The problem was that if CMS didn't approve the waiver, the entire program would be shut down, kicking some 600,000 Michiganders off their healthcare coverage next April.
Unlike the exchange QHP enrollments, which will always continue to be the heart and soul of this website (it's right there in the name, after all), I've kind of gotten away from trying to track Medicaid expansion on a granular level over the past few months. The main reason for this is that in many of the expansion states, they've simply maxed out on enrollees, and the numbers from week to week or even month to month are simply holding steady at this point.
This is the first post I've written since Friday, partly because I had my kid's Lego® Robotics League event all day Saturday, partly because I came down with a 24-hour (I hope) flu yesterday.
MICHIGAN WAIVER PUTS CMS IN TOUGH SPOT — The federal waiver Michigan needs to extend its Medicaid expansion has put CMS in a bind — either approve controversial conditions or let the program end next spring. Pro’s Rachana Pradhan writes, “The 2013 Michigan law expanding Medicaid included a provision requiring CMS to approve a waiver with drastically conservative changes by the end of this year. The waiver would require Medicaid enrollees earning above the poverty line to make a choice after four years of Medicaid coverage: Either enroll in a private subsidized plan on HealthCare.gov, or stay in Medicaid and pay up to 7 percent of household income toward health care costs — notably higher than the 5 percent ceiling CMS has held other states to.” If the waiver isn't approved, Medicaid expansion coverage is scheduled to end in April.
It appears that East Lansing-based Consumers Mutual Insurance of Michigan could wind down operations this year as it is not participating in the state health insurance exchange for 2016.
But officials of Consumers Mutual today are discussing several options that could determine its future status with the state Department of Insurance and Financial Services, said David Eich, marketing and public relations officer with Consumers Mutual.
Consumers Mutual CEO Dennis Litos said: "We are reviewing our situation (financial condition) with DIFS and should conclude on a future direction this week.”
Well I'll be damned. Given all the tea leaf/entrail-reading that I've had to do in some states to try and piece together the weighted average rate increases for 2016 (usually due to missing enrollment/market share data for the companies participating), it's a pleasant surprise to see that my own state of Michigan has posted the approved rate hikes without any gobbledygook:
Individual market to increase on average 6.5%, small group 1.0%
FOR IMMEDIATE RELEASE - August 18, 2015
LANSING - Michigan consumers and small businesses will experience lower increases in the cost of their 2016 health insurance plan than those in many other states, according to the Michigan Department of Insurance and Financial Services (DIFS). DIFS reports that the average approved rate changes on a premium weighted basis increased by 6.5 percent for the individual market and 1 percent for the small group market.
Once again, the Affordable Care Act (ACA) is proving its critics wrong. Opponents of the ACA, or Obamacare, have been falling all over themselves proclaiming that an influx of new patients will overburden the healthcare system, creating a dire doctor shortage.
At least in Michigan, that’s proven to be absolutely false.
A new University of Michigan study shows that the availability of primary care appointments actually improved for people with Medicaid in the first months after the state launched the Healthy Michigan Plan, the state’s Medicaid expansion under the ACA. What’s more, it remained mostly unchanged for those with private insurance.
This AP article provides snippets about a handful of states; it'd be nice if they just released the actual report so we could see the hard expansion numbers (as opposed to the total increase numbers, which are still obviously useful but don't distinguish between traditional Medicaid and ACA expansion enrollees):
In Kentucky, for example, enrollments during the 2014 fiscal year were more than double the number projected, with almost 311,000 newly eligible residents signing up. That's greater than what was initially predicted through 2021.
...At least 14 states have seen new enrollments exceed their original projections, causing at least seven to increase their cost estimates for 2017, according to an Associated Press analysis of state budget projections, Medicaid enrollments and cost details in the expansion states. A few states said they could not provide original projections.
As I noted at the end of April, after climbing at a furious pace every week for months on end, Michigan's implementation of the Affordable Care Act's Medicaid expansion provision (aka "Healthy Michigan") plateaued at around 600,000 enrollees back in February, and then bobbled around the 600K level for several weeks straight. As I noted at the time, I'm still checking this figure weekly, but it has never deviated far from that number--sometimes a bit higher, sometimes lower.
So, with all the fuss & bother over the imminent King v. Burwell decision, what's the deal here in the Wolverine state?
Well, first of all, here's what's at risk if the Supreme Court rules for the plaintiffs, Congress fails to pass a simple tweaking of the law to resolve the issue and the state administration fails to "establish" an exchange which passes muster with regard to the minimum legal definition required:
Right off the bat, I want to clarify that I might have misread some of the numbers here; while some states provide the per-company average rate change requests in a nice, simple table format, I had to wade through a mountain of forms at the SERFF Filing Access Database to hunt all of these down, and there seems to be little consistency from company to company about the formatting of the documentation, etc etc. It's possible that I've confused a Small Group filing for an Individual one, for instance, and I may have misunderstood the current enrollment number for one or two companies. Finally, in one case (Physicians Health Plan), their 2016 rate request seems to have been redacted for some reason. Fortunately, they only appear to have around 600 enrollees anyway, which means any change in their rates would barely move the state-wide needle at all anyway.
With those caveats out of the way, assuming I have these numbers straight, here's what it looks like...and remember, these are requested changes only; they still have to be approved:
