Illinois

My in box is once again flooded with ACA-related stories which are interesting but which I just don't have time to do full write-ups on...

ILLINOIS: Clock Ticking For Illinois To Form State-Run Obamacare Exchange

Unless Illinois acts quickly, it will leave hundreds of millions of federal dollars on the table that would go toward building its own health insurance marketplace, potentially upping the cost of coverage for nearly 170,000 Illinois residents. State lawmakers, unable to break a years-long standoff, have not passed a law authorizing a state-based exchange, the marketplaces created under the Affordable Care Act that allow consumers to compare and buy health coverage, often with the help of federal tax credits. As a result, Illinois was one of 36 states that relied on the federal government to host its marketplace on HealthCare.gov, the website that survived a disastrous launch late last year to enroll about 217,000 Illinoisans, 77 percent of whom received federal help.

Holy smokes! This may seem a bit anticlimactic after this morning's surprise announcement by CMS Administrator Marilyn Tavenner, but it's still just as important in other ways:

@JeffYoung @philgalewitz I can tell you there are now roughly 450,000 newly eligibles who enrolled so far in Medicaid in Illinois.

— Peter Frost (@peterfrost) September 18, 2014

When I inquired, he explained:

@charles_gaba @JeffYoung @philgalewitz Sure. Those are the figures from @CoveredIllinois. They say total is now 670,000 (mktplc + Medicaid)

— Peter Frost (@peterfrost) September 18, 2014

When I asked for a link for confirmation, Jonathan Ingram helpfully chimed in:

Last October, at the height of the botched HC.gov rollout, I repeatedly commented over at Daily Kos:

 I still don't know why they didn't roll it out one state per day; if they'd gone alphabetically, they would have had a solid week to work the kinks out with a (relatively) low volume before hitting a big state:

  • Alabama, Alaska, Arizona and Arkansas are all relatively low-population.
  • California, Colorado, Connecticut and Delaware* are all state-run exchanges.
  • That means they wouldn't have hit Florida on the federal site until tomorrow.

I know that the system still would have had serious software issues, but at least they wouldn't have to deal with the massive overload of traffic at the same time that they were trying to fix the issues.

*(Obviously I was mistaken at the time about Delaware running their own exchange, but it's still a low-population state so my point was still valid...and of course the District of Columbia does run their own exchange).

Well, obviously it was too late for that at the time, and they've since scrambled to get their act together on the individual exchange side.

Shades of John "OMG!! Papa Johns will be forced to raise prices by 14¢ a pizza!!" Schnatter in Chicago this week...

The Chicago Cubs denied an assertion by the Chicago Sun-Times on Friday that the tarp debacle earlier in the week against the San Francisco Giants happened because the club short-staffs the grounds crew at Wrigley Field in order to avoid paying health insurance.

The short version: The nasty storm last week ended up making Wrigley Field unusable because the grounds crew was shorthanded. According to the Sun-Times, the reason they were shorthanded is because the team management slashed their hours in order to avoid having to pay for (gasp! the horror!) healthcare coverage for the staff.

As writer David Brown notes, if true, this is pretty slimy behavior for two reasons:

If a grounds crew person needs to work at least 130 hours a month to meet the requirements for health care, that's the cost of doing business. But the Cubs have gone on the cheapsince being sold by Sam Zell, and it's not just in the free-agent market. 

The good news: Illinois ACA Medicaid expansion is up to 350K, a 20K increase from 2 weeks ago. This represents 44% of the 800K eligible for the expansion program in the state.

The bad news (or good news, depending on your POV): There's nother 250K still in the hopper to be processed. Assuming the same 70% approval rate, that should increase the enrollment number by another 175K.

As of last week, Illinois' backlog of unprocessed Medicaid applications stood at 250,000, up from about 200,000 state officials reported in mid-March, but down from a peak of nearly 500,000 in early April, according to state data.

Since Oct. 1, the start of open enrollment in an expanded Medicaid program authorized by the federal health law, the state has received nearly 900,000 applications for public aid, most of which included Medicaid. Thus far, it has processed about 650,000 of them, granting coverage to about 450,000.

Roughly 350,000 gained Medicaid coverage under the health law, which expanded eligibility to all adults who make less than about $15,500 a year. The remainder gained coverage under old Medicaid parameters, which generally covered children, families and a category of older, sicker patients.

Don't let the snarky headline fool you; I'm still very much a single-payer guy. However, anyone who still claims that the ACA exchanges are "socialized medicine" doesn't have the slightest clue what they're talking about. In case you needed even more proof that the ACA is very much private-market friendly:

Illinois:

After sitting out the first year, UnitedHealth Group Inc. intends to offer individual policies on the Illinois health insurance exchange next year, according to sources familiar with the company's plans.

The decision by UnitedHealth, the nation's largest and the state's No. 2 insurer, has the potential to shake up the Illinois market, which was dominated in 2014 by Blue Cross and Blue Shield of Illinois, the state's dominant insurer.

...United's participation also could help lower rates for consumers, a key concern among the law's supporters.

While United would neither confirm nor deny its plans to offer policies in Illinois next year, a spokesman said the Minnesota-based insurer intends to increase its participation over time in exchanges nationwide.

Lots of Medicaid expansion updates today; here's Illinois...

Statewide, about 330,000 have enrolled in the expanded Medicaid program through the end of May, blowing away initial state estimates of about 200,000 for all of 2014, Koetting said.

The total eligible for ACA expansion in Illinois is around 801,000, so they've hit around 41% of that already.

Simple and to the point: These are all expansion enrollees:

In Illinois, an additional 287,000 have enrolled in expanded Medicaid coverage.

(I previously had the total at 350K, but that included determinations, not actual enrollees).

My Medicaid spreadsheet currently estimates Illinois at roughly 200K "strict expansion" and another 115K "woodworkers". This article suggests that the woodworker number may be too high, but the "strict expansion" number may be dramatically low:

For the first time, low-income adults without children are eligible for government health coverage.

 In Illinois, officials expect that'll mean 350,000 new people in Medicaid. And that's not all.

 Julie Hamos, director of the Department of Health Care and Family Services, says the news reports and advertising and community outreach around the Obamacare deadline led to a separate spike.

 "We have 80,000 more than the usual enrollment of people who already were eligible, they just didn't sign up. But because of that activity in the communities, now they're signing up."

Earlier this evening I ran an update on Illinois which claimed 323K total exchange enrollments. Since IL had 114K QHPs and 132K Medicaid enrollments as of 3/01 (246K total) that seemed like a decent, if unremarkable update...about 17% above the February daily rate.

However, contributor deaconblues tipped me off that other Illinois stories floating around today seemed to indicate that the 323K figure might actually be the 3/01 numbers, plus another 77K or so of unspecified enrollments. I double-checked with GetCovered Illinois, and sure enough, received this response:

@charles_gaba 113,733 in QHPs, the other 200K Medicaid (as of 03/01). Tricky in part because Cook County got advance dispensation to enroll.

— Erik Wallenius (@ErikWallenius) March 27, 2014

OK, so never mind the earlier Illinois update; my apologies for the error. This also means that I can't use Illinois in the projection table at all, which is fine, since it was actually dragging the projection down anyway lol...

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