Charles Gaba's blog

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

KENTUCKY: Women leading Kentucky health: Kynect’s Banahan excited to reach even more people

First in a series of profiles about KY women in charge of the state exchange:

Energy exudes from Carrie Banahan when she talks about her work with others to bring affordable health care to more than half a million Kentuckians.

“I worked all my life to see this happen, that we can provide affordable health insurance to people, and it has actually happened,” she said. “I am thrilled that we are actually helping people in Kentucky. It is the highlight of my career.”

Banahan is executive director of the Kentucky Health Benefits Exchange, which the state has branded as Kynect, partly to avoid identification with the pejorative nickname Obamacare. She shares the credit for its success.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

MARYLAND: An Amazing Healthcare Revolution Is Happening In Maryland — And Almost No One's Talking About It

The Maryland ACA exchange has been one of the "middle-tier" models in my view; not an utter disaster like the ones in Oregon or Massachusetts, but still riddled with technical problems like the ones in Minnesota & Vermont. However, the state has apparently had a different healthcare-related initiative which has been a huge success so far:

Through innovative methods and a data-centric approach, Western Maryland Regional Medical Center, has become the cornerstone in Democratic Gov. Martin O'Malley's ambitious makeover of the state's healthcare programs.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:


Mark Pryor shows Democrats how they should campaign on the Affordable Care Act in a red state. You don't have to mention Obamacare (which technically doesn't even exist), you don't have to even mention the Affordable Care Act. You do have to personalize what the law actually means for real people with real medical issues which were fixed or improved by the law:

Read more on this ad & angle from Greg Sargent of the Washington Post.


Over at the CT Mirror, Arielle Levin Becker does the same type of wonky number-crunching that I specialize in here at to figure out whether the state's recent claims of the ACA slashing their uninsured rate in half (from 8% to 4%) hold water.

It gets a bit involved, but her conclusion is that yeah, it probably has been cut significantly, but a specific percent number is hart to pinpoint since there's still a lot of noise on the ESI side as well as continuous churn across the board as people move on & off of different plans.

However, it does include a few nuggets which help me update my own data. For one thing, CT's SHOP enrollment has gone up from 500 as of February to a whopping...602 people last month:

Access Health also operates an exchange for small businesses, although uptake has been low. As of mid-July, it covered 602 people.

Republicans Back Off Using Obamacare as Issue

"Republicans seeking to unseat the U.S. Senate incumbent in North Carolina have cut in half the portion of their top issue ads citing Obamacare, a sign that the party's favorite attack against Democrats is losing its punch," Bloomberg reports.

"The shift -- also taking place in competitive states such as Arkansas and Louisiana -- shows Republicans are easing off their strategy of criticizing Democrats over the Affordable Care Act now that many Americans are benefiting from the law and the measure is unlikely to be repealed."

Imagine that.

Minnesota continues to quiet down, with only 110 more QHPs added in the past 4 days, but over 3,200 more added to Medicaid via ACA expansion:

latest enrollment numbers

August 17, 2014

Health Coverage Type Total Enrollments 
Medical Assistance 176,416
MinnesotaCare 64,238
Qualified Health Plan (QHP) 53,647
TOTAL 294,301

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 364,929
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of August 18, 2014 
*Updated every Monday at 3 p.m.

Here's an educated guess as to the possible impact on Michigan's uninsured rate:

I haven't posted much the past few days, partly because of a lack of major ACA news, partly because I'm busily playing catch-up with my day job (I do have one, believe it or not), and partly because all the oxygen has been (rightly) sucked out of the news atmosphere the past week or so by the slow-motion trainwreck called "Ferguson, Missouri".

So, I was a bit surprised to see my name and this site figure heavily as a source by Megan McArdle over at BloombergView, in an article called "More Bad News for Obamacare". McArdle has decided to pick up the "Massive Attrition!!" ball which I debunked last week and run with it, citing me as a source several times (including using me as her source for the news of the HHS Dept. dropping off-season enrollment reports)...and yet completely ignoring my entire point:

on net, they expect enrollment to shrink from their March numbers by a substantial amount -- as much as 30 percent at Aetna Inc., for example.

