Thursday Short Cuts

• Hawaii works on waiver to preserve state's Prepaid Health Care Act

A state task force is developing a waiver request that would protect Hawaii’s employer-based health coverage law amidst other Affordable Care Act plans to be offered under the federal platform, the executive administration has confirmed.

...One concern is that employers could opt for cheaper federal plans in lieu of the state plans already in place.

Hawaii’s 41-year-old Prepaid Health Care Act requires employers to offer workers robust health insurance plans. Under the prepaid health care law, the Affordable Care Act’s bronze and silver plans are technically not legal in Hawaii.

• INDIANA: Some insurers plan to lower Obamacare premiums

Four of the nine health insurers selling Obamacare plans in Indiana are expecting to cut their average rates next year, according to filings with the Indiana Department of Insurance.

The largest seller of Indiana plans on the federal marketplace — health insurance giant Anthem of Indianapolis — is seeking a small rate increase, 3.8 percent.

Attention focused this month on insurance companies around the country that are seeking double-digit increases in premiums — and two that sell plans in Indiana through HealthCare.gov are proposing to do that.

But four companies are cutting average rates.

• KENTUCKY: Governor candidate says he will end all Obamacare programs

Matt Bevin, the Republican nominee for governor, has made clear that if elected he would end the Medicaid expansion that has provided free health coverage for more than 400,000 poor Kentuckians.

During his primary campaign, Bevin never made that quite plain, saying he would close the state’s health-insurance exchange, Kynect, because it would cost “hundreds of millions of dollars.” Kynect is paid for by insurance companies, so Bevin was alluding to to the state’s projected cost of expanding Medicaid, which enrolls through Kynect.

• SOUTH DAKOTA: Court ruling on 'Obamacare' subsidies could be disastrous for S.D.

I am very concerned about the impact such a court ruling would have on South Dakotans. It would be the latest disruption caused by the rocky implementation of this flawed law. Because South Dakota happens to be a state that uses the federal insurance exchange, rather than a state exchange, our consumers would no longer be eligible for insurance subsidies. At lower-income levels consumers may pay as little as two percent of income, with subsidies covering the balance of the premiums. Removing these subsidies would lead to skyrocketing insurance costs and an unsustainable system.

This Op-Ed is noteworthy mainly because of who wrote it: The Republican Governor of the state. While he obviously tries to pin the blame on the "flawed law" itself and calls for President Obama to "compromise" with the GOP Congress, it's actually a pretty rationally worded piece. He lays out the background, the present situation and the potential damage in a pretty clear-cut, no-nonsense fashion, including an explanation/defense of why his adminstration decided not to set up their own exchange in the first place.

Aside from trying to pin the responsibility for resolving the issue on President Obama, the only other part which bothers me is the section where he claims that SD would have to set up a full exchange, including their own separate website (for $45 million or more), as opposed to taking the more rational route that Pennsylvania and Delaware just did last week: "Establishing" an exchange legally in name only but offloading the actual technical/website side to Healthcare.Gov as Oregon, Nevada and New Mexico have done.

Anyway, it's interesting to see a GOP Governor give a detailed take on the situation, as opposed to a quick "we'll wait & see" soundbite.