Source: http://acasignups.org/archive/201505
Timestamp: 2019-04-24 06:43:23+00:00

Document:
How to avoid higher administrative expenses under the ACA: 1. Single payer. 2. Increase loss ratios. 3. Don't give insurance to more people.
A sweeping measure to offer state-subsidized healthcare coverage to people in the country illegally was significantly pared back Thursday in an effort to rein in costs as it cleared a key legislative hurdle.
Rather than extend Medi-Cal--California's healthcare coverage for the poor--to all eligible adults regardless of immigration status, as originally proposed, the amended bill by state Sen. Ricardo Lara would set up a limited enrollment healthcare program.
The board of Connecticut’s health insurance exchange approved a 22 percent hike in the fee it charges insurers to help fund its operations, a cost that’s likely to be passed on to insurance customers.
Over the past 3 weeks, I've written not one, not two, but 5 different lengthy screeds about Luis Lang of Fort Mill, South Carolina.
My first three posts pretty much tore him and his wife to pieces.
The fourth post, written in response to an interview he did with my colleague Harold Pollack over at healthinsurance.org, was a bit more forgiving, but still brought out my nasty snark.
Then, a few days later, Lang dropped the bombshell: He and his wife were renouncing the Republican Party and openly calling for Single Payer healthcare.
Reading this story by Sarah Ferris at The Hill reminded me of the closing scene from Glengarry Glen Ross (starting at around 2:50 in).
WILLIAMSON: Where have you been, Shelly? Bruce and Harriet Nyborg?? Do you want to see the memos...? They're nuts... they used to call in every week. When I was with Webb. And we were selling Arizona...they're nuts...did you see how they were living? How can you delude yourself??
WILLIAMSON: Forget it. Frame it. It's worthless.
LEVENE: The check is no good?
WILLIAMSON: You stick around; I'll pull the memo. I'm busy now.
LEVENE: Wait a minute...their check's no good? They're nuts...?
WILLIAMSON: You wanna call the bank, Shelly? I called them. I called them four months ago when we first got the lead. (pause) The people are insane. (pause) They just like talking...to salesmen.
In 2014, the overall average premium payment rate for those who selected a Qualified Health Plan (QHP) from the various ACA exchanges ended up being around 88% nationally. This varied from state to state and company to company, but in the end it was roughly 88%.
The short version of the plaintiff's argument, of course, is that supposedly this means that federal tax credits are kosher for individual states which "established" their own exchanges (16 states plus the District of Columbia) but not for the remaining 34 states, since they're being run by the federally-"established" exchange.
Every once in awhile I'm accused of being a little too blunt. As a blogger, I'm presumably not under the same "professional standards" of language and protocol as, say, the New York Times, the Associated Press or the U.S. Congress.
"If you win the case you actually have people who lost their insurance. You now share the responsibility for fixing it," said former Rep. Tom Davis, R-Va., who once led the House GOP campaign committee. "And you've got a lot of pissed off people. That hurts you."
UPDATED: King v. Burwell: How many people would lose tax credits in YOUR state??
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.
Read more about UPDATED: King v. Burwell: How many people would lose tax credits in YOUR state??
NOTE I posted a partial version of this entry last night, then yanked it overnight in order to think about whether it was a valid concern or simply the same sort of click-bait headline hysteria that I've criticized other sites for posting.
After thinking it through, I"ve decided to go ahead and post a modified version with a bit of additional context and a less panicky headline. Think of it as more of a legal thinking exercise than anything else...but at this point, anything is conceivable.
For months now, I and many others have been sounding the warning bells re. the absurd King v. Burwell ACA case, currently awaiting a decision by the Supreme Court.
Tuesday Short Cuts: LIGHTNING ROUND! 16 stories you may have missed.
Read more about Tuesday Short Cuts: LIGHTNING ROUND! 16 stories you may have missed.
MNsure survived the legislative sessionwithout major changes. Some Republicans wanted to scrap the state's health insurance exchange altogether and some Democrats wanted to make it a state agency.
By some accounts, MNsure's performance has greatly improved since it's rocky 2013 roll out.
MNsure CEO Scott Leitz is leaving his position to work for a health care think tank. He took over the program after its first executive director resigned under fire.
The state Senate overwhelmingly adopted major health care changes Thursday in a bipartisan vote that reins in some facility fees, looks to development of a health information exchange to guarantee the sharing of patient data and aims to keep private physician practices in business.
A new healthcare reform debate may be on the horizon. Democrats refer to the issue at hand as the nation's "underinsured" population, reported the Associated Press.
Hey, guess what finally passed 12.5 million??
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).
Read more about Hey, guess what finally passed 12.5 million??
...The answer, from interviews with more than two dozen Democrats and Republicans involved in writing the law, is that the words were a product of shifting politics and a sloppy merging of different versions. Some described the words as “inadvertent,” “inartful” or “a drafting error.” But none supported the contention of the plaintiffs, who are from Virginia.
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.
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.
1. Is the "average" weighted by company?
2. Is the "average" weighted by plan/metal level?
3. What's the actual old/new pricing?
4. Have the rates been approved yet?
5. Does the rate change reflect how many people switched policies and/or companies?
Number 4 is easy: NO. None of the requested rate changes that you're seeing flying around right now (and will continue to for the next few weeks) have been approved yet. This could dramatically change some of the final rates.
As I’ve noted before, Republicans may try to pass a temporary patch for the subsidies, packaged with something like the repeal of the individual mandate, in hopes of drawing a presidential veto — so Republicans can then try to blame Obama for failing to fix the problem.
Bear in mind that "shopping around" doesn't necessarily mean that you switch policies, it just means that you at least looked around to see what was available.
The whole theory behind the "invisible hand of the free market = lower prices for all" mindset is that competition allows the consumer to shop around and compare pricing and other factors. However, the "competition = lower prices" theory only works if the customers actually do shop around. This year only 30% did, which is either unimpressive or impressive depending on your perspective.
Read more about King v. Burwell: Jeffrey Toobin may or may not be correct about his larger point, but he sure got one fact wrong.
Thanks to Politico reporter Burgess Everett for the heads up.
California: Holy Smokes! CA's total number may not impress, but have they managed a 95% payment rate this year??
Add them together and you get 1,529,224 total QHP selections to date (well, as of 5/10, anyway).
On the surface, aside from the extra 10K for #ACATaxTime, that doesn't sound too interesting...I already had CA down with 1,503,200 QHPs, so this is just 26,024 higher. Big deal, right?
Read more about California: Holy Smokes! CA's total number may not impress, but have they managed a 95% payment rate this year??
Kaiser Family Foundation releases a mountain of 2015 ACA data.
Holy smokes. The Kaiser Family Foundation, without which running this site would be much harder, has released their 2nd annual (I assume it'll be done every year) Survey of Non-Group Health Insurance Enrollees.
The survey, conducted February 18 – April 5, 2015, after the close of the second open enrollment period, includes individuals who purchased ACA-compliant coverage inside or outside of a Marketplace, as well as those who are currently enrolled in “non-ACA compliant” plans.
These are really important points to keep in mind when looking at their findings. It does include off-exchange enrollments, whether ACA-compliant or not (and in fact those distinctions are the focus of some of KFF's findings).
Read more about Kaiser Family Foundation releases a mountain of 2015 ACA data.
Updated: I don't want to hear one more "Obamacare is 2,000 pages long!!" attack. EVER.
Throughout the long, tortured life of the Affordable Care Act over the past 5+ years, one of the easiest attack points has been to go after the sheer bulk and complexity of the law itself. Whether you're referring to the actual wording of the law (supposedly a whopping 2,700 pages long) or, even worse, the 8-foot tall stack of 10,000 - 20,000 pages of regulations related to "Obamacare", Republican politicians, pundits and talk show hosts have used the immense size of the ACA itself to go after it.
