Charles Gaba's blog

Thanks to Louise Norris of healthinsurance.org for saving me the trouble of tracking all of the state exchange deadlines down. It's possible that a few more state-based exchanges (CT, ID, MD, NY & VT) could also extend their open enrollment deadlines beyond the official one on the federal exchange, but here's where things stand as of today (I'll update the graphic as necessary). Feel free to share widely.

Update 9/7/17: Two more state-based exchanges have chimed in: Vermont has clarified that they're sticking with December 15th, 2017; New York issued a press release that they're joining California & DC in extending Open Enrollment all the way through January 31st, 2018. The graphic below has been updated to include the New York extension.

Both Politico and Axios have picked up my story about the $60 million in ACA Open Enrollment Navigator/Outreach grants being cancelled at literally the last minute:

Politico:

Did CMS execute a last-minute reversal on navigator program? That's what independent blogger Charles Gaba is reporting, posting what appear to be internal CMS documents that show the agency was poised to essentially renew last year's funding for this year's ACA open enrollment.

One document posted by Gaba indicates that Randy Pate — tapped by the Trump administration to run Medicare's Center for Consumer Information and Insurance Oversight — signed off on $60 million in program funding on Aug. 24. More. However, CMS ultimately funded the program at less than $37 million for the upcoming enrollment, a 41 percent cut from last year.

Hey Michigan Residents! Do you live in the Birmingham/Bloomfield area?

If so, come on out to Bloomfield Hills on Saturday, September 9th, and join State Representatives Christine Greig, Robert Wittenberg, Adam Zemke and myself as we explain what the latest craziness is regarding the ACA, the GOP attempts to repeal and/or sabotage it and healthcare policy in general from 1:00pm - 3:00pm at the Birmingham Unitarian Church in Bloomfield Hills:

Utah has also finally released their requested 2018 individual market rate increases. There are six carriers offering individual policies next year, but only 2 of them are participating on the ACA exchange (and the 4 off-exchange carriers hold less than 4% of the total market combined). In fact, two of the off-exchange-only carriers are barely participating at all: BridgeSpan has only 8 enrollees, while "National Foundation" (a "phantom carrier" which also goes by "Freedom Life" in other states) once again supposedly only has a single "enrollee". Molina has a few hundred off-exchange enrollees, but the bulk of their 70,000-person membership are in exchange-based policies, and they're dropping off the exchange next year, so those 70K will have to choose from one of the two remaining exchange carriers: SelectHealth and the University of Utah.

Until recently, my 2018 Rate Hike project was still missing 4 states: Kansas, Missouri, Nevada and Utah. Last week Missouri finally posted their requested rate increases for next year. Today it looks like Kansas has done the same...at least partly.

As I noted back in June, there are 3 carrers on the KS individual market this year: Medica, Blue Cross Blue Shield of Kansas Solutions and Blue Cross Blue Shield of Kansas City. Any confusion between the BCBS names was made moot, however, as BCBS of KC announced they were dropping out of the indy market anyway.

That leaves Medica and BCBSKS, both of whom filed plans to stay on the market...but only Medica appears to have actually submitted rate requests, for a mere 7,600 enrollees:

ACA Signups isn't normally known for "big scoop" stories. Yes, I'm often the first one to openly post analysis and/or debunking of information/data/claims which have already been made public, but I'm not usually the first one to actually make the underlying data itself public in the first place.

This is an exception to that rule.

I've recently acquired documentation related to last weeks' shock announcement by the Trump Administration's Centers for Medicare & Medicaid that they're slashing the advertising/marketing budget for HealthCare.Gov for the upcoming 2018 Open Enrollment Period by 90%...as well as cutting the in-person outreach program budget by nearly 40%.

I've confirmed the veracity of these documents, and the claims related to them seem to be on the level.

According to my source, these are signed orders instructing the grant awarding officer to distribute $60,000,000 in grants with an effective date and time of August 31st, first thing in the morning.

Thanks to Zach Tracer for the heads up!

My 2018 Rate Hike project petered out a few weeks back with the requested rate increases posted for 46 out of 50 states (along with DC). Unfortunately, the last 4 states (Kansas, Missouri, Nevada and Utah) decided to keep their cards close to their chest, delaying any public viewing of even the requested rate increases for awhile longer.

Lori Lodes used to be Communications Director for the Centers for Medicare & Medicaid until last year under President Obama. As such, a big part of her job was administering ACA outreach efforts.

This evening, upon learning of the Trump administration's announcement that they're slashing advertising budget by 90% and outreach/navigation assistance funding by 39%, she was...not pleased. She took to Twitter to get a few things off her chest.

Instead of embedding a bunch of full Tweets, I'm pasting in the actual text of her thread to give the full picture:

Time to put on my "I used to run outreach for Obamacare" hat and talk about the Admin's decision to gut outreach and education.

***note*** This thread is long and barely touches on just how bad the impact of the Admin's decision will be.

First, it's the job of the government - in regs and everything - to educate people about signing up for health care.

Second, slashing navigator funding in a 3 yr cycle from $67m (2016) and $63m (2017) to $33m (2018) will mean that fewer people get covered.

via Sarah Kliff of Vox.com:

Trump is slashing Obamacare’s advertising budget by 90 percent

The White House will also cut the in-person outreach program by $23 million.

The Trump administration plans to deeply cut Obamacare outreach and advertising, officials announced Thursday.

Trump will reduce Obamacare advertising spending 90 percent, from the $100 million that Obama administration spent last year to $10 million this year. It will also cut the budget for the in-person enrollment program by 39 percent.

Administration officials cited “diminishing returns” from outreach activities. In a phone call with reporters, they said that most Americans already know about the Affordable Care Act.

As a reminder, here's what happened back in January, when Trump pulled the plug on advertising for HealthCare.Gov in the final, critical week of the 2017 Open Enrollment Period:

(I stole "Kasichlooper" from Zachery Tracer)

Right on top of the letter sent by all twelve state-based exchange heads to the Senate HELP Committee comes a similar open letter signed by eight sitting Governors to all four Congressional leaders (McConnell/Ryan & Schumer/Pelosi). It includes 5 Democratic Governors, but also 2 Republicans and one Independent.

The effort was spearheaded by Republican John "Yeah, he's definitely primarying Trump in 2020" Kasich of Ohio and Democrat John Hickenlooper of Colorado, but also includes Brian Sandoval (GOP, NV); Tom Wolf (Dem, PA); Bill Walker (Indy, AK); Terry McAuliffe (Dem, VA); John Bel Edwards (Dem, LA); and Steve Bullock (Dem, MT).

Here's a partial version of the letter with the meat of the asks:

Immediate federal action to stabilize markets.

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