Anyway, while there's a mountain of legalese to wade through here, the first one which leaps out at me is the one relating to the public Rate Review policy.
Yeah, I know it's extremely short notice, but if anyone happens to spend a half hour listening to me drone on about the whole Single Payer kerfuffle, feel free to tune into Netroots Radio tomorrow morning (Monday, Feb. 29th) at 8:00am EST, where I'm being interviewed by "Hopping Mad with Will McLeod and Arliss Bunny":
And then there are the portions of the law which have gone, well, not so great, to put it mildly...in particular the non-profit, public/private hybrid Co-Ops, which are the only remaining remnant of the originally much-hoped-for "Public Option". For a variety of reasons, not the least of which was an utterly unnecessary and ultimately pointless stunt pulled by Marco Rubio and other Congressional Republicans (aka the Risk Corridor Massacre), over half of the two dozen Co-Ops nationwide melted down in spectacular fashion last fall, leaving only 11 of them surviving into 2016 after the dust settled.
In light of this, I figured it would be worth posting some positive Co-Op news for a change. First up, Ohio.
On September 26, 2013, just 5 days before the disastrous initial launch of HealthCare.Gov (as well as ugly rollouts of many of the state-based exchanges), President Obama gave a speech pumping up the impending start of the first Open Enrollment Period at Prince Geroge's Community College.
At one point in the speech, he touted how easy and handy the website would be to use:
Starting on Tuesday, every American can visit HealthCare.gov to find out what’s called the insurance marketplace for your state. Here in Maryland, I actually think it's called MarylandHealthConnection.gov. (Applause.) MarylandHealthConnection.gov. But if you go to HealthCare.gov, you can look and they'll tell you where to go. They'll link to your state.
Now, this is real simple. It’s a website where you can compare and purchase affordable health insurance plans, side-by-side, the same way you shop for a plane ticket on Kayak -- (laughter) -- same way you shop for a TV on Amazon. You just go on and you start looking, and here are all the options.
Well, there's two more rather interesting developments to the Risk Corridor mess.
...This fall, more than a dozen health insurers representing 800,000 people have dropped out of the ObamaCare exchanges, many out of fear that the administration no longer has the cash to cushion their losses in the costly early years of the marketplace.
In 2014, Open Enrollment officially ended on March 31st, but they allowed a 2-week "overtime" period for people who had started the process before the end of March but weren't able to complete it. The true deadline ended up being April 15th, although the official, final ASPE report ended up tacking on 4 more days (thru April 19th) for whatever reason. The final report was released 12 days later, on May 1st, 2014.
Last year, Open Enrollment officially ended on February 15th, but they tacked on a one-week "overtime" period, so the true deadline ended up being February 22nd. The official, final ASPE report was released 16 days later, on March 10th, 2015.
This year, Open Enrollment officially ended on January 31st, although the final Weekly Snapshot Report for the federal exchange tacked on 1 extra day (February 1st), so I assume that will be included. That means it's been 24 days so far, and the ASPE report hasn't been released as of yet...
To the best of my knowledge, the entire U.S. individual health insurance market should be roughly 19 million people this year. Of that, around 12 million are, of course, ACA exchange-based (I'm lopping off 700K to account for those who didn't pay their first premium, dropped out after the first month or otherwise aren't actually enrolled at the moment).
The other 7-8 million or so are off-exchange...people who enrolled directly through their insurance carrier, bypassing the ACA exchanges. Since off-exchange enrollees don't qualify for federal tax credits, the vast majority of these folks (a good 95% or more, I'd imagine) earn too much to receive them (officially over 400% of the Federal Poverty Line; realistically, some are in the 300-400% FPL range). The rest of them are presumably either undocumented immigrants, people who still don't know about the tax credits via the exchanges, or weren't able to find an exchange-based policy which they were satisfied with, even with the tax credits.
However, even then there are 4 different types of off-exchange policies:
*(OK, not really; I'm not the only one who was suggesting this, but it some people really do seem to think that I have dictatorial control over CMS...)