I'm bringing this up now because my big project the past week or two has been to track down the various 2016 policy premium rate change requests for the companies operating both on and off the ACA exchanges in all 50 states (+DC, of course).
So far I've done a pretty good job with OR, WA, CT, MI, DC and VT...and I have partial data for MD & IA.
Read more about Updated: I don't want to hear one more "Obamacare is 2,000 pages long!!" attack. EVER.
This July, up to 14 million people could be in Luis Lang's shoes...even if they did the right thing.
But there’s another potential twist to the tale: Just as he is now seeking to get on Obamacare, he could very well find himself unable to sign up for coverage, if the Supreme Court rules for the challengers in King v. Burwell next month.
...an HHS official tells me that if he can get his income up a bit — it reportedly fluctuates — he could probably qualify for a category that would allow him to apply for Obamacare again before next year’s open enrollment period.
But if the Court strikes subsidies in three dozen states on the federal exchange — one of which includes South Carolina — it could put Obamacare even further out of reach for Lang.
Read more about This July, up to 14 million people could be in Luis Lang's shoes...even if they did the right thing.
Remember this tweet 5 weeks from now.
The Supreme Court is expected to issue their ruling in the King v. Burwell case around the end of June, 2015.
.@FamiliesUSA briefing: Health insurers can submit revised rates over summer if #KingvBurwell case blows up subsidies.
Of course, if the Supreme Court decides to blow up the entire system with an adverse King v. Burwell decision, all bets are off, as none of the “requested” rate changes will have any meaning whatsoever in the 34 states without their own exchange.
...In short, if the King plaintiffs win, prepare for one heck of a mess next year.
Read more about Remember this tweet 5 weeks from now.
10% of the country is now enrolled in ACA-enabled healthcare coverage.
Yesterday I noted that a seemingly minor announcement (HHS tweeting that the final #ACATaxTime tally for the federal exchange from 3/15 - 4/30 ended up being 147,000 people) had a greater significance than that, because tacking that onto the grand national total brought the official tally up to the 12 million milestone.
Personally, this didn't mean much to me because I estimate that the actual total (including unreported numbers from various exchanges) is more like 12.4 million or higher anyway...and on the flip side, the number of people actually paid up with effectuated enrollments is more like 10.1 million, and has been for a month or so now. Still, officially hitting the 12 million mark seemed worth noting, so I did so.
Read more about 10% of the country is now enrolled in ACA-enabled healthcare coverage.
I wish sincere good luck to Mr. Lang; he's going to need it.
Read more about I wish sincere good luck to Mr. Lang; he's going to need it.
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 Daily Kos 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?
Thanks to Margot Sanger-Katz for the heads up.
From March 15 to April 30, 147,000 consumers signed up for coverage through http://t.co/eTfU7hSMWR using the tax special enrollment period.
No splashy press release, charts or graphs; just a simple number. In the end, while it was far lower than my original spitball take (600K+), it was also higher than my revised estimate of 135K - 140K.
That precise 64,000 QHP number is up 2,126 since April 13, while Medicaid and MinnesotaCare are (combined) up a whopping 34,538 people, which is pretty impressive.
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!
Maryland's rate request website is an exercise in frustration. At first glance, it looks very cut and dried: A full table of each health insurance company, broken out by either individual or small group market, whether the filing is for policies sold on or off the ACA exchange, and the "average % change requested", along with direct links to the actual filing documents (where, presumably, I can dig up the crucial enrollment numbers, which are vital to determining the weighted average rate requests).
Unfortunately, once you get into the actual documents...they're completely scattershot. Some companies list the number of enrollees who would be impacted by the requested rate changes; some don't. That makes it impossible to determine the market share, which in turn means there's no way of weighting the average.
Blue Cross Blue Shield of VT is requesting avg. 8.38% increase for 31,147 individual exchange enrollees and 35,903 small business (small group) enrollees.
As you can see, about 1.6% of enrollees would see an increase of 5% or less, while 32% would see a 10-15% increase, with the remaining 66% between 5-10%.