Our roads become more expensive by the second

The value of roads declines at $32/second

A couple of weeks ago, I posted about how insurance providers in Connecticut requested rate changes ranging up to 12.8%...but the approved rate increase, overall, appeared to only be around 4.5% when weighted by market share. However, that was based on the assumption that the largest provider, Anthem BCBS, would end up with an approved average of around a 6% increase.

Today, it was revealed that Anthem's actual rate changes for 2015 will be an average of 0.1% lower:

Anthem, the state’s largest insurer, initially requested approval to raise rates by an average of 12.5 percent. But the insurance department rejected the proposal and asked the company to resubmit its plan using different calculations.

The result: An average premium decrease of 0.1 percent for Anthem customers.

This is a classic case of one's attitude determining whether this is good or bad news. The headline and lede make a huge deal about 400,000 people having to re-enroll in the Massachusetts ACA exchange this winter...except that I've been pushing hard for everyone to be required to re-enroll once per year anyway regardless of whether their personal incomes/circumstances have changed over the past year or not...which means that to me, it's not only not a big deal that everyone in MA will be required to re-enroll, but it's actually a good thing:

Nearly 400,000 people in Massachusetts will need to reapply for health insurance before the end of the year, and many of them probably do not even know it.

They are people who do not have employer-sponsored health insurance and who instead sought insurance through the state. After the Massachusetts insurance website failed last year, most of them were enrolled in temporary coverage that ends Dec. 31, which is why they must select a new plan.

While the technical overhauls/transfers of exchanges in states like Oregon, Nevada, Massachusetts and Maryland have been taking up all of the "ACA tech problem" news (the former two are moving to for 2015; the latter two are completely overhauling their own websites), Hawaii's technical woes seem to always have operated in something of a news vacuum. The Hawaii website problems were always just as bad as some of the other states listed, yet not once have I received any indication of whether they were abandoning their software like OR & NV or fixing it like MA & MD.

Over the past couple of weeks, the answer seems to have revealed itself: The Hawaii Health Connector website has been a WordPress-based site. However, this appears to only be the "welcome/info" portal; actually clicking the "Enroll" links takes you to a different domain name at which seems to be the actual HI exchange.

Not a lot of news this week as the whole country seems to be transfixed by the shooting death of Michael Brown and the insane overreaction by the police in Ferguson, Missouri (as well as the deaths of legends Robin Williams and Lauren Bacall).

However, Minnesota continues to quietly crank along, adding 141 people to the QHP tally and 4,748 to Medicaid in just the past 3 days:

enrollment update

latest enrollment numbers

August 13, 2014

Health Coverage Type Total Enrollments 
Medical Assistance 173,953
MinnesotaCare 63,437
Qualified Health Plan (QHP) 53,537
TOTAL 290,927

On the one hand, this has nothing to do with the ACA whatsoever.

On the other hand, in a weird sort of way it has everything to do with it.

Last night, the town of Ferguson, Missouri turned into a warzone. I've never seen anything like least here in the U.S. A few days after police gunned down an unarmed black teenager (possibly shooting him in the back) and the refused to release the name of the officer who shot him, I watched live video of the St. Louis County PD very much unallegedly demanding that the news media turn off their cameras, fire tear gas and rubber bullets into an unarmed, fairly peaceful crowd and people's yards and generally terrorize the very populace that they're supposed to be protecting.

And in the middle of this utter mess, White House Principal Deputy Press Secretary Eric Schultz decided it was the perfect time to tweet the following:

Readout of tonight's social gathering coming shortly - spoiler alert: a good time was had by all.

— Eric Schultz (@Schultz44) August 14, 2014

...One of the scariest claims was that premiums were going to shoot up because only the sick and the old would sign up. The danger, of course, was that this would set off the so-called death spiral, where high prices prompt people to drop their coverage until eventually the whole project collapses in failure and shame.

...Here we are five months later, and those insurance officials have begun reporting their premium increases for next year. To put it mildly, those increases do not seem to fit the definition of “skyrocketing."

...The average national increase of 7.5 percent is “well below the double-digit increases many feared,” [PwC] HRI Managing Director Ceci Connolly wrote in ane-mail.

Needless to say, this is quite a bit different than the scenario the Hill laid out in March. A 7.5 percent average increase is somewhat smaller than the 100 percent increase the newspaper was predicting only five months ago.

The only caveat here is that the 7.5% average only covers 27 states; according to PwC researcher Caitlin Sweany, the overall average is actually a bit higher: