GRAHAM-CASSIDY REPEAL BILL DEADLINE:

Time: D H M S

UPDATE: Too damned much happening to keep up with.

OK, all sorts of craziness happening, I've been swamped with stuff, so here's a quick roundup:

KANSAS, MISSOURI, NEVADA, FLORIDA, GEORGIA, INDIANA, OHIO, TEXAS, WASHINGON: CENTENE EXPANDING INTO ACA EXCHANGES:

Health insurer Centene Corp. plans a broad expansion of its Obamacare offerings next year at a time when many of its big rivals are retreating from the program.

Centene said Tuesday that it would sell Affordable Care Act plans in three additional states: Kansas, Missouri and Nevada. The company also said it will expand in six states where it already offers Obamacare plans.

“Centene recognizes there is uncertainty of new health-care legislation, but we are well positioned to continue providing accessible, high quality and culturally-sensitive health-care services,” Chief Executive Officer Michael Neidorff said in the statement.

The company specializes in providing Medicaid coverage for low-income people, and has said the skills it’s honed in that business have helped make it successful in Obamacare markets.

Aetna Inc., Humana Inc. and UnitedHealth Group Inc. have largely quit Obamacare after wracking up losses, leaving some consumers with fewer options. Republican efforts to repeal the health law, and uncertainty over the degree to which President Donald Trump’s administration will continue to run it, have led to volatility in the market and contributed to the exits.

Centene’s expansion could help add options for consumers who’ve seen other health plans quit their markets, though the company didn’t give details on its exact plans. The states the company is expanding in are Florida, Georgia, Indiana, Ohio, Texas and Washington.

NEVADA: AETNA EXPANDING AFTER ALL:

Aetna reverses course, files to offer Obamacare policies in Nevada

The insurance titan has filed to offer Obamacare policies in Nevada in 2018. The move comes a month after it announced it was pulling out of all the states where it offers Obamacare coverage this year.

Aetna (AET) agreed to participate on the Nevada exchange to help it win a contract to offer Medicaid policies in the state. Nevada gives insurers extra points in the Medicaid bidding process if they also agree to participate on its exchange. Nevada is one of 11 states that runs its own exchange, rather than using the federal marketplace, healthcare.gov.

The carrier, however, still won't fully commit to Obamacare. Insurers have until mid-September to sign their contracts, locking in their participation for 2018.

"We've filed rates based on a contractual obligation with the state, but no final decision on our participation has been made," an Aetna spokesman said, declining further comment.

That's actually reasonable under the circumstances...and this is the strongest support yet for Suggestion #10 on the If I Ran The Zoo list...

OHIO: OSCAR EXPANDS INTO ACA EXCHANGE:

A Kushner Bets on Obamacare in the Era of Trump

President Trump’s unexpected win in November sent the company into crisis mode and prompted it to rebrand itself as a champion of individual health insurance—rather than one focused exclusively on Obamacare. The company started offering plans to small businesses and has been looking for ways to expand into new markets without taking on much more financial risk. The biggest evidence of this shift in focus is set to be announced on June 15, when Oscar and the Cleveland Clinic, the internationally known Ohio hospital system, will unveil an insurance company that will sell plans in metropolitan Cleveland on the Obamacare exchange.

The plans will be co-branded, but to keep costs down, the network will be limited to the 96-year-old Ohio institution’s hospitals, health centers, and affiliated doctors, including its top-rated surgeons and specialists. The two companies will share profits or losses. “The individual segment is here to stay even though there is turmoil right now,” says Kevin Sears, a Cleveland Clinic executive director.

NEVADA: GOV. SANDOVAL HAS 4 HOURS TO SIGN OR VETO MEDICAID PUBLIC OPTION:

Nevada may become the first state to open Medicaid to all residents.

The Democratic-led state legislature passed a bill earlier this month that would allow anyone to purchase a Medicaid-like policy, regardless of their income. Governor Brian Sandoval, a Republican, has until midnight Friday to sign or veto the bill, which was approved along party lines.

The bill calls for the state to create the Nevada Care Plan, which would be separate from the state's Medicaid program but offer nearly all the same benefits. It could either be administered by the state's Medicaid department or officials could contract with an insurer to run it.

The legislation contains few details on how the program would work or what the premiums would be. Instead, it's more of a framework to help Nevadans access coverage that's more affordable and comprehensive, particularly if Congress repeals Obamacare, said the bill's sponsor, Assemblyman Mike Sprinkle.

