A brief recap of ACA Medicaid expansion in the great state of Utah:
November 2018: Utah voters pass Proposition 3, a "clean" Medicaid expansion ballot initiative, by a solid margin, 53-47. "Clean" expansion means just that: The program would be expanded to every legally documented Utah resident earning up to 138% of the Federal Poverty level, without requiring additional barriers like work requirements, etc.
February 2019: The Utah state legislature, blatantly defying the clear will of the people, votes to effectively ignore Prop 3 by replacing it with Senate Bill 96, which would only partially expand Medicaid to those earning just 100% FPL (around 50,000 fewer low-income residents) while also tacking on work requirements to boot.
Adding insult to injury, while you might think this would at least save the state a few bucks (under ACA Medicaid expansion, the federal government pays 90% of the bill for the expanded population while the state has to pay the other 10%), this would actually cost the state around $50 million more, because the partial expansion, if approved by the federal government, would mean the state would instead pay the 32% portion they already pay for other Medicaid populations. The state put in a separate waiver request asking for the feds to agree to the 90% match rate anyway.
Well, for good or for bad, billionaire and former New York City mayor Michael Bloomberg is actually registering in the mid-single digits for the Democratic primary in recent polling, so he's a force to be reckoned with whether I'm a fan of his literally buying his way onto the national stage or not.
Anyway, he rolled out his official healthcare platform the last week, and it's not bad, it just looks less impressive compared to most of the field. In all honesty, it pretty much amounts to a somewhat weaker version of Joe Biden, Pete Buttigieg & Amy Klobuchar's "ACA 2.0 w/Public Option" proposals (which are already considered "weak tea" by the more progressive members of the Democratic base, although I'm actually pretty impressed by each of them myself).
Nevada’s State Based Exchange Announces Enrollment Figures for Plan Year 2020
Carson City, Nev. – The Silver State Health Insurance Exchange (Exchange), Nevada’s state agency that helps individuals get connected to budget‐appropriate health coverage through the online marketplace, Nevada Health Link, enrolled 77,410 Nevadans during Open Enrollment for Plan Year 2020. The Exchange's seventh Open Enrollment Period ended Dec. 15, 2019 and included an extension for consumers who started the enrollment process on or before Sunday, Dec. 15 to complete their application by Friday, Dec. 20.
MNsure Reports Strong Enrollment Numbers in Seventh Open Enrollment Period
ST. PAUL, Minn.—117,520 Minnesotans signed up for private health coverage during MNsure’s seventh open enrollment period which ended on December 23, 2019—2,525 more sign-ups than the exchange received by December 23 of the previous year.
That's a 2.2% enrollment increase year over year (114,995), although CMS's official total was slightly lower than that (113,552 QHP selections). I don't know if the 1,443 discrepancy is due to clerical error cleanup, standalone dental plans being included in the higher number or what, but assuming the 117,520 figure stands, that's actually a 3.5% increase.
MNsure’s operations were notably smooth, and consumers reported improved customer experiences with the new online shopping and enrollment tools MNsure unveiled this year.
Former Republican Gov. Matt Bevin’s controversial plan to impose work requirements and monthly premiums for many Kentucky Medicaid recipients is no more, Democratic Gov. Andy Beshear announced Monday.
(Monday = Last Monday; this is from a week ago)
In one of his first major moves as the 63rd governor of Kentucky, Beshear signed an executive order Monday rescinding Bevin’s Kentucky HEALTH plan, which sought to impose strict work requirements for able-bodied, working-age adults. It would have ended health coverage for an estimated 95,000 Kentuckians.
...More than 486,000 individuals have been determined eligible for the new state subsidy, including about 23,000 in the 400 to 600 percent range of the federal poverty level, which could extend to an individual making up to $74,940 and family of four with a household income of up to $154,500. Of those in this income range who have signed up through Covered California, 44 percent have been found eligible for the state financial assistance.
...If I'm following correctly, the total breakout is:
777,000 = either 138 - 200% FPL or not eligible for any subsidies
463,000 = 200 - 400% FPL; receiving both federal & state subsidies
23,000 = 400-600% FPL; receiving state subsidies only
The press release also broke out the household average for the new/expanded subsidies:
Your Health Idaho, the states' ACA exchange, reminds residents who completed their enrollment applications that they still have until midnight tonight to actually select a policy:
Last chance to #GetCovered!
For those Idahoans who submitted an application for 2020 health insurance coverage by December 16, you have one more day to pick a plan! Do not wait! Find your perfect plan today at YourHealthIdaho.org!
Update 12/23: I've updated the text and graph to include the final numbers from Minnesota & Nevada.
This is by no means the final version of The Graph for 2020, of course; there's still no data at all from the District of Columbia, Idaho, Rhode Island or Vermont, and the deadline is still days, weeks or even a month away for nine states.
Having said that, with the Week 7 HC.gov Snapshot Report being released earlier this afternoon, this is a good time to pause and take a look at how the 2020 Open Enrollment Period is shaping up. Remember, even HC.gov's total will change slightly when the dust settles...they're still missing the final 3 hours of the extended Open Enrollment Period (I'm guessing perhaps 30,000 more?), plus an unknown number of "callbacks" to people who were unable to get through on 12/15 but left their contact information (perhaps another few thousand?).
Washington Healthplanfinder Reminds Customers to Make First Premium Payment
Payment options available online and by phone or mail through insurance companies.
Washington Health Benefit Exchange (Exchange) is reminding customers who selected a plan during 2020 open enrollment to make the first month’s premium payment to their health insurance company.
