HELENA, Mont. (AP) — Montana will become the 30th state to expand its Medicaid program after federal health officials on Monday approved provisions that include requiring beneficiaries to pay premiums that amount to 2 percent of their income.
Gov. Steve Bullock announced the Centers for Medicare and Medicaid Services' approval of the federal waiver needed for state officials to start enrollment this fall and begin coverage on Jan. 1.
The governor's office has said 70,000 people or more would be eligible for coverage under the expansion, but legislative fiscal analysts predicted about 45,700 would actually participate over the next four years.
Actually, if the past 2 years of Medicaid expansion in the other 29 states are any guide, Montana will probably hit 50-60K easily within the first year. Many other states ended up maxing out by the end of 2014.
I admit that given the carnage of the past couple of weeks, I'm almost afraid to post this entry...but I had to write something positive about the CO-OP situation.
With the ACA-created CO-OPs seemingly dropping like flies due to the #RiskCorridorMassacre, I thought this would be a good time to flip things around and look at which CO-OPs are doing well (or at least not badly).
This isn't much, but it'll do for now:
Wisconsin's insurance department says it has no intention of shutting down its #ACA co-op, which appears it will remain solvent next year.
Last month I wrote a quick post about the Montana individual market; with only 3 players, all of whom had requested >10% increases, it was pretty easy to plug the numbers in: 22.2%, 29.3% and 34.0%.
Commissioner Monica Lindeen's office says the average rate increase for all plans next year will range between 22 percent and 34 percent. For the popular Silver plan, the increase will range from $80 to $88 a month for a 40-year-old person.
Lindeen said Thursday the rates affect about 41,000 people. They don't include people who receive federal tax credits or those who have insurance through their employers.
The "good" news here is that the affected number is only 41K instead of the 76K I had on record. It's possible that the middle carrier had their rates changed, but overall it looks like the commissioner just signed off on the original requests, for a roughly 26% average increase.
Montana's Dept. of Insurance website doesn't really provide the actual rate filings (or if it does, I can't find them), but it does include this handy chart laying out every carrier offering individual policies in the state (there's only four of them, and one, Assurant, just went belly-up this past spring). That leaves just three companies to track: BCBS of Montana, Montana Health COOP and PacificSource.
Fortunately (well, unfortunately, actually), all 3 of these are listed on Healthcare.Gov's "Rate Review" website, making it fairly easy to generate the weighted average. Sadly, it's grim news in Big Sky country next year:
Democratic Gov. Steve Bullock signed the Montana Health and Economic Livelihood Partnership (HELP) Act into law Wednesday in the Capitol rotunda as hundreds of people cheered.
The bill was introduced by Republican Sen. Ed Buttrey of Great Falls after lawmakers defeated the governor's expansion proposal.
Buttrey calls the plan the most conservative in the nation due to copays, premiums and other provisions. Because of those items, the state must seek a waiver from the federal government to put the program in place.
Assuming the vast majority of those eligible enroll (which seems to be the case in most states which have gone through with expansion to date), we should be able to chalk up another 35,000 - 70,000 Medicaid expansion enrollees over the rest of the year.
I'm back from a short vacation to Chicago (we had a blast, thanks for asking...visited the Shedd Aquarium, Adler Planetarium and Museum of Science & Industry), so obviously my in box has built up quite a bit of ACA news over the past week.
It'll take awhile to sift through everything, but in the meantime there are some state-specific developments which stand out:
MONTANA: A couple of years back, Montana held a vote on the ACA Medicaid expansion provision. It was a tight vote, but should have passed...unfortunately, one state legislator accidentally voted the wrong way on the bill. Seriously:
Some states have declined to expand Medicaid because they oppose Obamacare. Others worry about the financial burden of expanding the entitlement. But there appears to be only one state where the Medicaid expansion failed due to a Democratic legislator accidentally voting against it.
I have a ton of ACA-related stories cluttering up my in-box again; here's some of the more interesting ones, all regarding ACA Medicaid Expansion:
MICHIGAN:
For months now, I've been a bit obsessed with figuring out how my home state's Medicaid expansion enrollment has managed to reach as high as 21% more people than were supposedly even eligible for the program. Estimates last year ranged from 477,000 - 500,000, yet enrollment in Healthy Michigan (Gov. Snyder's name for Obamacare Medicaid Expansion) currently sits at a whopping 579K, less than 1 year into the program.
Montana's official 4/19 exchange QHP tally was 36,584, of which I estimate around 33,000 have actually paid their first month's premium. Since MT has not expanded Medicaid, and is a sparsely-populated state, I only have them pegged with around 5,000 Woodworker enrollees, for a total of around 38,000 people.
Considering that the Kaiser Family Foundation has estimated the "previously uninsured" rate at only around 57% nationally, it's actually quite impressive that the net reduction in Montana's uninsured is 30,000; that suggests that for this state at least, it's closer to perhaps 79%:
HELENA, Mont. (AP) — About 30,000 more Montana residents are enrolled in a health insurance plan than were before the Affordable Care Act enrollment period took place, state officials said Tuesday.
State Insurance Office Deputy CommissionerAdam Schafer told a legislative panel his office surveyed the state's largest insurance companies to learn whether the number of uninsured decreased after the federal health care overhaul.
UPDATE: On the down side, I was off by 4% this time around.
On the up side, I UNDERESTIMATED:
Actual Feb. enrollments: 942,833, for a total of 4,242,325 thru 3/01/14.
Sarah Kliff at Vox just announced that the February HHS report is expected to be released today at around 4:00pm. A few items in anticipation of that:
As I've noted several times, I'm projecting the report to total around 902,000 exchange-based private QHP enrollments for the month of February (technically 2/02 - 3/01)
If accurate, this would bring the cumulative total of exchange-based private QHP enrollments to 4.202 million (from 10/1/13 - 3/01/14)
From the data I have, the average daily enrollment rate in February was almost identical to that of January, which had about 1.146 million QHP enrollments. HOWEVER, the January report included five weeks of data (12/28 - 2/01), while the February report will only include four weeks (2/02 - 3/01). Therefore, even at the same daily average, it'll be about 20% lower no matter what.
Don't be surprised if Peter Lee of CoveredCA decides to steal some thunder by announcing that California has enrolled 1,000,000 QHPs all by itself either today or tomorrow. However, that would include the past 10 days, while the HHS number will only run thru 3/01.
If you want to get REALLY specific, call it 902,800 and 4,202,292.
I've been dead-on target 6 times in a row without hyping up my projections beforehand. This time I am hyping myself up beforehand, so I'll probably be way off...but as long as I've UNDERestimated the tally, I'll be perfectly fine with that...
The report will be released in about 5 minutes, but my kid gets home from school in about 10, so it'll be a good 20 minutes before I can really post anything. Feel free to follow Sarah Kliff of Vox in the meantime!
