Wednesday Short Cuts

• Is it cheaper to provide health insurance or pay the fines? Affordable Care Act Q&A

A Roseburg-based nonprofit recently made news when it announced it can't afford to offer health care insurance for its employees and is preparing to pay a federal fine under the Affordable Care Act that's likely to reach six figures.

Adapt provides drug and addiction treatment in three Southern Oregon counties and employs 183 people. However, rising costs have made group health insurance so expensive that the organization has decided to budget for fines of up to $2,000 per employee, according to Susan Jeremiah, the agency's human resources director.

As of Jan. 1, 2015, all employers with more than 100 full-time equivalent employees are required to offer affordable health care insurance or face penalties.

In view of broad reader interest in the story, we asked Portland attorney Iris K. Tilley, a partner with Barran Liebman who advises employers on employee benefits, to answer a few questions about the Roseburg case and the ACA in general.

• Most directors have resigned from O-Care exchanges, analysis finds

The original directors of ObamaCare's state-based exchanges have almost all resigned since the beginning of the law's first enrollment period, a new analysis found. 

Only five of the original 16 officials remain in their posts, according to Dan Diamond, manager of The Advisory Board's "Daily Briefing" newsletter. 

Most of the resignations took place during the exchanges' first sign-up window, when many online systems ran into technical flaws that put state officials in hot water. 

• Medicaid's Western Push Hits Montana

The Affordable Care Act is on the move in Western states, with the governors of Utah, Wyoming and Montana all working on deals with the Obama administration to expand Medicaid in ways tailored to each state.

But getting the federal stamp of approval is just the first hurdle. The governors also have to sell the change to their state legislators, who have their own ideas of how expansion should go.

The latest example is Montana, where the governor and the legislature have competing proposals about how much federal Medicaid expansion cash the state should try to bring in.

• Hawaii to Fill Medicaid Fee Shortfall for Six Months

Hawaii’s Department of Human Services announced that it will extend for six months increased fees paid to Medicaid primary care providers. Fees nationally were boosted for two years under the Affordable Care Act, but federal funding for the increase expired on December 31, 2014.

Without the six-month extension, Medicaid providers in Hawaii would have suffered a 48 percent pay cut, according to the State Department of Human Services.  Other states--where legislators have not agreed to make up the difference--face even steeper cuts, including California, Florida, New York and Pennsylvania, where fees will decline by more than 50 percent.

(file this one under "no duh..."):

• Survey: Fewer Vermonters Lack Health Insurance

The percentage of Vermonters without health insurance has dropped to 3.7 percent, second lowest in the nation, according to new data from a survey of 4,000 households.

Massachusetts, which mandates health insurance coverage, has the lowest percentage of uninsured.

Since the last state-sponsored survey, in 2012, the number of uninsured Vermonters declined from 42,760 to 23,231.

• Only a fourth of those eligible have bought subsidized health coverage through Kynect

While 85,000 people are covered by private health plans through Kynect, that’s only one-fourth of the 340,000 that state officials estimated would be able to buy subsidized coverage through the state insurance exchange. That “underscores some of the challenges” of the federal health reform law, Abby Goodnough reports for The New York Times, in the latest of series of stories using Kentucky as a bellwether for Obamacare.

• Georgetown researchers: D.C. created stronger protections than most states under ACA

D.C. has more consumer protections than the majority of states when it comes to how much health insurance premiums can differ based on an individual's age, tobacco use or geography, an analysis released Monday by Georgetown University shows.

Under the Affordable Care Act, individuals are protected from being charged more for insurance based on factors like medical history or gender. But ACA also established new limits on how insurers could adjust premiums for age, tobacco use and geography.