The 2016 Rate Request Train continues to chug along; in addition to Oregon, Washington State, Connecticut and Michigan, I can now add the District of Columbia to the list.
The first thing to note about the DC market is that one of only two (the other is Vermont) in which all individual and small group enrollments are done through the ACA exchange; no off-exchange enrollees here. That makes things a bit simpler.
Which Mystery States have dropped their exchanges when I wasn't looking?
I was poring over a bunch of ACA-related stories last night, many of which have to do with last week's announcement that the Hawaii ACA exchange is very close to having to shut down in 2016 just as both Oregon's and Nevada's already did in 2015.
Don't get me wrong, there's no putting a positive spin on this development (other than to say that it's not a done deal; HI Gov. Ige is still negotiating with the Federal government and a way to save the exchange may come through at the last minute). However, one curious thing jumped out at me in not one, but two different stories about the Hawaii exchange.
Hawaii’s move to the federal exchange would leave only 13 states with state-based marketplaces. Already, about a half-dozen states, including Oregon and Nevada, have had to scrap their exchanges and move to the federal system because of funding and technological issues.
Read more about Which Mystery States have dropped their exchanges when I wasn't looking?
Pro tip: When you invite 200 people to your wedding, don't be surprised when 200 people show up.
Over at Politico this morning, Rachana Pradhan has an excellent article about the real-world impact of the ACA's Medicaid enrollment expansion program on, well, the expansion of Medicaid enrollment. The gist of it is that, as I've been noting for months now, additional enrollment in the Medicaid and/or CHIP programs have far exceeded "expectations" to date, with a net increase of over 12.6 million people since the ACA was passed into law (over 11.7 million of which has happened since the expansion provision officially went into effect a year and a half ago).
Read more about Pro tip: When you invite 200 people to your wedding, don't be surprised when 200 people show up.
Lawmakers and the governor reached a deal to pass a health care package that, as one senator put it, will “keep the lights on” for health care reform.
The package contains $3.2 million in new state health care spending, which is eligible for roughly another $3 million in federal match. The money will be used to level-fund exchange subsidies for out-of-pocket costs, target increases to Medicaid rates and invest in initiatives to strengthen the primary care system.
UPDATE 5/19/15: SEE IMPORTANT UPDATE TO THE LUIS LANG SAGA!!
I know I said I was done writing about Luis Lang, the guy in South Carolina who's going blind and is uninsured due to a combination of his own decisions and the SC administration. However, my colleague Harold Pollack over at healthinsurance.org just posted a lengthy interview with the guy to get his take on things. Since I'm one of those who tore him to shreds, it behooves me to let him say his piece.
UPDATED: Off-Topic: "Attorney Chad" is about to have a really bad weekend.
NOTE: READ THIS IMPORTANT UPDATE.
Read more about UPDATED: Off-Topic: "Attorney Chad" is about to have a really bad weekend.
Hey, remember this Nontroversy from 2012?
For a few hours yesterday, the top link on the Drudge Report led to a YouTube video in which an Ohio woman said she's going to vote for President Obama because he gave her a phone. The woman is inarticulate and she speaks loudly, and on top of those things she's black. Basically, she is exactly the kind of person many on the right envision—wrongly, it should be said—when they think of who is guzzling from the government teat these days. That she was bragging about Obama giving "every minority in Cleveland" luxuries like cell phones was just the icing on the cake.
A couple of weeks ago I posted an entry about the latest quarterly Gallup poll results, which show that the uninsured rate among U.S. adults has continued to drop, and stood at just 11.9% as of the end of March.
But more than half of the adults who bought such plans had deductibles of $1,500 or more, Families USA, a Washington nonprofit organization focused on health care, found. Adeductible is the cumulative amount a person has to spend on health care before his or her insurance company starts to pay. Despite receiving tax credits to help offset the cost of coverage, these deductibles were prohibitively expensive.
In addition, NJ FamilyCare – the state’s primary Medicaid coverage program -- has added 463,463 residents to its rolls since December 2013, including 42,947 in April.
