2018 MIDTERM ELECTION

Time: D H M S

Thursday Short Cuts

I know I snarked about "nothing interesting happening" while I was out of town/unavailable yesterday/this morning, but the reality is that a whole mess of stuff is always going on in the healthcare/ACA field, so here's a quick roundup:

...lawmakers went along with Raimondo’s bid to raise the state’s $3.50-a-pack cigarette tax — already the third-highest in the nation — by 25 cents to reap an extra $7.1 million.

They backed a scaled-down version of the new health-insurance surcharge that Raimondo proposed to pay for the state-run health-care exchange that they expect to average 2.86 percent on individuals’ monthly premiums, and .59 percent on average for small-business groups’ monthly premiums.

There were also an estimated $120.9 million in spending cuts in the state’s fastest-growing subsidy program: Medicaid, including $70.5 million in projected state dollar savings.

OK, it sounds like Rhode Island's ACA exchange funding concerns have been addressed, anyway (at least for next year).

Now, as the country awaits a ruling in the second major challenge to Obama's signature Affordable Care Act, a question is whether the justice who was the voice of the opposition then could provide the critical fifth vote to uphold the law on the nine-justice court now.

...On healthcare, either Kennedy or Roberts could tip the balance. Yet the 78-year-old Kennedy, appointed to the bench in 1988 by Republican President Ronald Reagan, may be in a more pivotal position based on his respect for state sovereignty and concern for the practical consequences of a decision.

If the Supreme Court rules this month that Hoosiers can no longer receive federal subsidies to buy health insurance on HealthCare.gov, Indianapolis residents would be among the hardest hit in the state.

People in the city have been using HealthCare.gov at higher rates than the rest of the state, according to an analysis by the nonpartisan Kaiser Family Foundation.

There is no official plan.

There is no time to execute one, even if there were a plan.

And, most importantly, there appears to be no political leadership in Florida to act if the Supreme Court rules this month more than 6 million Americans, including about 1.3 million Florida residents, can no longer receive federal subsidies to help pay for health insurance under the Affordable Care Act, according to health policy experts.

Health care providers across Vermont will be forced to repay insurers. That's after the state's health exchange green lighted payments for patients with canceled coverage.

Thousands of requests to cancel Health Connect coverage sat in limbo for months and in some cases, more than a year.

Over that time, insurers unwittingly continued covering some of those people. Now all involved need to make sure the right people are paid.

Vermont Health Connect canceled 6,000 policies as staff work their way through old requested coverage drops from 2014.

About 600 had claims paid out by the wrong provider despite policy-holders securing different coverage.

That means care providers will need to pay back more than half-a-million dollars, and bill the proper private insurer or Medicaid.

Gov. Tom Wolf's administration will pull the plug on its effort to start running the insurance marketplace created by the 2010 health care law if the U.S. Supreme Court allows federal health insurance subsidies to keep flowing to hundreds of thousands in Pennsylvania, a spokesman said Tuesday.

The administration's application to the federal government is strictly a contingency plan, Wolf press secretary Jeff Sheridan said.

"If they rule that these individuals are eligible for subsidies, then we are not moving forward with this," Sheridan said.

When it comes to Kentucky's health insurance exchange, that's the decidedly complicated question facing Democrats running for statewide office in a state that seems to hate Obamacare and seems to like Kynect.

Yes, they are the same thing, but polling has generally revealed that Kentuckians don't view them equally, most likely because of the prefixes.

Many poor Californians have obtained insurance coverage only to face great difficulty finding doctors and other providers, fueling demands by medical groups to raise reimbursement rates that were slashed during years of state budget distress.

The Legislature’s dominant Democrats placed money in their version of the budget to raise rates over opposition from Brown’s budget advisers.

The budget deal announced Tuesday doesn’t include provider rate hikes, but they could re-emerge in a special legislative session that Brown called on health issues.

Twenty-nine temporary staff for the Hawaii Health Connector have received lay-off notices as the exchange winds down operations to move enrollment processes from the state-run online health insurance exchange to the federal government's online platform.

The temporary staff, some of whom worked in outreach, were notified Friday, and their positions will be eliminated within the next two to three weeks, Hawaii Health Connector Executive Director Jeff Kissel said.

The New York State Senate passed legislation Wednesday which would allow uninsured pregnant women to purchase health insurance through the state's exchange.

The bill sponsored by state Sen. Jim Seward would add pregnancy to the list of qualifying events which allows individuals to purchase health insurance through the exchange, New York State of Health, outside of an open enrollment period.

Two new reports out by state officials find that their respective Medicaid managed-care programs are rife with errors and waste. Blame was pinned on state Medicaid agencies as well as the private health insurers that cover Medicaid beneficiaries.

The cost for enrolling people in temporary Medicaid coverage last year due to Massachusetts' failed Health Connector website was $658 million, according to the Massachusetts Executive Office of Health and Human Services.

State officials say the cost is based on claims processed as of May 31 for the approximately 321,000 people who were enrolled in temporary Medicaid coverage through the end of February.

Harriett Zak has plenty of complaints about Obamacare, but if the U.S. Supreme Court rules in favor of a challenge to the health care program, Zak's monthly premium will jump from about $443 to about $755.

And she's not sure how she can afford her three prescriptions and doctor visits that keep her healthy.

Immigrant children who are in the country illegally would receive public healthcare coverage in California under a budget deal announced Tuesday by Gov. Jerry Brown and legislative leaders.

An estimated 170,000 immigrants 18 and younger could qualify, marking another victory for advocates and lawmakers who have worked to make the state more welcoming to unauthorized residents.

Since the ink dried on President Obama's Affordable Care Act in 2010, critics have railed against the landmark healthcare system overhaul. The small-government battalion has decried it as a public takeover of the healthcare industry, while locally MNsure's junky website has given aspiring insurance card carriers fits.

Now, new federal data shows that Minnesotans buying plans through the insurance exchange receive the lowest rate of ObamaCare tax breaks in the country. The eyebrow-raising stat from the Centers for Medicare and Medicaid show Minnesotans copping plans get nearly 36 percent fewer premium-shaving tax credits than the national average.

Nevada, New Mexico, Oregon, and Hawaii all created the legal framework for their own state exchanges and still run big aspects of their Obamacare markets. But they decided to rely on HealthCare.gov when they couldn’t make their own systems work. Under the health law, they qualify as states that adopted Obamacare, so they can keep getting subsidies no matter what the court does in King v.Burwell.

But the GOP senators running for president — starting but not ending with firebrand Ted Cruz — threaten to stymie their leaders’ carefully hatched plans. Any whiff that the GOP’s Plan B is a continuation of Obamacare is bound to spark furious protests from the conservative base, putting pressure on the presidential hopefuls to respond. Cruz, for one, would press for a wholesale repeal of the law — or to allow states to opt out of Obamacare — if the high court provides the opening.

Top Republicans warn those conservatives are playing with fire.

“Things can’t be turned on a dime,” said Senate Majority Whip John Cornyn of Texas. “People can run for president, but we’ve actually got to solve a problem.”