I guess the question here is just how much verification the HHS Dept. and/or the assorted state-based exchanges are doing of these claims. In cases like getting married/divorced, giving birth, becoming a citizen or getting out of jail, I would imagine the verification should be pretty easy. However, the "Tax Penalty Ignorance" exception was pretty much based on an honors system, and I don't know how easy/difficult it is for the feds to "verify" that your income has increased/decreased substantially...at least, not until you file your taxes the following year, which could be up to a year after the claim is made.
...So, what's the solution to this, assuming the problem is widespread? Well, I can think of some obvious tweaks to the rules, almost all of which involve simply reducing grace periods:
5. It can be kept and substantially improved, which is what Hillary Clinton is now proposing.
6. It can be kept and substantially improved, while also laying the groundwork for a series of gradual, longer term steps towards universal, comprehensive single payer (or similar) plan, which is what I'm proposing ("longer term" defined as 10-20 years, possibly longer).
7. It can be kept in place for now (along with Medicare, Medicaid, employer-sponsored insurance, the VA/TriCare, etc.) but replaced in the short term ("short term" defined as "within the next 5 years"), which is what Bernie Sanders is proposing.
8. It (along with Medicare, Medicaid, employer-sponsored insurance, the VA/TriCare, etc.) can be immediately replaced on January 20, 2017, which is what some Hillary supporters are trying to claim that Bernie Sanders is proposing, but which he isn't.
INDIVIDUAL AND FAMILY ENROLLMENT • As of February 20, 2016:
36,004 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.
The majority of these individuals are 2015 HSRI enrollees that were auto-renewed into a 2016 plan.
8,657 of the 36,004 individuals have selected a plan for 2016 coverage, and are new to HSRI this year or returning after being enrolled with HSRI at some point during a prior year.
33,920* of the 36,004 individuals are enrolled in 2016 coverage through HSRI, and have paid their first month’s premium.
*The number of paid enrollments is expected to increase as payments for March coverage are made by today’s deadline and processed over the next several days.
Actually, two of the data points (private QHPs and BHP enrollment) aren't very different from what I already knew. However, there's some interesting news on the Medicaid & Child Health Plus side:
Rate of Uninsured Drops to Lowest Level in Decades
ALBANY, N.Y. (February 23, 2016) - NY State of Health, the state’s official health plan Marketplace, today announced more than 2.8 million people have signed up for health insurance as of January 31, 2016, the end of the 2016 open enrollment period. Since the Marketplace opened in 2013, the number of uninsured New Yorkers has declined by nearly 850,000. According to recently released data by the Centers for Disease Control and Prevention, the rate of uninsured declined from 10 percent to 5 percent between 2013 and September 2015 and is at its lowest level in decades.
As I've noted before, one of the biggest hurdles to overcome when considering moving to Single Payer healthcare is that at least a half a million people currently work directly for health insurance carriers, plus (I'm guessing) another couple million in directly related services. While I do support moving to SP eventually, any plan which replaces the current private insurance industry would have to also take into account what would happen to those people.
Clinton revives support for health care 'public option'
Hillary Clinton wants to bring back the public option, offering a competing vision to Bernie Sanders’ support for a more progressive health care system.
Clinton's campaign has updated its website to note her continued support for the government-run health plan that was dropped from Obamacare during the law's drafting. The idea was popular among progressives who prefer a single-payer plan -- like the one Bernie Sanders is touting.
...A new version of Clinton’s campaign website suggests she won't try to push the public option through Congress, but instead will work with governors using existing flexibility under Obamacare "to empower states to establish a public option choice." That may be a reference to a waiver program taking effect in 2017 that lets states assert greater control over their health care systems.
If she's serious about this, this could be very interesting indeed.
About 8,000 CT exchange customers didn’t pay first bill
About 8,000 people who signed up for coverage through the Connecticut’s health insurance exchange missed the deadline for their first payment and lost coverage, exchange CEO Jim Wadleigh said Monday.
“This number is bigger than we were anticipating,” Wadleigh said. Just over 116,000 people signed up for private insurance through Access Health CT, the state’s exchange, during the open enrollment period that ended Jan. 31. “The fact that all these customers have not made their first payment was kind of a shock to even us.”
As I noted last week, Your Health Idaho has released their final official OE3 number. I had previously noted that there were only 8 states in which the exchanges appeared to have performed worse on private policy enrollment in 2016 than they did in 2015, and that most of those had special circumstances:
So, last year, after getting a chuckle out someone snapping up TedCruz.com and posting a pro-immigration reform message on it, I snapped up a few other variables which Senator Maple Leaf missed, such as TedCrooz.com, TedCruise.com and so forth. I figured I'd get a handful of visits from people misspelling his name, but I also kind of assumed that those people would instantly realize their error, seeing how the moment the site loads, it's pretty obvious that not only is this not Ted Cruz's campaign website, the whole site is the complete opposite of everything Cruz-ish...especially in regards to the Affordable Care Act.
Apparently I was wrong. It never fails to amaze me how utterly oblivious some people supporters are to the websites they're visiting. Check out the most recent missive I received over the weekend:
Every year, at least since the ACA exchanges went into effect, insurers have been required to submit their plans and premium rates for the upcoming year to state or federal regulators months ahead of time, in order to allow time to review, modify and approve rates. Once Open Enrollment begins, it was my understanding that the specifics of the plans offered are supposed to be locked in for the full calendar year. In other words, no bait & switching allowed: If a certain plan was set to cost someone $300/month with a $2,000 deductible, 70% actuarial value, such-and-such co-pays and so forth, they aren't allowed to change those plan specs once the Open Enrollment Period begins, and they're required to stick to those prices and coverage specifics for the full upcoming year.
For months now, several large insurance carriers (especially the biggest of them, UnitedHealthcare) have been griping about losing money hand over fist on the ACA exchanges, and yes, that's probably true (although other carriers are making money, albeit not as many and not as much as the losses).
That's 300 more people who signed up for QHPs in the first 2 weeks of the off-season, plus another 6,500 added to MinnesotaCare and over 17,000 added to Medicaid (both of which are year round).
The QHP number (just 21 per day) is kind of interesting when compared to Rhode Island, which has has averaged 90 additional people per day in the first 2 weeks of February, yet has a population only 1/5th the size of Minnesota's. When adjusted for total population, Rhode Island's off-season rate is over 21x that of Minnesota.
The big difference, of course, is that Minnesota's BHP program (MinnesotaCare) cannibalizes the QHP market tremendously. When you add those 6,500 to the mix, MNsure has averaged 485 per day...or slightly higher than Rhode Island when adjusted for inflation (around 97/day when divided by 5).
... all young people in Flint the chance to receive publicly funded health care services for lead exposure amid the city's contaminated drinking water crisis.
...The White House and federal Department of Health and Human Services did not have an immediate response Tuesday to Snyder's initiative targeting Flint residents up to age 21 through the expansion of Medicaid.
Specifically, the initiative, which is expected to be sent to the Obama administration in the next week, seeks expanding Medicaid eligibility to those affected regardless of income level. The request would also include the expansion of Medicaid coverage for people already enrolled in other forms of insurance.
Covered California held a press call a few minutes ago in which they released detailed enrollment numbers for the 2016 Open Enrollment Period, broken down a number of different ways, including by rate region and individual carrier market share. They even broke the individual numbers out between renewals and new enrollees.
Unfortunately, I only caught half the call, but the full press release should be coming out momentarily which is supposed to have all of the numbers broken out every which way.
Until then, here are some oddball key points from the call:
The final 2016 Open Enrollment Period exchange-based QHP selection numbers have been posted for just about every state for a couple of weeks now...but until today, there were still 3 states with missing data: Idaho, New York and Vermont.
Unfortunately, both NY and VT are still AWOL, but moments ago Idaho scratched itself off the list with the following press release:
Your Health Idaho Reaches Record Enrollment
Idaho has second largest per capita enrollment in the U.S.
BOISE, Idaho – Your Health Idaho today announced that 102,353 Idahoans have enrolled in Qualified Health Plans for 2016 through the state’s health exchange.
Idaho had just over 97,000 QHP selections last year, so this is about a 5% increase. Not fantastic, but not terrible; this puts ID in between Kansas and New Mexico in terms of year over year enrollment increases.
In any event, I can at least plug in one more data point.
OK, that was possibly the worst headline I've ever written.
So, the insurance carriers have been getting the vapors of late because they're absolutely certain that uninsured off-season Special Enrollment Period (SEP) enrollees are gaming the system, taking advantage of the poor multi-billion dollar insurance carriers' hearts by tracking down the list of Qualifying Life Events (QLEs), shoehorning themselves in so that they're eligible for one of them (or simply lying about having one), signing up for coverage during the off-season, racking up gobs of expensive medical procedures and then kicking the policy to the curb without so much as a promise to call them the next day.
I've already discussed this issue ad nauseum, including point/counterpoints with folks like Richard Mayhew of Balloon Juice, Michael Hiltzik of the L.A. Times and Michael "King v. Burwell" Cannon of the CATO Institute.
My takeaway is that yes, people "gaming" the system probably is happening to some extent, but that there are some fairly simple steps which can be taken to prevent this (or at least to reduce it considerably).
Better yet, they're also making sure to include both the gross enrollment and net effectuated enrollment numbers. If every state exchange (and especially HealthCare.Gov, of course) were to do this, I'd be a very happy man indeed. In the meantime, I'll have to settle for RI's regular updates, although extrapolating anything nationally from a single state with just over 1 million people is a bit tricky.
Unintended Consequences: In the social sciences, unintended consequences are outcomes that are not the ones foreseen and intended by a purposeful action. The term was popularised in the twentieth century by American sociologist Robert K. Merton.
When United States Supreme Court Justice Antonin Scalia passed away Saturday evening, the reaction from Republican Senators and right-wing political pundits was instant and consistent: President Obama shouldn't be allowed to nominate anyone to replace him (even though that's precisely and specifically one of the responsibilities of the current President of the United States is supposed to do), and if he does so, the U.S. Senate will refuse to even allow the nominee a hearing, much less confirm them.
It's a series of questions, some of which are yes/no, some are checkboxes and so forth about your situation. I've posted screen shots below (note that some of the info is phony for demo purposes):
As of 2/1, total QHPs are 165,123 (49,377 new + 115,746 renewal-active and passive).
However, this number didn't include a few "overtime" days of enrollees, which padded the number a bit more...nor did it include the subtraction of unpaid QHP enrollees (ie, cancellations/purging of enrollees who didn't pay their January premiums in time, were transferred to Medicaid due to income changes and so forth).
On the one hand, I'm kicking myself for not noticing this red flag when the final 2016 Open Enrollment numbers were released last week. On the other hand, I was trying to absorb, analyze and compile a lot of data at the time, so I should cut myself a bit of slack for missing it.
When the numbers were announced, one figure which seemed surprisingly high was that New York (which still hasn't actually released their final numbers yet) apparently enrolled around 400,000 people in their new ACA-created Basic Health Plan (BHP)...and that 300,000 of these folks had supposedly shifted to the BHP program from existing exchange QHP policies.
This did seem surprisingly high to me; I had assumed that instead of NY's QHP total going up around 25% (as I was expecting in most other states), it would stay essentially flat, with the cannibalization by BHPs essentially cancelling out the 100,000 new QHP enrollees I was expecting. 300K making the move was 3x as many as I was expecting. However, in the flurry of other data to crunch, I let this slip by me.
As of this morning, there were still 4 states with some 2016 Open Enrollment data missing: Idaho, Massachusetts, New York and Vermont. The Massachusetts exchange board held their monthly meeting today, so I can cross one more state off the list:
By early February, approximately 201,000 individuals were enrolled in 2016 health coverage.
Over 36,000 new members are enrolled in QHPs. For a frame of reference, our new members amount to about 15% of the size of last year’s estimated uninsured population*
Of the approximately 27,000 new members who indicated a race or ethnicity in their application, about 12% are of Hispanic, Latino or Spanish origin, 8% are African American and 4% are Chinese
We continue to see a high retention rate for our 2015 membership at about 94%
Individuals who selected a plan between January 24th and January 31st still have time to pay for coverage effective March 1, so new membership tied to Open Enrollment may continue to grow
Once the dust settled on the 2014 and 2015 Open Enrollment periods, only a handful of state exchanges bothered continuing to report off-season exchange enrollments, but I was able to extrapolate those numbers pretty accurately nationwide: Around 7,500 people per day were still signing up via Special Enrollment Periods throughout the summer/fall of 2014, and around 8,500 per day did so last year (not including the time-limited #ACATaxTime SEP from mid-March through the end of April 2015).
