Health Connector Authority "Obamacare" Exchange Is Irrelevant in Massaschusetts

It's hard to follow all the numbers the Massachusetts Health Connector Authority is broadcasting this month but they really do not matter because they represent such a small part of the Massachusetts total that they do not even show up on a representative bar graph (see image below).

 

The important numbers relative to health insurance in Massachusetts are as follows:

• There are about 6,500,000 Massachusetts residents. Around 5,000,000 (77%) of us get our health insurance through current or former employment and could care less about the Massachusetts Health Connector
• Around 100,000 of us (1%-2%; see very top of each bar) get our health insurance ourselves on our own paying full price; between 2007 and 2013, a small number of this already small number used the Massachusetts Health Connector as an insurance broker; that was hard to do in 2014 because the Health Connector web site worked poorly
• Around 200,000 of us (3%; in red oval¹) never get or only occasionally get health insurance or Medicaid (called MassHealth in Massachusetts); we use the Massachusetts free care pool (name was called to the Health Safety Net in 2006), which is not insurance and which is funded by higher insurance premiums paid by the 5,100,000 people mentioned directly above; through the free care pool Massachusetts resident can go to one of Massachusetts' over 40 community health centers as well as to most Massachusetts hospitals; many of the people in the free care pool have trouble understanding all the crazy rules put out the the Massachusetts Health Connector Authority or Massachusetts Medicaid bureaucracy and prefer to keep their lives simple; most of them would qualify for a Connector Authority program or for Medicaid if they had made out the paperwork
• Around 1,000,000 Massachusetts residents (18%) qualify for and have signed up for Medicaid, which is also not insurance; those on Medicaid never have previously been involved with the Health Connector and it is unclear if they have to use it now (if so, they are certainly not flocking to it)
• Finally -- and this is the Health Connector Authority's only reason for existence -- about 200,000 (3%) Massachusetts residents used the free care pool before 2007 and were switched to RomneyCare (often without their knowledge) between 2007 and 2013; RomneyCare is insurance; RomneyCare provided most of the 200,000 mostly "free" insurance paid for by the Massachusetts free care pool (that is, paid for by the 5,100,000 noted above) and by Medicaid. (NOTE: RomneyCare is no longer offered and has been replaced by ConnectorCare, which I call Grubercare after its "architect.")

When those in this last small group in this list (the illustration breaks the group even finer, so fine that the various subsegments almost don't register visually) tried to renew their RomneyCare insurance a year ago, the new Health Connector website didn't work well so many of them were given Medicaid temporarily. Some of them were going to be put on Medicaid even if the web site had worked because of Obamacare. Because Medicaid is not insurance, many of them made other arrangements during 2014. This is driving the Health Connector Authority crazy.

¹An interesting aspect of the Massachusetts insurance-buyer-funded free care pool -- represented by the red oval -- is the fact that it went negative in 2014. That is, in theory Massachusetts had more people insured than it had people (as explained here). That's why the red oval in 2014 is below the bottom axis.