“It is critical that customers make their first premium payment associated with their 2020 health insurance coverage,” said Pam MacEwan, chief executive officer at the Exchange. “This simple action will prevent unintended loss of health coverage or delays in accessing care in the new year.”
Normally the Weekly HC.gov Snapshot Reports are released on Wednesdays. This week it was delayed until Friday in order to include the extra 2 1/2 days:
The final official day (Dec. 15th) fell on a Sunday this year
The additional 36 hour extension from 3pm on Monday 12/16 - midnight Eastern on Wednesday 12/18*
Not only is "Week 7" actually 9.5 days, but the final week of Open Enrollment also always includes a last-minute enrollment surge as people scramble to beat the deadline (both the original and the extension). In addition, it's also traditionally the week that CMS adds all of the auto-renewals to the report for current enrollees who neither actively selected a policy for 2020, nor did they cancel their coverage for the new year.
Healthcare Open Enrollment Going Strong in Washington, DC!
DC Residents Can Sign Up for Quality Affordable Coverage Through Jan 31, 2020
WASHINGTON, DC – District of Columbia residents still have more than six (6) weeks to sign up for quality, affordable health insurance through DC Health Link, the District’s state-based health insurance exchange established under the Affordable Care Act. While the final deadline has passed for individuals across the country to sign up for health insurance through the federal marketplace (HealthCare.gov), DC Health Link’s Open Enrollment for individuals and families continues on until January 31, 2020.
Monday is Your Last Chance to Enroll in Private Health Coverage Through MNsure
December 20, 2019
ST. PAUL, Minn.—Minnesotans have until 11:59 p.m. on Monday, December 23, to enroll in health insurance coverage through MNsure for 2020.
"MNsure stands ready to help Minnesotans in the final days of open enrollment," said MNsure CEO Nate Clark. "The time to get enrolled is right now—don't lose out on your opportunity to get coverage in the new year."
MNsure will have extended Contact Center hours beginning tomorrow:
Saturday, December 21: 10 a.m. to 6 p.m.
Sunday, December 22: 10 a.m. to 8 p.m.
Monday, December 23: 8 a.m. to midnight
Most people qualify for financial help. Minnesotans can see their estimated eligibility for financial help by using MNsure's plan comparison tool.
Please note, this deadline does not apply to Medical Assistance or MinnesotaCare recipients or members of federally recognized Indian tribes. More information about renewing eligibility and reporting changes for Medical Assistance or MinnesotaCare.
More than 153,000 Coloradans Enrolled in Health Insurance So Far; Less than Four Weeks Remain to Enroll for 2020 Coverage
DENVER — More than 153,000 Coloradans signed up for a health insurance plan through Connect for Health Colorado’s Marketplace by Dec. 18, 2019. Approximately 68 percent of applicants qualify for financial help to lower monthly premium costs.
“I am encouraged by the pace of sign-ups so far,” said Connect for Health Colorado® CEO Kevin Patterson. “However, it’s not too late to get covered for 2020. I urge you to take advantage of the final deadline and all the support we offer by visiting our site, giving us a call, or finding local help in your community.”
The Open Enrollment period in Colorado ends Wednesday, Jan. 15, 2020. Residents who sign up for a health insurance plan by the deadline will receive a Feb. 1, 2020 coverage start date.
The wording of the first part varied somewhat depending on the candidate's position on healthcare policy, but the second part was identical for each. Here's how I worded it for Bernie Sanders:
"Senator, you've long been a staunch advocate of moving to a universal, mandatory, single-payer healthcare system which you call "Medicare for All", and have publicly rejected any proposal which includes cost sharing at the point of service or which continue to allow private major medical plans as not being acceptable.
However, until this year you were also a co-sponsor of Senator Warren's "Consumer Health Insurance Protection Act", or CHIPA, which amounts to a robust ACA 2.0 bill, and until recently you were also a co-sponsor of Senator Schatz's "State Public Option Act" which amounts to a Medicaid buy-in plan.
Nationally, they concluded that the U.S uninsured rate would increase by nearly 20 million people, while the 50 states (+DC) would collectively lose out on nearly $135 billion in federal funding.
Having stated the above, the ACA is still indeed very much in jeopardy. Going forward, the case will follow one of two possible routes:
Officially, it's supposed to go back to the judge who ruled against the ACA in the first place a year ago to "reconsider" which parts of it can be "saved"...after which it would then go back to the 5th Circuit Court of Appeals, and then to the U.S. Supreme Court. That full process could take well over a year.
However, it's possible that the Supreme Court will intervene and agree to take the case up instead of it going to the original judge first, which is what the defending states are now requesting. This full process...could still take up to a year, although it's conceivable that a final ruling would be issued before the election.
Well, as if Impeachment Day wasn't tense and historic enough already, the 3-judge panel of the 5th Circuit Court of Appeals has finally issued their decision on the Texas vs. U.S. (aka Texas vs. Azar, aka Texas Fold'em) lawsuit intended to strike down the entire Affordable Care Act:
Before KING, ELROD, and ENGELHARDT, Circuit Judges. JENNIFER WALKER ELROD, Circuit Judge:
Covered California Releases New Enrollment Data and Issues Reports on Five Years of Improving Affordability, Access and Accountability
Covered California announced that there are more than 230,000 new plan selections during the current open enrollment period – up approximately 16 percent over this time last year. More than 1.15 million people have also renewed their coverage.
In addition, more than 540,000 people will receive new state subsidies that will make quality health care coverage more affordable in 2020.