This year, that number is expected to drop somewhat due to HHS supposedly cracking down on SEPs in both variety and eligibility verification, but I still wouldn't be surprised if at least, say, 6,000 people per day end up signing up between now and next November (or around 1.6 million total, give or take).
Anyway, even the state exchanges which did keep posting updates generally only did so monthly...which is why I was pleasantly surprised to see that the Rhode Island exchange appears to be sticking to their Weekly Enrollment Report guns even after the dust has settled:
I'm swamped with day job stuff today, but this email just came through:
On the Oriely Factor it was indicated that you propose taking away social security benefits. I paid into ssi from age 13 to age 67. I support your ur champagne with donations and support your conditional approach. Please do not take my earned SSI
It took me a few minutes to figure out how this ended up in my in box, but then I realized: TedCrooz.com
As far as I can tell, this poor soul...
a) Mistook this website for that of Ted Cruz's, even though it's pretty obvious that it has no connection to his campaign whatsoever.
b) Watches The O'Reilly Factor on FOX News (he appears to be in at least his late 60's, so no shocker there)
c) Is (or was, until now) a supporter of Ted Cruz, to the point that he's apparently made financial donations to his campaign.
d) Is now, however, deeply concerned about Ted Cruz taking away his Social Security benefits, which he paid into for 54 years.
At first, I started to chuckle a little at his error and the "champagne" misspelling...but the more I thought about it, this is just plain sad and anger-inducing.
In all, 116,019 Connecticut residents signed up for private insurance through the state’s health insurance exchange, Access Health CT, during the open enrollment period that ended last week, officials said Monday.
That figure is slightly higher than the 110,095 who signed up during last year’s enrollment period and exchange officials’ goal for this year of signing up 105,000 to 115,000.
Connecticut only improved over last year by about 5.4%, but much of that is because, according to the Kaiser Family Foundation, CT only had around 62,000 uninsured people eligible for APTC assistance to begin with (they also have around 100K more uninsured who'd have to pay full price if they enrolled via the exchanges, but those people can get the same policies off-exchange anyway, and many very well might have done just that).
Emails released last week by the State Department that were found on Mrs. Clinton’s private server show that she was keenly interested in the administration’s push to win passage of the health care law.
...The email messages show that throughout the fall of 2009, as the health care push entered a decisive phase, Mrs. Clinton lobbied some members of Congress for votes and even debated sometimes-esoteric policy proposals with aides, some of whom had worked with her in the White House when she was first lady, after her own failed attempt to push a national health care overhaul.
...Congressional officials who worked on the Affordable Care Act said that Mrs. Clinton was an important and effective advocate.
About 316,000 households that got tax credits paid to them in advance but did not file any return at all last year. Before the healthcare law, many low-income people were not required to file taxes. Now they must do so if they got a subsidy. But if taxpayers don't realize it, that can create mix-ups.
Some 976,000 households that got tax credits and filed 2014 returns, but omitted a new form that is the key to accounting for their subsidies. Called Form 8962, it was introduced for the 2015 tax filing season.
About 147,000 households that had requested extensions to file their 2014 taxes, but never followed through.
For the past few weeks, I've been pointing out some of the reasons why a wholesale replacement of the entire U.S. healthcare system with a universal, comprehensive, single payer system in one shot (or even a short-term series of shots) would be absurdly improbable to happen even if Bernie Sanders not only won the Presidency (which, unlike some people, I do think could happen), but also somehow managed to along solidly progressive majorities in both the House and Senate (which, I'm sorry, I just don't). I then took a closer look at the ideas which Hillary Clinton has proposed so far, and found them to be important but mostly minor improvements.
Hmmm...OK, I guess "as of today" means I need to make the "thru date" 2/04/16 instead of 1/31 or 2/01, but whatever; the point is that this is Kentucky's final official total.
Kynect's total was 81,121 as of 12/26, so they only added about 12,500 more since Christmas. 93,687 is only around 75% of the 125K I was expecting, and is over 12,600 fewer private enrollees than they had last year, making them one of only 8 states to drop their open enrollment total.