The fact that 9% of the net increase happend 16 months after the Medicaid expansion provision started is surprising to me, consideirng that according to the Kaiser Family Foundation, only around 390,000 uninsured NJ residents were even eligible for the program as of last fall to begin with. In other states, like Michigan, things have pretty much plateaued as every eligible resident has pretty much been enrolled already.
In a unanimous vote, the Legislature’s Insurance and Financial Services Committee endorsed the effort to maintain the health insurance premium subsidies that are offered as tax credits through the Affordable Care Act. Those credits are being challenged in a federal lawsuit known as King v. Burwell, which the U.S. Supreme Court is expected to decide next month.
After using most of $1 billion in federal start-up money, California's Obamacare exchange is preparing to go on a diet.
That financial reality is reflected in Covered California's proposed budget, released Wednesday, as well as a reduced forecast calling for 2016 enrollment of fewer than 1.5 million people.
The recalibration comes after tepid enrollment growth for California during the second year of the Affordable Care Act. The state ended open enrollment in February with 1.4 million people signed up, far short of its goal of 1.7 million.
A number of factors contributed to the shortfall, but health policy experts said that some uninsured folks still find health insurance unaffordable despite the health law's premium subsidies.
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.
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.
(ok, not much of an article here, I mainly linked to it as an excuse to jot down a note: The exchange market share breakout in Wyoming is roughly 9,500 via WINHealth & 10,500 via BCBSWY).
The Connect for Health Colorado staff has recommended more than doubling the fee that insurers pay on each policy purchased on the exchange — a charge that is passed on to consumers.
The state marketplace would increase the carrier fee from 1.4 percent to at least 3.5 percent of the premium charged on exchange health plans — the same rate charged through the federal exchange, under the recommendation made Monday.
For a consumer holding a $4,000-a-year health plan, the increase would be $84 a year. The estimated increase in revenue for the exchange would be about $5.8 million.
So, this morning I posted a story about one Luis Lang and his wife, the ever-so-lovely Mary Lang, who are in quite a bind down in South Carolina.
UPDATED x3: See man hate Obamacare. See man refuse to get Obamacare. See man whine that he can't get Obamacare when he needs it.
Yeah, that's right, I'll say it: Luis Lang is a hypocrite.
Over at Talking Points Memo, Josh Marshall has a story about a guy in South Carolina named Luis Lang who's in a nasty situation due to a combination of bad timing, Republican cold-heartedness and, to be blunt, his own stupidity.
As the Charlotte Observer explains, Lang is a self-employed handyman who works as a contractor with banks and the federal government to maintain foreclosed properties. He was making a decent living, enough to be the sole breadwinner in the family. As the Observer puts it, Lang "he has never bought insurance. Instead, he says, he prided himself on paying his own medical bills."
Read more about UPDATED x3: See man hate Obamacare. See man refuse to get Obamacare. See man whine that he can't get Obamacare when he needs it.
There's good news and bad news out of Iowa tonight. For 2015, there were originally only 2 insurance companies to choose from on Healthcare.gov: Coventry and CoOportunity. Unfortunately, the latter of these went belly-up for a variety of reasons, leaving Coventry the sole provider available on the exchange.
Moderate-income Iowans who want to use Affordable Care Act subsidies to purchase health insurance will still not be able to choose policies from Wellmark Blue Cross & Blue Shield next year, but they should be offered policies from at least two competitors.
Oh, wait; that's a scarlet "S".
But instead of Hester Prynne’s infamous “A,” insurance cards for Texans with coverage under the federal Affordable Care Act would bear the letter “S,” for subsidy.
Supporters of House Bill 1514 by state Rep. J.D. Sheffield, R-Gatesville, say it’s necessary to standardize insurance cards and clarify the type of health coverage a patient has.
Needless to say, I'm appalled.
Joan McCarter over at Daily Kos has already given a proper takedown of this utterly unnecessary & shameful bill.
Hawaii: (sigh) HI Health Connector about to bite the dust??