The agency also released two extensive reports that detail Covered California’s impacts on lowering costs and assuring quality care in its implementation of the Affordable Care Act.
Since 2013, California has reduced its uninsured rate by more than any other state in the nation has by expanding Medi-Cal, investing in marketing and outreach and keeping costs low for consumers.
California’s individual market consistently ranks among the healthiest in the nation, helping unsubsidized consumers save about $1,550 annually in 2018 on their premiums compared to consumers in the federal marketplace.
Covered California’s open-enrollment period runs through Jan. 31. Consumers must sign up before the end of Dec. 20 for their coverage to start on Jan. 1. California is one of 10 state marketplaces that are still open for business, representing 28 percent of Americans.
Nevadans Who Started Their Enrollment Applications on or Before the Dec. 15 Deadline Have Until Dec. 20 to Complete Applications for Coverage that Begins on Jan. 1 2020
Carson City, Nev. – The Silver State Health Insurance Exchange (Exchange), Nevada’s state agency that helps individuals obtain budget-appropriate health coverage through the online marketplace, Nevada Health Link, has extended its Open Enrollment deadline to 11:59 p.m. PST Friday, Dec. 20 for consumers who started the application process on or before the Dec. 15 midnight Open Enrollment deadline.
"We recognize the enrollment process for health insurance can be time-consuming. That’s why we are giving consumers five extra days to complete their application to purchase plans for coverage that begins Jan. 1, 2020," said Heather Korbulic, executive director, Silver State Health Insurance Exchange.
Less Than a Week to Enroll; MNsure's Open Enrollment Period Ends December 23
ST. PAUL, Minn.—Minnesotans have until 11:59 p.m. on Monday, December 23, to enroll in coverage through MNsure. After that date, Minnesotans will only be able to enroll in private health insurance coverage through MNsure if they qualify for a special enrollment period.
"Anyone with questions or who needs help enrolling should phone our Contact Center or reach out to a MNsure-certified assister,” said MNsure CEO Nate Clark. “We’re here to help. Don't wait until the last minute—get covered today!”
MNsure will have extended Contact Center hours leading up to the deadline:
158,600 MARYLANDERS ENROLLED THROUGH MARYLAND HEALTH CONNECTION
2020 enrollment total largest in four years
BALTIMORE (DEC. 17, 2019) – A total of 158,600 Marylanders enrolled in private health coverage for 2020 on Maryland Health Connection, the largest enrollment in four years on the state-based health insurance marketplace.
That was 1,637 more enrollees than a year ago when 156,963 enrolled. It was also the largest enrollment on the health insurance marketplace since 2016 when 162,652 enrolled. Enrollments for 2020 coverage grew in 20 of 24 jurisdictions.
The 45-day open enrollment period for the coming plan year began Nov. 1 and ended Sunday. A few hundred additional enrollments will be completed this week for consumers who had begun the process but hadn’t finished by Sunday night.
Connect for Health Colorado Extends Enrollment Deadline for January Coverage to Dec. 18, 2019
DENVER – To help as many people as possible get Jan. 1, 2020 coverage, Connect for Health Colorado is pleased to announce that the deadline to get coverage on Jan. 1 has been extended. Coloradans have until 11:59 p.m. on Wednesday Dec. 18, 2019 to sign up for a health insurance plan that starts on Jan. 1, 2020.
To sign up for coverage that begins Jan. 1, 2020, Coloradans must take the following steps:
1. Complete an application and select a health insurance plan online at ConnectforHealthCO.com, over the phone at 855-752-6749, or by working with a certified enrollment expert by 11:59 p.m. on Wednesday, Dec. 18.
OK, this isn't much of an extension, since the DCHealthLink.com exchange already lets people enroll as late as January 31st...but it's still important:
DC Health Link didn’t have any website issues on Sunday 12/15, but we know that news for other states may have caused confusion.
You now have until December 18 to sign up for a plan that starts January 1.
In response to tremendous pressure after yesterday's major technical issues at HealthCare.Gov, CMS Administrator Seema Verma just announced that the deadline for people to #GetCovered in the 38 states which host their ACA enrollment platform with HealthCare.Gov will indeed be extended by 2 days:
We at @CMSGov want to ensure a seamless shopping experience for everyone seeking coverage, so starting at 3 pm ET today, we are extending the marketplace #OpenEnrollment deadline until 3 am ET December 18! https://t.co/HmVdpJlX2C
OK, this is about as obscure of an "announcement" as I can imagine: Per a heads up from Louise Norris, if you visit the Washington HealthPlan Finder website this morning, there's a simple message at the top reading:
There's still time to get covered. Sign up by Dec. 30 to get coverage that starts Feb 1st.
That's it. There's no link to a press release, there's nothing in their "news announcements" archive, and as of this writing there's no tweet from their Twitter account announcing it...just that simple text message.
I'll update if/when there's a formal announcement, but until then...it appears that Washington State residents do indeed have another 16 days to #GetCovered after all, even if they'll face a one-month gap in coverage.
UPDATE: Confirmed:
Still need to sign up in a health plan? You're in luck!
Enroll in a plan from now through Dec. 30 at 8pm to receive coverage starting Feb. 1, 2020. #GetCoveredWA
As of today, their press release page states the following:
Stats as of December 13, 2019:
Qualified Health Plans (QHP):
Net Total QHP Enrollment: 102,589
2020 OE Acquisition Summary: 15,067
Overall Volume
Unique Website Visitors: 157,591
Calls Handled: 152,733
Medicaid: Completed applications/redeterminations processed through the integrated eligibility system: 35,231
This was as of 12/13, so it's missing the last 2 days of Open Enrollment signups. They would have to have added another 8,500 people in the final two days in order to beat last year's total of 111,066.