So...what went wrong? Well, from the HHS Dept's POV, nothing...or at least nothing that they didn't already project last October. They had already openly stated that they didn't expect any dramatic exchange enrollment increases this year, giving a wide open enrollment range of 11.0 - 14.1 million QHP selections...which has a mid-range of 12.6 million.
The better question is how I managed to be off by so much, overestimating (originally) by a whopping 2 million people, Obviously I can't be expected to nail every number, but that would be the least-accurate projection I've had to date (overshooting by 15.7%).
There's still a handful of enrollees left to be added to the state-level numbers (perhaps 60K or so collectively), but it's time to look at the major reasons for the shortfall.
Some of these are well-documented criticisms: Premiums and/or deductibles are simply too damned high for many policies/regions in general. This post is not about price/affordability issues, however; this is about more specific factors.
First, let's take a look at the state-by-state enrollment table, sorted highest to lowest in terms of how well each did vs. my personal projections:
The final numbers (through either 1/31, 2/01 or 2/02 depending on the state) are now in for 44 states plus DC. There are still 6 states which are missing some enrollment data:
Your Health Idaho informs me that their official final OE3 total won't be announced until after February 15th, but here's a quick mini-update:
More than 97,000 Idahoans Select Insurance through Idaho Exchange
Lawmakers Get Update on Your Health Idaho’s Progress
BOISE, Idaho – Your Health Idaho executive director Pat Kelly went before lawmakers on Tuesday to give them an update on the second year of operations for Idaho’s state-based health insurance exchange. Kelly said Idahoans have benefitted from state lawmakers’ choice to keep the federal government out of Idaho’s health insurance decisions.
Currently, more than 97,000 Idahoans have selected a health insurance plan through the exchange. In 2015, Idaho ranked fourth in the nation per-capita for enrollments and had the highest enrollment numbers of any state-based health insurance exchange.
YHI also makes a strong case for keeping full state exchanges as opposed to moving to HealthCare.Gov (Matt Bevin of Kentucky might want to take notice...):
This Just In...the DC exchange has issued their official enrollment report as well (note: remember that this includes the first 2 days of February as well):
DC Health Link Individual Marketplace Data for Third Open Enrollment Period
61% of New Customers are 34 years old and Younger
Washington, DC – Today, the DC Health Benefit Exchange Authority (HBX) released preliminary individual marketplace data for the third open enrollment period for DCHealthLink.com, the District’s online health insurance marketplace for individuals, families and small businesses.
The third open enrollment period for individuals and families ended January 31, 2016. District residents had two extra days to enroll due to the historic snow storm that hit the DC region. Data includes people enrolling from November 1, 2015 to February 2, 2016.
There are 22,912 customers with 2016 health insurance coverage through DC Health Link’s individual marketplace:
OK. As expected, HHS released the "top line" number for the 2016 Open Enrollment Period: 12.7 million Qualified Health Plan enrollments nationally.
On the one hand, yes, I blew it this year: This is almost exactly 2.0 million fewer than the 14.7 million I originally projected for this year.
HOWEVER, as I've noted many times before, this isn't an apples to apples comparison, because that 12.7 million is after subtracting a minimum of 300,000 cancelled plans (pre-purging). The first two years, any plan cancellations during open enrollment weren't subtracted until after the dust settled; this year, due to improved backend software, CMS was able to purge/remove most cancelled plans from HC.gov on the fly.
In other words, an apples to apples comparison of the actual grand total of QHP selections vs. the same figure last year is at least 13.0 million (actually somewhat higher, since CMS hasn't released the total number of "pre-purges").
SACRAMENTO, Calif. — With three days left for consumers to finish their applications for affordable, quality health care coverage through the Patient Protection and Affordable Care Act, Covered California announced that more than 425,000 consumers had made plan selections during its third open-enrollment period.
UPDATE 4:00pm: OK, the HHS call is over now (see notes below), but now I'm on the Covered California call...and my kid gets off the school bus in 10 minutes, so it'll be a bit before I can post a fuller analysis of anything.
OK, everyone, here we go...a press call with the heads of HHS/CMS/HC.gov:
Secretary Sylvia M. Burwell, U.S. Department of Health and Human Services
Andy Slavitt, Acting Administrator, Centers for Medicare and Medicaid Services
Kevin Counihan, CEO, Health Insurance Marketplace
Remember, last years' total exchange enrollment was around 11.7 million nationally (8.8 million via HC.gov). HHS's official projection for 2016 was only around 10% higher (officially between 11.0 - 14.1 million, with a midrange around 12.6 million or so), while mine was more ambitious (around 25% higher overall, or 14.7 million).