For months now, the ACA state exchanges in small states like Rhode Island, Vermont and Hawaii have been struggling mightily with either funding issues (RI) or both funding and technical problems (VT & HI). Most of my own focus has been on the 2 northeastern states.
May 09--The Hawaii Health Connector has prepared a contingency plan to shut down operations by Sept. 30 after lawmakers failed to pass legislation to keep the state's troubled Obamacare insurance exchange afloat.
Read more about Hawaii: (sigh) HI Health Connector about to bite the dust??
The looming case of King v. Burwell threatens subsidies that help 7.5 million people* afford health coverage in the roughly three dozen states using the Affordable Care Act’s federally run marketplace.
*(Note: As I've stated repeatedly, the actual number who would lose tax subsidies is "only" about 6.5 million, but the number who would lose their insurance as a result is likely a couple million more, plus another 4-5 million who'd pay through the nose to keep their coverage).
The Associated Press-GfK poll released Monday finds 56 percent wants the justices to rule to continue the subsidies, while 39 percent wants them invalidated for the federally run marketplaces.
In the latest update to The Graph, in addition to simply updating both the currently confirmed and estimated exchange-based QHP totals, I've also made one significant addition: The estimated number of HC.gov-based enrollees who are currently receiving federal tax credits from the IRS, and how many of those I expect to lose those credits in the event that the Supreme Court rules for the plaintiffs in the King v. Burwell case.
The total numbers nationally are notable mainly because of the milestones which have now been passed: Over 11.9 million QHP selections have been confirmed as of today, and I estimate that the actual total should have passed the 12.4 million mark by now. I now expect to hit my official "Open Enrollment Period" QHP selection target of 12.5 million in another couple of weeks (hey, look at that!--I was right after all, just early by...um....3 months...ok, never mind...).
Colorado just released an updated enrollment report bringing things all the way up through April 30th...and as always, CO's report is both extremely comprehensive and extremely confusing at the same time.
King v. Burwell: Bagley echoes my point last summer w/real legal opinion again, & is June 29th "K-Day"?
A week or so ago, U of Michigan assistant law professor Nicholas Bagley and his associate, Boston U. public health asst. professor David K. Jones) posted a lengthy, comprehensive analysis of potential post-King v. Burwell options for the HHS Dept. and/or the impacted states in the event that the Supreme Court rules in favor of the plaintiffs. As I noted at the time, several of their points were very close to my own last July...except that I was just shooting off at the mouth, whereas they actually know what they're talking about, legally speaking.
What if HHS declared that any state that performs substantial, ongoing, and essential exchange functions has established an exchange, even if the state never formally elected to do so?
Read more about King v. Burwell: Bagley echoes my point last summer w/real legal opinion again, & is June 29th "K-Day"?
Last year, Connecticut was a perfect example of how the initial requested insurance policy rate changes from the companies involved in a given state can end up changing dramatically after the approval process (and in CT's case, change even more when the actual Open Enrollment period actually arrives). The original requested average increas in CT was 12.8%, but the approved changes ended up only being around 4.5%...and in the end they were far lower: Less than a 1% overall weighted average increase!
Four major health care providers that offer plans on Connecticut's health insurance marketplace have filed for rate increases for the upcoming open enrollment period that begins Nov. 1, 2015.
...The following increases have been proposed: 2 percent for ConnectiCare, 6.7 percent for Anthem, 12.4 percent for United Healthcare and 13.96 percent for Healthy CT.
Thanks to Rebecca Stob for the heads up.
On the one hand, Washington State, like Oregon, has a nifty, easy-to-use web-based searchable database for their 2016 rate request filings, yay!
On the other hand, when you get into the details, some of it can be pretty confusing stuff. In 2014, there were 8 companies approved for the WA exchange. For 2015, there were 10 companies, plus 2 more which didn't make the cut. For 2016, a total of 17 companies/subsidiaries have requested approval to sell on the individual market. There's no guarantee that all 17 will be approved to sell in the state, but I'm assuming they all will be for the time being.
There's actually 18 listings, however, because Lifewise split their policies into two entries...one of which is "grandfathered" policies only, and is therefore not relevant for the table below...although this does answer the question "how many people are sill enrolled in Grandfathered policies in Washington State?" The answer appears to be just 15,677 people...out of 343,348 total in the individual market, or only 4.5% of the total.
Shortly after my not (semi) successful campaign to shame Michigan State Senator Patrick Colbeck and the Detroit News into correcting the record in his absurdly off-base Op-Ed piece a couple of weeks ago, the News decided to run a response Op-Ed, submitted by Marge Robinson, the president of SEIU Healthcare Michigan.
They said no one wanted it.
They said it would destroy the economy.
They said it would create chaos in the healthcare industry and cause masses of people to lose their insurance.
They said no one would sign up for it; especially healthy and young people.
They even said it would lead to “death panels” deciding who will live or die under Obamacare.
Good News!! FL Senate pushing for Obamacare Health Exchange Website...with a catch.
It would be for Medicaid expansion only.
Just as House lawmakers were putting together their annual “trains” — cramming multiple, tangentially related bills into hundreds of pages of amendments so they could pass them all at the 11th hour — a funny thing happened. They upped and quit.
On April 27, House Speaker Steve Crisafulli prematurely banged his gavel, ending the session, leaving the Senate holding the bag on this year’s biggest, most contentious issue: Medicaid expansion under the Affordable Care Act. Now a group of Senate Democrats has sued the GOP-dominated House, and as of this writing, the Florida Supreme Court says the lower chamber must explain its abrupt adjournment.
Read more about Good News!! FL Senate pushing for Obamacare Health Exchange Website...with a catch.
Insurance coverage has increased across all types of insurance since the major provisions of the federal Affordable Care Act took effect, with a total of 16.9 million people becoming newly enrolled through February 2015, according to a new RAND Corporation study.
Researchers estimate that from September 2013 to February 2015, 22.8 million Americans became newly insured and 5.9 million lost coverage, for a net of 16.9 million newly insured Americans.
Among those newly gaining coverage, 9.6 million people enrolled in employer-sponsored health plans, followed by Medicaid (6.5 million), the individual marketplaces (4.1 million), nonmarketplace individual plans (1.2 million) and other insurance sources (1.5 million).
...it could actually be several hundred dollars lower.
A week ago I posted a story in which I busted Michigan State Senator Patrick Colbeck for blatantly spewing nonsense numbers about the ACA in an Op-Ed in the Detroit News.
Yesterday, my follow-up story, about the Detroit News allowing Colbeck to go back in and correct some (but not all) of his insanely false factual garbage a solid 10 days later (while failing to give any indication about just how absurdly wrong he had been in the first place) went viral, generating more visitors than any other story I've posted in months.
After an all-day saga, the end result was that the Detroit News finally posted a "correction" notice...except they did so in such a disingenous way (and so long after the original editorial was publshed) as to be nearly meaningless.
I actually missed this report a few days ago, partially because I thought the February report had already been released a few weeks back; it turns out I was thinking of January's.
For January I overshot the mark a bit, but for February my projections were pretty much bang-on target, with an net incrase of 12.65 million Medicaid/CHIP enrollees to date thanks to the ACA. But wait, you're saying: The report says the net gain is only 11.7 million!
Hartford, Conn. (May 5, 2015) – Access Health CT (AHCT) today announced that they enrolled 1,429 Connecticut residents during the Special Open Enrollment Period which began April 1, 2015 and ended April 30, 2015. The special enrollment period was open to individuals who did not have health care coverage in 2014 and were subject to a penalty on their 2014 federal taxes.
It's important to bear in mind that this number specifically does not include "normal" off-season QHP enrollees via marriage, birth, job loss and so forth.
1,429 over 30 days = about 48 per day. My final estimate of 3,000/day nationally would scale down to just 28/day for Connecticut specifically based on their Open Enrollment Period percentage, so this is actually pretty good.