If you still missed the deadline, you won't be eligible to enroll for ACA-compliant major medical coverage for the rest of the year unless you qualify for a Special Enrollment Period (SEP) due to a qualify life event lke getting married/divorced, moving, giving birth/adopting a child, turning 26, becoming ineligible for Medicaid or losing your employer-sponsored health insurance coverage.
Dammit, I took a couple of hours off to rewatch The Force Awakens with my kid (in anticipation of The Rise of Skywalker coming out this week), and look what happens...
HealthCare.Gov is not letting people login to enroll. This is the second outage, the first lasted 15 minutes. We're 8 minutes into the second. Last time this happened, 100k people could not enroll. @CMSGov must extend the deadline.
Due to high call volume and enrollment demand, @CoveredCA will extend the deadline for Jan. 1 coverage through midnight next Friday, Dec. 20. That means consumers have an extra 5 days to sign up for #ACA#healthcare coverage for all of 2020. Check rates.
Moments ago, Covered California, the nation's largest state-based ACA exchange, released data via a media teleconference regarding the 2020 Open Enrollment Period.
In addition to being the largest ACA exchange after HealthCare.Gov, this info from Covered California is especially significant for the 2020 OEP due to their newly expanded/enhanced premium subsidies.
To recap: Under the ACA, financial subsidies are available to exchange enrollees earning between 100-400% of the Federal Poverty Level (FPL). That's between around $12,500 - $50,000/yr if you're a single adult, or between $25,000 - $100,000/yr for a family of four. Under the standard ACA formula, enrollees in that income range have their premiums capped at no more than around 2.0 - 9.8% of their income, on a sliding scale.
Unfortunately, this means that people earning more than 400% FPL are eligible for no financial assistance at all, a sudden drop-off known as the Subsidy Cliff.
More Than 200,000 New Yorkers Enroll in a Qualified Health Plan During First Forty-One Days of the 2020 Open Enrollment Period
December 15 is the Deadline to Enroll for January 1 Coverage
(ALBANY, N.Y.) December 12, 2019 - NY State of Health, the state’s official health plan Marketplace today announced that as of December 11, more than 200,000 consumers have enrolled in a 2020 Qualified Health Plan (QHP) through NY State of Health, the official health plan Marketplace, outpacing enrollment in a QHP at the same period last year by approximately 7,000 enrollees. Consumers must enroll or renew by December 15 for coverage beginning January 1, 2020.
Yes, that's right: Not only did they lop 50,000 people out of the loop entirely, the other 90 - 100K enrollees will also be subject to...wait for it...work requirements. Well...sort of; keep reading.
First, it looks like they'll have to apply to at least 48 employers as well. So...what, if they get hired by the first one they still have to apply with 47 more?
Note that it says "and" before the fourth item, not "or"...which means all of them will have to register online, complete a training assessment, apply to at least 48 companies and complete an online training course.
...Oh by the way, one more thing: The minimum wage in Utah is $7.25/hour.
ST. PAUL, Minn.—With the end of MNsure's open enrollment period just under two weeks away, MNsure is reminding private health plan enrollees that there is still time to renew or change their coverage for 2020. Additionally, those who are seeking coverage for 2020 and have not yet submitted an application through MNsure can do so through December 23, 2019.
"We strongly encourage all Minnesotans to come back to MNsure.org and compare plans to ensure they are getting the best deal and the best coverage for their family," said Nate Clark, MNsure CEO. "Financial assistance to lower premium costs is available, and the majority of Minnesotans qualify."
MNsure's open enrollment period runs through December 23, 2019, eight days longer than the federal open enrollment period.
Below is a brief guide to assist Minnesotans with coverage during open enrollment:
In most states, the 2020 Open Enrollment Period deadline is midnight on Sunday, December 15th. In a few states, the deadline is as late as January 31st.
And then there's Idaho. Via Your Health Idaho, the state's ACA exchange:
Deadline to apply for 2020 health insurance is December 16
Your Health Idaho extends hours to support increased interest
BOISE, Idaho – Idahoans seeking 2020 health insurance coverage must complete their application through the state insurance exchange, Your Health Idaho, by Monday, Dec. 16. In anticipation of increased interest and high demand, Your Health Idaho is extending customer support hours through December.
Your Health Idaho will be open Monday through Friday, December 9-20, from 7 a.m. to 8 p.m. MT. Phone lines will also be open Saturday, Dec. 14, and Saturday, Dec. 21, from 10 a.m. to 4 p.m. MT.
This report provides average monthly effectuated enrollment and premium data for the individual market Federal and State-Based Exchanges for the first six months of the 2019 plan year. The Centers for Medicare & Medicaid Services (CMS) publishes effectuated enrollment data semiannually to provide a more accurate picture of enrollment trends for the Exchanges than indicated by the number of individuals who simply selected a plan during Open Enrollment. For coverage to be considered effectuated, individuals generally must pay the first month’s premium for the plan.
So last night I whipped up a bit of a fuss on Twitter with my response to an exchange between Pete Buttigieg and Rachel Maddow:
Asked by @maddow about a McKinsey client laying off thousands of insurance company workers — and whether Buttigieg’s work played a role — Buttigieg turns it around and warns that Medicare for All advocates would end every insurance worker’s job.
Maddow: "When you did that cost & overhead assessment for Blue Cross Blue Shield of Michigan, a couple years after that, they laid off like 1,000 people. Was your work part of what led to those layoffs?
Buttigieg: " I doubt it...I don't know what happened after the time that I left, that was in 2007, when they decided to shrink in 2009. Now, what I do know is that there are some voices in the Democratic primary right now who are calling for a policy that would eliminate the job of every single American working at every single insurance company in the country."
The Week 6 HealthCare.Gov Snapshot Report from CMS should be released sometime Wednesday afternoon, covering enrollment in 38 states from Dec. 1st - 7th.
As a reminder, here's what the Week 5 report looked like (for Nov. 1st - 30th):
There are two major things to account for when comparing the two years: First, there's a day missing due to Nov. 1st falling on a Friday instead of a Thursday this year. This likely accounts for around ~120,000 of the difference. Secondly, Nevada split off from HC.gov this year, which accounts for around ~19,000 of the gap the first 3 weeks. In addition, a small portion of the difference is likely due to Idaho and Maine expanding Medicaid; exchange enrollees earning between 100-138% FPL should be tranferred over to Medicaid instead.
Deadline is Approaching for Open Enrollment Sign-ups
CONCORD, NH – New Hampshire residents should be aware that the deadline to enroll in individual health insurance for 2020 is this Sunday, December 15. After this date, the only way people can enroll in an individual insurance plan is if they qualify for a special enrollment period, typically during the 60 days following certain qualifying life events. Enrollees must pay the first monthly premium by the insurance company’s due date before 2020 coverage can take effect on January 1.
"Now is the time for New Hampshire residents who need individual coverage to enroll in a health plan for next year," said Insurance Commissioner John Elias. "Only if someone has a qualifying life event such as getting married or having a baby can they change their plan during the year. If consumers still have questions about what plan is best for their needs, they should reach out to an insurance agent or an enrollment assister for help understanding their options."
via the House Energy & Commerce Committee via email:
Bipartisan House Leaders Raise Medicare Plan Finder Concerns
Committee Leaders Urge CMS to Open Special Enrollment Period for Beneficiaries Who Used Plan Finder to Make Enrollment Decisions
Washington, D.C. – Bipartisan House health leaders sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma expressing concerns over reports that the Medicare Plan Finder was confusing, generated incorrect results, and inadvertently led beneficiaries to select plans with lower premiums but higher overall costs.
Massachusetts Health Connector Open Enrollment Continues through January 23, Offering High-Quality and Affordable Coverage to Residents
BOSTON – December 9, 2019 – Open Enrollment for health insurance through the Massachusetts Health Connector continues through January 23, 2020, providing residents time to find affordable coverage that delivers a wide range of benefits to make it easier and less costly to get health care.
Uninsured residents have until December 23 to apply, pick a plan and make a payment in order to have coverage starting January 1, and they have until January 23 to apply for coverage starting February 1. In contrast, Open Enrollment in other states served through the federal marketplace ends as early as December 15.
Covered California and the Challenged Athletes Foundation Team Up to Promote Open Enrollment and the Dec. 15 Deadline for Coverage During All of 2020
While Covered California’s Open Enrollment period runs through Jan. 31, 2020, consumers must enroll by the end of Dec. 15 to have their coverage begin on Jan. 1.
Covered California is teaming up with the Challenged Athletes Foundation, to host a Holiday Boot Camp to promote the importance of health, fitness and the open enrollment period.
The Boot Camp will be led by Paralympian, 2019 Parapan Gold Medalist and World Record Holder Scout Bassett and Nike Master Trainer Betina Gozo.
Californians who choose to go without coverage could face a penalty when they file their 2020 taxes.
Covered California continued its statewide open enrollment campaign by teaming up with the Challenged Athletes Foundation in San Diego for its Holiday Boot Camp on Tuesday. The event comes as Covered California alerts consumers about a critical upcoming deadline. Consumers must sign up by Dec. 15 if they want their coverage to start on Jan. 1.
For three years running, thanks to a combination of the way the ACA's premiums subsidy formula works and the Silver Loading workaround, several million low-income people are eligible for fully ACA-compliant healthcare policies which end up costing them NOTHING in premiums after federal tax credits are applied.
Here's why: Under the ACA's subsidy formula, if you earn between 100% - 400% of the Federal Poverty Line ($12,490 - $49,960/yr if you're single), you're eligible for subsidies which bring the cost of the benchmark Silver ACA plan down to between 2.06 - 9.78% of your income, on a sliding scale.
If you earn less than 200% FPL (just under $25,000), you also qualify for heavy cost sharing reduction assistance as well...but only if you enroll in a Silver plan.
So, let's suppose you earn exactly $25,000/yr (just over 200% FPL). At that income, you'd qualify for subsidies bringing the benchmark Silver down to 6.5% of your income, or $135/month. If the benchmark plan costs, $600 at full price, you'd therefore be eligible for $465/month.
Medicare chief asked taxpayers to cover stolen jewelry
A top Trump health appointee sought to have taxpayers reimburse her for the costs of jewelry, clothing and other possessions, including a $5,900 Ivanka Trump-brand pendant, that were stolen while in her luggage during a work-related trip, according to documents obtained by POLITICO.
Seema Verma, who runs the Centers for Medicare and Medicaid Services, filed a $47,000 claim for lost property on Aug. 20, 2018, after her bags were stolen while she was giving a speech in San Francisco the prior month. The property was not insured, Verma wrote in her filing to the Health and Human Services department.