Regular readers know that although I do spend a lot of time updating this website, I do still have to do my day job running a website development firm. As a result, I'm simply not able to keep up with every healthcare-related hot tip which comes my way.
So, when the following link was forwarded to me a few days ago, while I did find out more details from the sender, I didn't happen to get around to actually posting anything about it before today:
UnitedHealthcare Announces Changes to 2016 Exchange Sales and Compensation
Over the past few months, we've seen an acceleration of changes in the health insurance market. UnitedHealthcare is continually evaluating all aspects of the evolving exchanges so that we can provide coverage options that best meet consumers' health care and financial needs.
Nearly every county in Washington saw a drop in the uninsured
The report highlights the positive impact of the federal Affordable Care Act in Washington with county-by-county data on the uninsured and the law’s effect on many segments of the population.
PROVIDENCE – HealthSource RI (HSRI) has released certain enrollment, demographic and volume data through Saturday, January 31, 2016 for Open Enrollment.
INDIVIDUAL AND FAMILY ENROLLMENT • As of January 31, 2016:
34,670 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.
The majority of these individuals are 2015 HSRI enrollees that were auto-renewed into a 2016 plan.
7,538 of the 34,670 individuals have selected a plan for 2016 coverage and are new to HSRI this year or returning after being enrolled with HSRI at some point during a prior year.
32,286* of the 34,670 individuals are enrolled in 2016 coverage through HSRI, and have paid their first month’s premium.
*The number of paid enrollments is expected to increase as individuals pay for March coverage through the February 23 payment deadline.
This caused all sorts of shockwaves among the insurance industry, and of course gave ACA critics more ammunition with which to attack Obamacare as a whole, calling it evidence of the system being a failure, etc etc...even though several other major insurance carriers on the exchanges didn't seem to be complaining (or at least weren't making it out to be nearly as dire of a situation as UHC).
However, just to give you a taste of how jaw-dropping this hearing was, watch Rep. Elijah Cumming's question period with the head of Michigan's Dept. of Environmental Quality:
Isaac Bashevis Singer is famous for, among other things, his collection of Yiddish folk tales about The Wise Men of Chelm, a town in Poland which, according to the folk tales, was populated entirely by fools.
One of the stories about the people of Chelm was about a playground located near the top of a cliff. Every once in awhile, a child would fall off the cliff and injure themselves on the ground below.
The Wise Men of Chelm came up with an ingenious solution to the problem: They built a hospital at the bottom of the cliff. That way, the children could be rushed into the emergency room quickly for medical treatment.
...bans any public body or public official, except for “an election official in the performance of his or her duties,” from using public funds to issue any kind of communication that “references a local ballot question, and is targeted to the relevant electorate where the local ballot question appears on the ballot,” in the 60-day run-up to an election.
After the meeting in which the president tries to find areas of possible agreement with GOP leaders, [Republican Speaker of the House Paul] Ryan will hold another vote on repealing the Affordable Care Act. TheWashington Post reported:
The House is scheduled to vote Tuesday on overturning President Obama’s veto of legislation to repeal Obamacare and defund Planned Parenthood. The vote, appropriately scheduled for Groundhog Day, is expected to fail, leaving conservatives to gear up for a final year of budget fights with the president.
Asked about today’s events, White House Press Secretary Josh Earnest told reporters, “Republicans are poised to host another vote in the united states congress today for the 60th time to repeal Obamacare. It’s almost like it’s Groundhog Day, except today it is actually Groundhog Day and they’re doing it again.”
Since Open Enrollment for the Health Insurance Marketplace began on November 1, about 11.6 million people have signed up for or renewed a health plan (2.7 million through State-based Marketplaces through December 26 and over 8.9 million through HealthCare.gov or CuidadodeSalud.gov through January 23) that meets their needs and fits their budget.
Note: Obviously these numbers are a bit out of date; I've confirmed 11.86 million nationally, or around 260,000 more via the state-based exchanges than CMS has officially reported so far.