I wrote about this back in April, but honestly didn't think it would go anywhere; I thought it was either just a symbolic thing or, at best, that it would die in committee or whatever. Instead, it passed both the Nevada House and Senate, and is apparently sitting on Republican Gov. Sandoval's desk right now. I'd have to know more about the details to be sure, but this sounds like exactly the sort of path I'd recommend for eventually achieving a single-payer like system nationally.

UPDATE: Crap. (sigh) Never mind; he vetoed it.

SARAH KLIFF IS PISSED OFF (and that's not easy to do):

I’ve covered Obamacare since day one. I’ve never seen lying and obstruction like this.

...These are people like 6-year-old Timmy Morrison, who lives in a city halfway between Washington and Baltimore. He was born premature with a rare genetic condition and has racked up $3 million in medical bills during his short life. If the Senate follows the House’s path, it would pass a bill allowing companies to once again place lifetime limits on health benefits — which would mean Timmy could run out of care.

His parents don’t know what they would do if that happens. “We don’t really know what to do right now,” his mother, Michelle Morrison, told me in February. “Should we start pressuring his doctors to do a surgery now so he can get it in time? That doesn’t feel right. Insurance is supposed to cover things that you can’t anticipate — and for us, this is one of them.”

Voters can oust Republicans in the 2018 midterm elections if they don’t like the health care plan. But for people like Cliff and Timmy, the damage will already be done. The election is secondary to their ability to get health insurance coverage.

This is the most damaging part of the lack of public discourse around the Republican repeal efforts: There are millions of real lives at stake that could be hurt. These people would suffer the consequences that will happen much faster and matter much more than any election.

OREGON: MEDICAID EXPANSION GETS 2-YEAR EXTENSION:

Oregon House passes $550 million tax bill to fund Medicaid

Lawmakers in the Oregon House voted Thursday to pass a $550 million health care tax plan they said was necessary to prevent cuts to the state's Medicaid program.

The legislation, which now goes to the Senate, includes a tax increase on hospitals and new taxes on health insurance plans. Gov. Kate Brown supports the bill, and said last week it's among her three top priorities for lawmakers to approve before going home by July 10.

The Oregon state Senate is controlled by Democrats 18 to 12, so I'm reasonably certain it'll go through.

MARYLAND: EVERGREEN HEALTH CO-OP REBORN AS A PRIVATE, FOR-PROFIT INSURANCE CARRIER:

Maryland Insurance Administration Issues Order Approving Evergreen Health, Inc. to Convert to For-Profit Status and Be Acquired By Investors

​BALTIMORE – Commissioner Al Redmer, Jr. signed an administrative order today that states that it is in the public interest to approve Evergreen Health, Inc. to convert to a for-profit status and be acquired by investors. The investors include: JARS Health Investments, LLC, Anne Arundel Health System, Inc., and LBH Evergreen Holdings, LLC. The Maryland Insurance Administration (MIA) staff heard testimony from the interested parties on June 7, 2017 regarding this request to convert to a for-profit status and enter into a Stock Purchase Agreement.

“After a year of working with management representatives from Evergreen, the investor groups, and Centers for Medicare & Medicaid, we are pleased to issue this order today that permits Evergreen Health to convert to a for-profit status and be acquired by investors,” said Commissioner Redmer. “This is a positive step forward for Evergreen Health, their 65 employees and the consumers they serve today and in the future. We expect the financial condition of the acquiring parties to ensure the company’s financial condition and protect the interests of its policyholders.”

Evergreen was one of the handful of ACA-created Co-Ops which survived the Risk Corridor Massacre a couple of years ago. They decided that the only way to continue operating was to sell themselves to private investors, which took quite a bit of legal/financial finagling but has finally been completed.

CONNECTICUT: EXCHANGE HEAD CONFIRMS Q1 RETENTION RATE BETTER THAN PRIOR YEARS:

The Secretary of Health and Human Services said new data showing people dropping out of coverage under the Affordable Care Act is proof government should step back from health care. But the head of Connecticut’s health care exchange begged to differ. 

..."If government is not helping everyone in the country with health care -- who should be, then?” responded Jim Wadleigh, the CEO of Access Health CT, the state’s own Obamacare exchange.

Wadleigh told WNPR this phenomenon of dropout has happened every year in Connecticut.

Generally around 15 percent of those who sign up, in the end, don’t activate their plan.

"Interestingly enough, right now, that number has been a little bit less," Wadleigh said. "We’ve only seen about a ten percent drop at this point in the year."

Access Health CT always attempts to survey every customer who leaves, and Wadleigh said they consistently hear a variety of reasons.

“We find residents are moving out, we find residents get a job that has employer sponsored health care, we find that residents may move into Medicaid,” he said.

Gee, who woulda thunk?