it’s unlikely Congress would be able to agree on a solution before heading out of Washington for summer recess.

Here are a few scenarios that could play out:

·  Congress votes to amend the language of the ACA allowing subsidy distribution to remain as is.

·  Congress creates a bill allowing federal subsidies to continue IF the individual and/or employer mandates are eliminated.

·  Congress blames the problem on the administration and the former Democratic majority…and goes on vacation.

·  HHS allows carriers to submit alternate 2016 rates to account for the healthy population that drops coverage. Most carriers drop out for the 2016 plan year.

·  HHS releases a rule allowing early use of the ACA’s 1332 waivers, which give states some flexibility to come up with their own strategies to reform insurance markets.

·  State legislatures hold emergency sessions and vote to allow a transition to a federally supported state marketplace model.

What do you think? Will the Supreme Court rule against HHS in King v. Burwell? If that happens…what happens next?

Today's Datapoint

Roughly 800,000 customers were lost by Cigna Corp. after CEO David Cordani assumed his current role in 2009 because the insurer decided certain employers did not share the health plan's vision for value-based care, Cordani told a National Business Group on Health conference on March 4.

Quote of the Day

"A compliance officer's role is to tell senior leaders what they have to hear, not just what they want to hear....Their goal should always be to protect the organization."

— Julie Chicoine, senior assistant general counsel at Wexner Medical Center at the Ohio State University Medical Center, told AIS's Report on Medicare Compliance.

Tuesday, March 17, 2015

Change in State Uninsured Rates Based on Medicaid Expansion

According to the Gallup-Healthways Well-Being Index:

% Uninsured, 2013

  • 16.1% - States with both Medicaid expansion and state exchanges/partnerships
  • 18.7% - States with only one or neither

% Uninsured, 2014

  • 11.3% - States with both Medicaid expansion and state exchanges/partnerships
  • 16.0% - States with only one or neither

Change in uninsured rates 2014/2013

  • (-4.8%) States w/Medicaid expansion and state exchanges/partnerships
  • (-2.7%) States w/only one or neither
Source: Gallup

According to a recent survey,

77% of employers spent 16% or more of their total health care budgets on pharmacy benefits in 2014, up from 71% in 2013.

Source: "Majority of Employers Spend 16 Percent or More of Health Care Budget on Pharmacy Benefits: Buck Consultants Survey," Buck Consultants at Xerox Press Release, February 25, 2015, http://news.xerox.com/news/5th-Annual-Buck-Consultants-at-Xerox-Prescription-Drug-Benefit-Survey

4 Reasons Both Parties Should Be Sweating Bullets Over King V. Burwell

1.    The biggest political threat is to the president

2.    Republicans might not be the winners

3.    It will be hard for Republicans to unify around a replacement for Obamacare

4.    Republican governors will be under tremendous pressure

Source: NPR

5 States Reaching the Greatest Share of the Potential Market (using HealthCare.gov)

1.    Florida 64%

2.    Maine 60%

3.    Pennsylvania 52%

4.    Delaware 52%

5.    North Carolina 51%

Source: The Wall Street Journal

Ten Things to Know about 2015 Public Exchange Enrollment Numbers

1.    Nearly 11.7 million consumers selected or automatically re-enrolled in coverage through the Marketplace

2.    8.84 million (76%) were in states using the HealthCare.gov platform

3.    2.85 million (24%) were in the 14 states (including DC) using state platforms

4.    87% (nearly 7.7 million individuals) qualified for an average tax credit of $263 per month

5.    55% paid $100 or less per month after tax credits

6.    4.1 million+ consumers under age 35 signed up for Marketplace coverage (35% of all signups)

7.    Almost 3.3 million consumers age 18 - 34 signed up for Marketplace coverage (28% all Signups)

8.    53% of HealthCare.gov signups are new consumers who did not have Marketplace coverage as of Nov. 2014

9.    Of the 4.2 million consumers who re-enrolled, 2.0 million auto re-enrolled and 2.2 million actively re-enrolled

10.  Of the 2.2 million active re-enrollees, 1.2 million switched to a different plan from 2014 (54% of active re-enrollees and 29% of all re-enrollees)

Source: HHS Press Release, March 10, 2015: Nationwide nearly 11.7 million consumers are enrolled in 2015 Health Insurance Marketplace coverage