The federal health department ultimately reimbursed Verma $2,852.40 for her claim, a CMS spokesperson said.
via email from the House Energy & Commerce Committee:
Bipartisan House and Senate Committee Leaders Announce Agreement on Legislation to Lower Health Care Costs
Legislation ends surprise medical bills; funds Community Health Centers for five years; increases the purchasing age of tobacco to 21; lowers prescription drug and other medical costs by requiring more transparency and competition
WASHINGTON, December 8, 2019 — Senate Health Committee Chairman Lamar Alexander (R-Tenn.) and House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-N.J.) along with Ranking Member Greg Walden (R-Ore.) today announced they have reached a bipartisan, bicameral agreement on legislation to lower what Americans pay out of pocket for their health care.
Whether it actually makes it through both the House and Senate and gets signed by Trump or not, just getting this type of announcement itself is pretty unheard of these days for any significant policy.
As noted a few days ago, House Democrats have officially scheduled a floor vote on H.R. 3, the Lower Drug Costs Act of 2019, for next week:
Pelosi, Hoyer, Pallone, Neal and Scott Joint Statement Announcing Floor Vote on H.R. 3
Washington, D.C. – Speaker Nancy Pelosi, Majority Leader Steny Hoyer, Energy & Commerce Committee Chairman Frank Pallone Jr., Ways & Means Committee Chairman Richard E. Neal and Education & Labor Committee Chairman Bobby Scott released the following joint statement:
“Next week, the House of Representatives will pass the Elijah E. Cummings Lower Drug Costs Now Act.
“We have now received enough guidance from CBO to bring the Lower Drug Costs Now Act to the Floor and to reinvest its savings in one of the most transformational improvements to Medicare since its creation.
Washington Health Benefit Exchange Issues Statement on Approval of Cascade Care Plan Designs
Washington Health Benefit Exchange (Exchange) board approved the design for Cascade Care plans today. Cascade Care plans are qualified health plans that have a standard health benefit design across health insurance carriers making it easier to understand and offer more value for Washington Healthplanfinder consumers.
Today, Pam MacEwan, CEO of the Washington Health Benefit Exchange, and Ron Sims, the Exchange’s Board Chair, issued the following statement regarding the approval of the designs as a step in implementing Senate Bill 5526 (Cascade Care):
The clock is ticking on picking the best health insurance plan for 2020. High quality and affordable health coverage is available through HealthSource RI, and Rhode Islanders have until December 23rd to purchase coverage that starts on January 1st.
Getting health insurance is even more important this year because coverage is now required in the state of Rhode Island. As of January 1st, residents who don’t have health insurance will pay a tax penalty when filing for the prior year.
AGAIN: The federal shared responsibility requirement (aka the individual mandate penalty) may have been zeroed out by Congressional Republicans, but in addition to the District of Columbia, four states (Massachusetts, New Jersey, California and Rhode Island) have reinstated it at the state level.
A few weeks ago, I did a write-up about a concerning development at HealthCare.Gov: The growing push under the Trump Administration to not only partner with 3rd-party web brokers (which has been done since the first days of the ACA under the Obama Administration), but to actively promote those third-party brokers over HealthCare.Gov itself.
In and of itself, this wouldn't be too problematic as long as people are still ultimately enrolling in fully ACA-compliant policies and receiving ACA subsidies if they're eligible for them. Hell, one of these 3rd-party authorized web brokers even has a banner ad at the top of my website...which I only allow because this particular one only sells on-exchange ACA-compliant policies.
Open Enrollment for Idaho is coming to a close, don’t miss out on enrolling in an affordable health insurance plan! You can set up an account, shop for plans, and apply for coverage online. Visit Apply and Enroll for more information. No computer? No problem. To apply over the phone or to request a paper application, call Your Health Idaho at 1-855-944-3246.
We’re Here to Help!
Your Health Idaho will have extended hours throughout December*:
December 1 – 6: 7am – 7pm
December 9 – 13: 7am – 8pm
December 14 (Saturday): 10am – 4pm
December 16 – 20: 7am – 8pm
December 21 (Saturday): 10am – 4pm
This is the perfect opportunity for those Idahoans who were unable to reach us during the busy work week.
*All times are in Mountain Time Zone.
All private health plans offered on the MNsure marketplace limit the out-of-pocket cost to enrollees for insulin prescriptions in 2020. Each of MNsure's four insurers are offering either low-cost or free insulin benefits, meaning consumers purchasing plans through MNsure will pay no more than 25 dollars per month for insulin.
"The rising cost of insulin has put a huge financial burden on many families across Minnesota," said Nate Clark, MNsure CEO. "It’s so important to have access to insulin at an affordable price. We encourage all those looking for prescription insulin coverage to check out the plan options at MNsure.org."
Medicaid: Completed applications/redeterminations processed through the integrated eligibility system: 29,692
I'm assuming this means that they've joined several other state exchanges and are front-loading their auto-renewals of everyone currently enrolled. I'm further assuming that of those 99,322 people, 10,281 of them are new enrollees. If so, that means they'll have to enroll just 11,744 more people over the next four weeks to beat last year's 111,066 total.
Connect for Health Colorado® Urges Residents to Shop by December 15 for January Coverage
Nearly 42,000 Coloradans signed up for a health insurance plan through Connect for Health Colorado’s Marketplace between Nov. 1 and Nov. 30. Approximately 70 percent of applicants qualify for financial help in the first month of the Open Enrollment period. Residents must sign up for a plan by Dec. 15, 2019 to have coverage in place by Jan. 1, 2020, however, Open Enrollment runs through Jan. 15, 2020.
Coloradans can sign up for a Marketplace plan online, over the phone or in person with a certified enrollment expert. Connect for Health Colorado has 23 enrollment centers to provide residents with walk-in help at different times throughout the week. Residents can also schedule an appointment.
I have a different California-specific post coming later this afternoon, but I stumbled across a mildly interesting bit of data and figured this would be a good time to share it while I wait to be able to post that one.
As you may recall, while the ACA required that most individual market major medical healthcare policies sold have to comply with full ACA regulations, there were some exceptions to this. The biggest exception made was for major medical plans which had been continuously enrolled in since before the ACA was signed into law in March 2010.
These plans were grandfathered in, and so are appropriately called "Grandfathered Plans", and applied to perhaps 5 million people or so back in 2014, when ACA-compliance became mandatory for newly-sold policies.
Don't ask me why, but for some reason, in the midst of my pushing hard for the major ACA 2.0 bills to be passed (H.R. 1868 and H.R. 1884), I've written nary a word about another important (and actually more impactful if it were to be passed and signed into law) bill: H.R.3, the Lower Drug Costs Now Act of 2019:
This bill establishes several programs and requirements relating to the prices of prescription drugs.
Washington Healthplanfinder Urges Customers to Act Fast for Jan. 1 Coverage
The Washington Health Benefit Exchange (Exchange) today is warning customers without 2020 coverage that Sunday, Dec. 15 at 11:59 p.m. is the deadline to sign up for health and dental plans through Washington Healthplanfinder that begin on Jan. 1.
Since the open enrollment period began, more than 187,000 Washingtonians have already selected 2020 Qualified Health Plans (QHP) using Washington Healthplanfinder, including around 15,000 residents who signed up for health coverage over the past week. With traffic to wahealthplanfinder.org expected to continue rising, customers needing 2020 coverage are directed to submit an application and lock in their plan selection immediately to avoid any potential delays.
I'm just putting this out there today because I know there's gonna be a bunch of eye-rolling stories completely misunderstanding the data later on this week.
Last Wednesday, the Week 4 HealthCare.Gov Snapshot Enrollment Report came out and showed a "mysterious" 41% increase in ACA exchange enrollments for the week vs. last year...jumping from 500,437 QHP selections to 703,556 QHP selections for the corresponding week this year.
This Wednesday, the Week 5 snapshot report will come out and will almost certainly show a "mysterious" large drop in ACA exchange enrollments vs. last year...from 772,250 down to perhaps 500,000 or so.
Gov. Gretchen Whitmer said delaying implementation of work requirements for enrollees in Michigan's Medicaid expansion program would prevent the state from potentially wasting at least $1 million.
The Democrat issued a special message to legislative leaders Tuesday, a day after saying the Republican-controlled Legislature should pause the rules taking effect in January.
Whitmer said the state has spent $28 million to implement the workforce engagement requirements and is on track to spend an additional $40 million this fiscal year — an unnecessary expense if a federal judge blocks the rules.
Coming on top of not one, not two, but three other states either scrapping or "delaying" implementation of Medicaid expansion work requirements (Arizona, Indiana and Montana), this one isn't particularly surprising given that Democrats hold the governor's seat and just flipped both the state House and Senate. Still welcome, though!
Gov. Ralph Northam has directed Virginia's Medicaid program to "pause" negotiations with the federal government on approval of a work requirement that was central to a political deal that allowed the state to expand eligibility for the program's health care benefits to hundreds of thousands of uninsured Virginians.
Northam cited the Democratic takeover of both chambers of the General Assembly in legislative elections last month. He also referred to litigation that has faced other states that have tried to link Medicaid health benefits to requirements that program participants seek work, training, education or other forms of civic engagement.
Less Than Two Weeks Remain To Enroll In A Qualified Health Plan Through Nevada Health Link
Free enrollment assistance available; Weekend call center hours extended for duration of Open Enrollment
Las Vegas, NV - The clock is ticking with only 13 days left to enroll before the December 15th midnight deadline approaches. Nevadans can find coverage in a Qualified Health Plan (QHP) and Qualified Dental Plan (QDP) through Nevada Health Link, the online insurance marketplace operated by the state agency, Silver State Health Insurance Exchange – and the only place consumers can get financial assistance (subsidies) to help offset the cost of insurance.
To ensure consumers have as much access to help with the enrollment process, Nevada Health Link's call center has extended its weekend hours through the end of Open Enrollment on December 15. The call center will be open 9 a.m. to 5 p.m. PST on Saturday, Dec. 7, Sunday, Dec. 8, and Saturday, Dec. 14 and will remain open until 11:59 p.m. PST on Sunday, Dec. 15.
Maryland Health Connection will hold nearly 20 “Last Chance” events throughout the state during the final week of open enrollment Dec. 7-15 to provide free help enrolling in health coverage. Marylanders can enroll in health and dental coverage until Dec. 15 through Maryland Health Connection, the state’s health insurance marketplace.
At the free “Last Chance” events, certified health insurance navigators will help Marylanders sign up for a health plan and understand their coverage options and financial help available. Assistance also is available in Spanish.
Visit MarylandHealthConnection.gov or the Enroll MHC mobile app to browse plans, compare coverage and costs, and enroll.
The fall open enrollment is for private health and dental plans only. People who have coverage through Medicaid will receive a notice when it’s time to renew; enrollment for Medicaid is all year for eligible Marylanders.
ALBANY, N.Y. (December 3, 2019) – NY State of Health, the state’s official health plan Marketplace, today announced its continued partnership with NYS Department of Agriculture and Markets in an effort to educate shoppers at farmers markets throughout New York State about low-cost, high-quality health coverage during the Open Enrollment Period.
Consumers must enroll by December 15, 2019 for coverage beginning January 1, 2020. Certified Enrollment Assistors will be available leading up to the December 15 deadline at select markets to answer any questions about enrolling in a health plan through the Marketplace and to set up enrollment appointments. In addition, NY State of Health educational materials will be available at select farmers’ markets across the state. This is the fourth year of the NY State of Health-NYS Department of Agriculture and Markets partnership.
This isn't the biggest development in the world, but exactly a year ago today I made a big fuss about how New Jersey (and DC) had reinstated their own health insurance individual mandate penalties after the federal version was zeroed out by Congressional Republicans...but didn't seem to be going through much effort to let people know about the penalty.
While Massachusetts had launched a massive multi-media awareness/education blitz statewide to make sure people knew that they had dusted off their pre-ACA coverage mandate requirement, New Jersey and DC didn't appear to be doing much, if anything, to let people know that they'd face a stiff tax penalty if they didn't either #GetCovered or qualify for an exemption.
As I noted at the time, just like the Doomsday Device in Dr. Strangelove, it completely defeats the whole point of having a penalty if no one knows it exists.
Back in March I wrote an analysis of H.R.1868, the House Democrats bill which comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.
Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.
The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".
Back in March I wrote an analysis of H.R.1868, the House Democrats bill which comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.
Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.
The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".
A couple of weeks ago, BeWell NM, the name of the New Mexico ACA health exchange, held their latest board meeting. There's two key things to keep in mind about New Mexico:
First, they've been officially operating as a state-based exchange while "piggybacking" off of HealthCare.Gov since the very first Open Enrollment Period in 2013-2014...but they announced over a year ago that they're following Nevada's (and Idaho's) lead in splitting off onto their own full exchange, starting in 2021.
In mid-November, a few dozen of the country’s most influential advocates of Medicare-for-all were reviewing details of Sen. Elizabeth Warren’s plan to finance the proposed government-run program when they learned that she had unexpectedly changed her position.
I haven't written anything about Pennsylvania's surprisingly bipartisan decision to break off of the federal ACA exchange at HealthCare.Gov onto their own state-based exchange since June:
After some last-minute drama in one state and a surprising lack of drama in another, both New Jersey and Pennsylvania have officially passed bills allowing them to each establish their own ACA exchanges and enrollment platforms, splitting off from the federal exchange and HealthCare.Gov:
Pennsylvania is poised to roll out its own online health insurance exchange to take the place of the one run by the federal government for the state's residents since 2014, saying it can save money for hundreds of thousands of policy-buyers.
Over the past few years, more and more of the state-based exchanges have shifted from waiting until the end of Open Enrollment to officially report auto-renewals of existing enrollees...to going ahead and auto-renewing everyone up front, and then subtracting those current enrollees who actively cancel their renewals.
This has caused a bit of confusion, since the exchanges don't always make it clear who's being counted and when.
Case in point: Access Health CT, Connecticut's ACA exchange. Last year they reported 12,777 enrollees during the first two weeks of Open Enrollment...and also noted that there were another 85,000 existing enrollees who hadn't yet actively renewed their policies as of 11/18.
For the past two weeks, along with other noteworthy Open Enrollment data numbers, I've been scratching my head over what the deal is in Mississippi:
Once again, Maine remains the worst-performer year over year, mostly due to their expansion of Medicaid. Idaho isn't listed because they're a state-based exchange and haven't reported any data yet. Mississippi, on the other hand, continues to be the top out-performer vs. last year, which is interesting because there doesn't seem to be any particular reason for it.
Unlike some states, Mississippi hasn't implemented any additional subsidies, a mandate penalty or a reinsurance program of any sort. They haven't had any new carriers join the ACA market, nor have any of them left. I don't think either of the carriers on the exchange have significantly expanded their territory or changed their offerings that much either...in fact, average premiums are essentially flat year over year.
In other words, by all rights, Mississippi should be performing almost exactly as they did last year...but enrollments are up 15.5% to date. Huh.
I just received the following 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):
It looks like we’ve pretty much wrapped up auto-renewal, how about an update on 2020 enrollment:
As of Nov. 29, we had a total of 286,640 people enrolled in Jan. 1 coverage, 6 with February or March enrollments, and 10,852 who had selected plans and had not yet paid to enroll. So, by the CMS definition, we are at 297,498. That includes about 17,000 new enrollments from people who did not have coverage as of Nov. 4 with the Health Connector.
I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for Januar vs. Feb. or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).
I'm just putting this out there today because I know there's gonna be a bunch of eye-rolling stories completely misunderstanding the data later on this week.
Last Wednesday, the Week 4 HealthCare.Gov Snapshot Enrollment Report came out and showed a "mysterious" 41% increase in ACA exchange enrollments for the week vs. last year...jumping from 500,437 QHP selections to 703,556 QHP selections for the corresponding week this year.
This Wednesday, the Week 5 snapshot report will come out and will almost certainly show a "mysterious" large drop in ACA exchange enrollments vs. last year...from 772,250 down to perhaps 500,000 or so.
Around 7,000 or so of this drop will likely be due to Nevada splitting off onto their own ACA exchange. A small number will be due to Idaho expanding Medicaid. But the vast bulk of this seemingly disastrous ~35% drop will be for a far simpler reason...the same one which caused the seeming 41% spike last week: Thanksgiving.
