Charles Gaba's blog

This Just In...

77 new health insurance issuers means greater choice and competition for consumers

A report released today by the Department of Health and Human Services shows that consumers will have more choices as they shop for quality, affordable coverage on the Health Insurance Marketplace in 2015, because there will be a net 25 percent increase in the number of issuers offering Marketplace coverage in 2015.  In total, 77 new issuers will offer Marketplace coverage. 

“When consumers have more choices, we all benefit,” said Secretary Sylvia M. Burwell.  “In terms of affordability, access, and quality, today’s news is very encouraging.  It’s a real sign that the Affordable Care Act is working.”

Today’s report examines preliminary data from 36 states run or fully supported by the federal government (Federal Marketplace) plus eight states operating State-based Marketplaces, and finds that a larger set of insurance issuers will offer plans in the Marketplaces in 2015.  Specifically:

(sigh) I debated whether to respond to the latest nonsense spewed forth by FOX News' Jim Angle (he's their "chief national correspondent", don'cha know?), since I've already pre-debunked (pre-bunked??) pretty much every mouse pellet that he drops in this article, but what the hell:

President Obama’s claim last spring that 8 million people had enrolled in ObamaCare recently got a significant downgrade from the head of the agency overseeing the plan.

  • STOP: No one enrolls "in" ObamaCare. They enroll in either a commercial healthcare policy via a healthcare exchange providede for by the Affordable Care Act or they enroll in Medicaid or CHIP thanks to provisions within the Affordable Care Act.
  • No, Tavenner did not give a "significant downgrade". She was actually quite happy (and rightly so) to report that a good 90% or so of ACA QHP enrollees have paid their first month's premium and continue to do so from month to month.

Go on...

OK, I suppose there have been worse U.S. Senate candidates in the past, and it's conceivable that there are worse ones this year thrown in by one major party or the other as "Some Dude®" sacrificial lambs in deep Red or Blue states. However, Terri Lynn Land is certainly the worst "serious" contender this cycle that I can think of.

Anyway, Land, who somehow managed to win statewide office twice as Michigan's SOS in the past, has apparently decided that 630,000 of her potential constituents shouldn't have decent, affordable healthcare coverage, so she's signed a pledge vowing to repeal the Affordable Care Act.

Well, OK, technically this isn't the same lawsuit that Speaker of the House John Boehner (that's "John Boehner", by the way, not "Ted Cruz" or "Mitch McConnell") is still supposedly planning on filing against President Obama, but it might as well be:

A federal appeals court has summarily tossed a lawsuit challenging the Obama administration’s delay of Obamacare’s employer mandate — a case that is similar to the one that House Republicans plan to file against the president.

This suit was filed by the Association of American Physicians and Surgeons, which argued that the delay could hurt doctors financially. But the 7th Circuit Court of Appeals in Chicago on Friday said the plaintiffs don’t have a right to sue.

Minnesota's QHP numbers continue to quietly rise slowly despite the news last week that the MNsure's largest participant, PreferredOne, is pulling out of the exchange for year two. Meanwhile, their Medicaid number is up another 6,541, and MinnesotaCare (which isn't actually Medicaid proper, but is sort of a quasi-Medicaid-like program allowed for & funded by the Affordable Care Act) is up 1,489.

I've generally sort of lumped Medicaid and MinnesotaCare together, but it's worth noting that the successful addition of 73.4K people to MinnesotaCare is one of the main reasons for PreferredOne pulling out of the exchange in the first place.

latest enrollment numbers 

September 21, 2014

Health Coverage Type Cumulative Enrollments
Medical Assistance 207,089
MinnesotaCare 73,449
Qualified Health Plan (QHP) 54,818
TOTAL 335,356

For the most part, this press release from CoveredCA is just a nice overview of the new offerings available on the little-discussed SHOP (small business) ACA exchange. As you may recall, CA was one of the few SHOP exchanges which ever got off the ground at all last year, and even then technical issues resulted in the exchange taking it offline back in February. When I last updated CA's SHOP total, it was at only 4,900 people...however, according to this PR, that number has more than doubled since last spring, and now stands at 11,510:

Sept. 19, 2014


Carriers Remain Consistent, but New and Expanded • Choices Are Now Available to Employees

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, 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...