Charles Gaba's blog

Apparently some insurance companies haven't been complying with the byzantine hoops that anti-choice forces demanded be included in the Affordable Care Act (although for the most part they still voted against it anyway):

The new GAO study shows that, instead, taxpayers are subsidizing abortions. Customers in five states have no abortion-free plans available to them, and in many states, customers can't tell which plans cover abortion and which don't.

...Fifteen issuers and the Washington Health Benefit Exchange ... did not itemize the premium amount associated with non-excepted abortion services coverage on enrollees’ bills nor indicate that they send a separate bill for that premium amount.

Well, well, well; imagine that...

While Obamacare attacks continue to fade, health reform’s success is even forcing some Republicans to acknowledge the law is having positive effects.

The latest example comes from Iowa’s third congressional district, where David Young (R) is facing former state Sen.Staci Appel (D) to replace retiring-Rep. Tom Latham (R-IA) in a toss-up seat.

...BORG: Did you favor the expansion of Medicaid, which was included in Obamacare?

YOUNG: It seems to be working in Iowa. I would make sure in any regards to Medicaid they would have some kind of flexibility.

...Still, Young was asked twice by Borg whether he would support repealing Obamacare, as has been the Republican mantra for the past four years. Both times, Young refused to say he wanted to do so.

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...

Fate of Children’s Insurance Program Is Called Into Question at Senate Hearing

WASHINGTON — A Senate hearing on Tuesday set the stage for a coming debate over whether the federal government should continue financing a popular health insurance program for lower-income children who are now eligible for new coverage options under the Affordable Care Act.

The Children’s Health Insurance Program, known as CHIP, has helped cut in half the uninsured rate for children, to about 7 percent in 2013 from 14 percent in 1997, when it was enacted. It provides coverage for about eight million children in families that earn too much to qualify for Medicaid, the government health care program for the poor, but cannot afford private coverage.

Zenefits’ Leader Is Rattling an Industry, So Why Is He Stressed Out?

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.

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...

Joe Sonka has an excellent (if depressing) analysis explaining why Kentucky Senate candidate Alison Lundergan Grimes isn't campaigning on the Affordable Care Act even though her opponent, Mitch McConnell, has done everything he can to tear away healthcare from a half-million Kentuckians:

The reasons for this disconnect are many and are closely tied to the decision of Alison Lundergan Grimes’ campaign to steer clear of the issue. But this decision by Grimes to avoid talking about the benefits of health care reform is not just an effect of the disconnect, it is also a cause of the disconnect, itself.

It's been over 3 months since I've been able to check in on the status of Ohio's implementation of ACA Medicaid expansion. As of mid-June, OH had racked up 243,230 people newly eligible thanks to the Affordable Care Act out of around 563,000 state residents who were eligible.

As of the end of August, that number has grown to 367,395 people, or over 65% of the total eligible:

Ohio Medicaid enrollment under Gov. John Kasich’s Obamacare expansion hit 367,395 in August, passing the Republican governor’s projection for July 2015.

Kasich told taxpayers and the Ohio General Assembly that an estimated 366,000 Ohioans would be enrolled in Medicaid under Obamacare at the start of the state’s 2016 fiscal year. This projection is reflected in a Governor’s Office of Health Transformation chart released in February 2013.

I'll give you a minute to get over the shock of that headline (and really, McArdle is the one who I've ripped on before, not Laszewski).

While I've been pretty much vindicated regarding the (eventual) 1st month premium payment rates, off-season enrollment rates and monthly attrition rates for exchange QHPs, there have still been two items which have bothered me.

Even after yesterday's Big 7.3 Million Currently Enrolled News (or perhaps because of it), there's still tremendous confusion about what that number actually means. In addition, there's been some ongoing confusion about some other numbers relating to the ACA exchange qualified healthcare policies (QHPs), so here's a rundown, in descending order, based partially on existing data and partially on my projections through November 15th (that's when the 2nd Open Enrollment period starts for coverage beginning on January 1st, 2015, making the current enrollment numbers partially moot).

As you can see, depending on what question you're trying to answerwhat you feel should "count" and what your political spin is, there are up to 12 different numbers (!!!) which you could conceivably "use" for your answer.

As I've stated many, many times before: In spite of their $300 million disaster of a website failing to enroll a single person, Oregon has still managed to rack up one of the most impressive enrollment tallies in the entire country relative to their population, with a grand total of over 481,000 people added between QHPs, Medicaid and CHIP (in addition to the 353,000 noted at the link, OR added another 128K to Medicaid via their "fast track" program which they don't list here for whatever reasons).

For a state with only 3.9 million people, that's bound to have an impressive impact on the uninsured rate...and sure enough...

Thanks to Jesse Lee for saving me the trouble of compiling these:

Report: 1/3 of #ObamaCare "enrollees" haven't paid premiums. How does not paying the premium constitute enrollment? http://t.co/OkkUhsJGyt

— Reince Priebus (@Reince) May 1, 2014

Uh oh: House committee claims only two-thirds of federal ObamaCare enrollees paid first… http://t.co/76cpotiWA4 http://t.co/d7lPrqVltS

— memeorandum (@memeorandum) May 1, 2014

New report confirms just 67% of ObamaCare ‘enrollees’ have actually paid their first month’s premium. http://t.co/2WYjCGpCpN

— NRCC (@NRCC) May 1, 2014

Another Big Number story today on top of the national and Illinois ones. My most recent numbers for California Medicaid expansion had it pegged at around 1.4 million "strict expansion" and around 600K "woodworkers" as of late June. However, that was just an estimate.

This article about a class action lawsuit being filed over the massive Medi-Cal backlog (down to 350K from a whopping 900K back in May) is mostly negative for obvious reasons. However, there's an interesting data point in the middle of it:

According to state officials, 2.2 million new Medi-Cal members were added as a result of the Obamacare healthcare expansion, bringing the total number of participants in the program to about 11 million.

State Department of Health Care Services spokesman Norman Williams said that as of Sept. 1, 350,000 applications remained backed up in the enrollment system. That system has been plagued by computer troubles that have stymied county government efforts to verify patients' Medi-Cal eligibility. 

The backlog was as large as 900,000 earlier in the summer.

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:

Apparently it took Congressional testimony to get it out of them, but here it is:

Another couple of key points...

7.3 million people were signed up for Obamacare as of Aug 15 and paid their premiums, HHS says

— igorvolsky (@igorvolsky) September 18, 2014

Now, before anyone claims that I'm "wrong" about the paid number being 7.3 million instead of 8.07 million, read the tweet carefully: I says that 7.3 million were enrolled as of August 15th. In other words, that's the net number after subtracting those who've dropped their coverage after 1, 2, 3 or more months.

This is FANTASTIC news.

It means that either...

In a new 60-second ad, Kentucky Senate candidate Alison Lundegran Grimes finally goes after opponent Mitch McConnell regarding his repeated attempts to damage/weaken Medicare. It isn't really connected to the Kynect = Obamacare = ACA issue, but it's in the ballpark, anyway:

The ad seems to have gotten under the skin of the McConnell campaign; they're actually attacking her grandfather for having a stroke:

.@Team_Mitch "Any1 who would use their grandfather's stroke" 2 reintroduce false ads "has run out of justification 4 their candidacy" #KYSen

— Phillip M. Bailey (@phillipmbailey) September 18, 2014

A ton of great ACA news coming out of Connecticut this morning, courtesy of Arielle Levin Becker (posted in reverse-chronological order, newest at the top):

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