Just over 1 year ago I posted a long, rambling entry which boiled down to: A bunch of thank-yous to those who helped get me through Year One; a reminder that I never intended this project to continue past the 2014 Open Enrollment period; and a committment to keeping the site, blog, graph and spreadsheets cranking along through Year Two as well.
Now that we're past the official 2015 Open Enrollment period (#OE2), the "In Line by Midnight" overtime period (#ACAOvertime and the Tax Filing Season Special Enrollment Period (#ACATaxTime), it's time for me to finally let folks know what my plans are for the site for Year Three.
UPDATED x2: Well this doesn't sound good..."S&P sees PPACA risk corridors program funding gap"
Analysts at Standard & Poor's Ratings Services say the effects of funding restrictions on the Patient Protection and Affordable Care Act (PPACA) risk corridors program may cause the program to hurt small and midsize health insurers.
Drafters of PPACA created the risk corridors program in an effort to make selling health insurance under PPACA rules less risky, by using cash from health insurers with good underwriting results for 2014, 2015 and 2016 to help insurers that get poor results for those years.
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Stinson, 50, has become an indispensable source for researchers and reporters looking into alleged crimes and acts of violence by police officers because he has built a database tracking thousands of incidents in which officers were arrested since 2005. His data has shown that even the few police officers who are arrested for drunken driving are rarely convictedand that arrests spike for cops who have been on the force 18 years or longer, contrary to prior research showing it was mostly new officers who were acting out.
Sunday Short Cuts: LIGHTNING ROUND!
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So, the good news is that new Democratic Pennsylvania Governor Tom Wolf, who has already scrapped his predecessor's unnecessarily confusing "alternative" Medicaid expansion plan in favor of regular expansion, has officially submitted a latter to the HHS Dept. stating that yes, if the Supreme Court does rule against the government in the King v. Burwell case, PA will indeed establish their own ACA healthcare exchange.
HARRISBURG, Pa. (AP) - Gov. Tom Wolf's administration advanced plans Friday to maintain federal health insurance subsidies for nearly 400,000 Pennsylvanians ahead of a U.S. Supreme Court decision that could wipe out the aid to insurance buyers in some states.
The Democrat wrote to U.S. Health and Human Services Secretary Sylvia Burwell to declare his administration's intent to take over operation of the insurance marketplace in 2016. The federal government currently operates the marketplace, which is a prominent feature of the 2010 federal health care law designed to extend insurance coverage to 35 million Americans.
With this morning's release of updated enrollment data from the Maryland Health Connection, confirmed 2015 QHP selections via the ACA exchanges have now officially broken the 11.9 million mark, with a minimum of 11,904,402 QHP selections having been reported by the various exchanges nationally.
However, there's still no enrollment data since late February for about 10 states, and only fractional data for the other 40. Based on my best estimates, the actual total QHP selections to date should be slightly over 12.3 million as of yesterday (click image below for the full-size version).
As for the tax filing season Special Enrollment Period specifically, there have been over 110,500 confirmed enrollments to date (68,000 via Healthcare.Gov, 33,000 in California, around 4,800 in Washington State and over 4,700 in Maryland). My best estimate is that #ACATaxTime QHPs will end up being roughly 140,000 in the end.
This is all I have to contribute to the Freddie Gray discussion.
Thanks to Ms. Brown for the tweet.
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At first Ford had formed a theory to account for this strange behaviour. If human beings don’t keep exercising their lips, he thought, their mouths probably seize up.
Sarah Ferris at The Hill has a story this morning about the Republican Party's "list of demands" in the event that the Supreme Court rules against the federal government in the King v. Burwell case.
But, in the event the justices rule against ObamaCare, Democrats will offer a simpler solution — passing a bill to fix the few sentences of the statute that are under scrutiny.
“The president can say, here’s our one-page bill,” Louisiana Gov. Bobby Jindal (R), who opposes the current congressional strategy, told a D.C. audience on Thursday.

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