...This fact sheet provides a point-in-time estimate as of January 28, except where noted, of the many numbers behind the 2016 Open Enrollment period.
The Washington State ACA exchange has been very good about providing enrollment updates over the final couple of weeks of open enrollment, although the numbers have been included as part of general press releases rather than detailed demographic breakdowns.
OLYMPIA, Wash. — The Washington Health Benefit Exchange today announced that more than 200,000 Washingtonians selected a Qualified Health Plan through Washington Healthplanfinder by the close of open enrollment on Jan. 31. The number of plans selected is nearly 25 percent higher than those selected in open enrollment last year, with approximately 39,000 more customers signed up for coverage this year than in 2015.
UPDATE 2/05/16: Unfortunately, I got swamped this week with the actual enrollment wrap-up stuff and never got a chance to write up the Part II promised at the end of this. I might have to re-think how I do this. I'll leave this post online, but might ot be referencing back to it for awhile longer than I expected. Sorry about that.
Better yet: This, in turn, led to another hostile encounter with another extreme Bernie supporter...a female one in this case, who was off her rocker, which in turn kind of proved Molloy's point about "Bro" not neccessarily having to be male. Additional irony: In both cases, I had actually been attempting to defend, or at least smooth over, the "Bernie Bro" insanity. And so it goes.
In any event, I had made a couple of other mistakes in my original post: While the title of the piece mentioned "siding with Hillary on healthcare", the post itself was really more about a) the problems I have with Bernie's plan and b) my own idea about how to eventually get to a single payer system...not what Hillary's plans actually are. In response, the following day I posted another piece which looked into what Hillary Clinton's ideas on healthcare policy actually are. On the one hand, they're far more detailed than Bernie's, which is a very good thing. On the other hand, even if every one of them were to be fully implemented, they'd significantly improve the current system but no, they still wouldn't bring about either single payer or universal coverage by themselves.
The last Colorado update, which ran through January 15th, had their numbers at 139,579 private policies (QHPs), 23,017 standalone dental plans, 45,100 in Medicaid and 2,771 in the SCHIP program.
I've just learned that Colorado's final tally as of the January 31st deadline stands at 153,583 QHPs, 25,604 dental, 54,447 Medicaid and 3,549 SCHIP, which means they added just over 14,000 in the final 16 days.
Of the estimated 12-13 million people who, in the end, appear to have enrolled in ACA exchange policies for this year, around 10-11 million of them are receiving federal tax credits, either as a monthly subsidy towards their premiums or as a "lump sum" tax rebate the following spring.
Either way, exchange enrollees will have to include two important new forms when filing their federal income taxes this year:
UPDATE 2/04/16: OK, I've confirmed that Covered California will be releasing their numbers at around 1pm4pm this afternoon (whoops...forgot about the time zone difference), while HHS will be holding a call at around 3pm to discuss the Open Enrollment period in general at around 3pm. I don't know if they'll give out just the HealthCare.Gov numbers (38 states) or the national total today, but even if it's HC.gov only, with CoveredCA and the 5 states which have already released their numbers (see below), that'll still be 44 states accounted for representing over 90% of the national total (plus most of the enrollment in the remaining 6 states +DC is already booked as well). Still, I'm pretty sure they'll give the grand total regardless. Stay tuned...
According to Dan Diamond of Politico, the total number won't be released by HHS until Thursday or Friday.
MNsure, the Minnesota ACA exchange, is the first one to report their final, official 2016 Open Enrollment numbers, and they have much to be proud of:
85,390 Minnesotans Enroll in Private Coverage Through MNsure During the 2016 Open Enrollment Period
Enrollment goal exceeded, Minnesota leads the nation in new enrollees
February 01, 2016
ST. PAUL, Minn.—Today, MNsure announced 85,390 Minnesotans enrolled private health insurance coverage through the state exchange during the 2016 open enrollment period, November 1, 2015, through January 31, 2016. MNsure's goal was to enroll 83,000 in private coverage.
In addition, 33,333 Minnesotans newly enrolled in MinnesotaCare and 73,173 newly enrolled in Medical Assistance. MNsure also enrolled 7,144 Minnesotans in a dental-only plan. These numbers are preliminary and are not yet final.
