Charles Gaba's blog

This Just In via the Washington HealthPlanFinder:

Washington Healthplanfinder Urges Customers to Act Fast for Jan. 1 Coverage

The Washington Health Benefit Exchange (Exchange) today is warning customers without 2020 coverage that Sunday, Dec. 15 at 11:59 p.m. is the deadline to sign up for health and dental plans through Washington Healthplanfinder that begin on Jan. 1.

Since the open enrollment period began, more than 187,000 Washingtonians have already selected 2020 Qualified Health Plans (QHP) using Washington Healthplanfinder, including around 15,000 residents who signed up for health coverage over the past week. With traffic to wahealthplanfinder.org expected to continue rising, customers needing 2020 coverage are directed to submit an application and lock in their plan selection immediately to avoid any potential delays.

 

Me, two day ago:

I'm just putting this out there today because I know there's gonna be a bunch of eye-rolling stories completely misunderstanding the data later on this week.

Last Wednesday, the Week 4 HealthCare.Gov Snapshot Enrollment Report came out and showed a "mysterious" 41% increase in ACA exchange enrollments for the week vs. last year...jumping from 500,437 QHP selections to 703,556 QHP selections for the corresponding week this year.

This Wednesday, the Week 5 snapshot report will come out and will almost certainly show a "mysterious" large drop in ACA exchange enrollments vs. last year...from 772,250 down to perhaps 500,000 or so.

Just days after a lawsuit was filed challenging Michigan's impending Medicaid expansion work requirements, Michigan Governor Gretchen Whitmer sent a letter to legislative Republicans urging them to stop throwing good money after bad on a policy which is pretty much doomed to failure anyway:

Gov. Gretchen Whitmer said delaying implementation of work requirements for enrollees in Michigan's Medicaid expansion program would prevent the state from potentially wasting at least $1 million.

The Democrat issued a special message to legislative leaders Tuesday, a day after saying the Republican-controlled Legislature should pause the rules taking effect in January.

Whitmer said the state has spent $28 million to implement the workforce engagement requirements and is on track to spend an additional $40 million this fiscal year — an unnecessary expense if a federal judge blocks the rules.

Coming on top of not one, not two, but three other states either scrapping or "delaying" implementation of Medicaid expansion work requirements (Arizona, Indiana and Montana), this one isn't particularly surprising given that Democrats hold the governor's seat and just flipped both the state House and Senate. Still welcome, though!

Gov. Ralph Northam has directed Virginia's Medicaid program to "pause" negotiations with the federal government on approval of a work requirement that was central to a political deal that allowed the state to expand eligibility for the program's health care benefits to hundreds of thousands of uninsured Virginians.

Northam cited the Democratic takeover of both chambers of the General Assembly in legislative elections last month. He also referred to litigation that has faced other states that have tried to link Medicaid health benefits to requirements that program participants seek work, training, education or other forms of civic engagement.

via Nevada Health Link:

Less Than Two Weeks Remain To Enroll In A Qualified Health Plan Through Nevada Health Link

  • Free enrollment assistance available; Weekend call center hours extended for duration of Open Enrollment

Las Vegas, NV - The clock is ticking with only 13 days left to enroll before the December 15th midnight deadline approaches. Nevadans can find coverage in a Qualified Health Plan (QHP) and Qualified Dental Plan (QDP) through Nevada Health Link, the online insurance marketplace operated by the state agency, Silver State Health Insurance Exchange – and the only place consumers can get financial assistance (subsidies) to help offset the cost of insurance.

To ensure consumers have as much access to help with the enrollment process, Nevada Health Link's call center has extended its weekend hours through the end of Open Enrollment on December 15. The call center will be open 9 a.m. to 5 p.m. PST on Saturday, Dec. 7, Sunday, Dec. 8, and Saturday, Dec. 14 and will remain open until 11:59 p.m. PST on Sunday, Dec. 15.

via the Maryland Health Benefit Exchange:

Maryland Health Connection will hold nearly 20 “Last Chance” events throughout the state during the final week of open enrollment Dec. 7-15 to provide free help enrolling in health coverage. Marylanders can enroll in health and dental coverage until Dec. 15 through Maryland Health Connection, the state’s health insurance marketplace.

At the free “Last Chance” events, certified health insurance navigators will help Marylanders sign up for a health plan and understand their coverage options and financial help available. Assistance also is available in Spanish.

Visit MarylandHealthConnection.gov or the Enroll MHC mobile app to browse plans, compare coverage and costs, and enroll.

The fall open enrollment is for private health and dental plans only. People who have coverage through Medicaid will receive a notice when it’s time to renew; enrollment for Medicaid is all year for eligible Marylanders.

Assistors Available On-Site at Winter Markets Across the State

ALBANY, N.Y. (December 3, 2019) – NY State of Health, the state’s official health plan Marketplace, today announced its continued partnership with NYS Department of Agriculture and Markets in an effort to educate shoppers at farmers markets throughout New York State about low-cost, high-quality health coverage during the Open Enrollment Period.

Consumers must enroll by December 15, 2019 for coverage beginning January 1, 2020. Certified Enrollment Assistors will be available leading up to the December 15 deadline at select markets to answer any questions about enrolling in a health plan through the Marketplace and to set up enrollment appointments. In addition, NY State of Health educational materials will be available at select farmers’ markets across the state. This is the fourth year of the NY State of Health-NYS Department of Agriculture and Markets partnership.

 

This isn't the biggest development in the world, but exactly a year ago today I made a big fuss about how New Jersey (and DC) had reinstated their own health insurance individual mandate penalties after the federal version was zeroed out by Congressional Republicans...but didn't seem to be going through much effort to let people know about the penalty.

While Massachusetts had launched a massive multi-media awareness/education blitz statewide to make sure people knew that they had dusted off their pre-ACA coverage mandate requirement, New Jersey and DC didn't appear to be doing much, if anything, to let people know that they'd face a stiff tax penalty if they didn't either #GetCovered or qualify for an exemption.

As I noted at the time, just like the Doomsday Device in Dr. Strangelove, it completely defeats the whole point of having a penalty if no one knows it exists.

Back in March I wrote an analysis of H.R.1868, the House Democrats bill which comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

Back in March I wrote an analysis of H.R.1868, the House Democrats bill which comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

A couple of weeks ago, BeWell NM, the name of the New Mexico ACA health exchange, held their latest board meeting. There's two key things to keep in mind about New Mexico:

First, they've been officially operating as a state-based exchange while "piggybacking" off of HealthCare.Gov since the very first Open Enrollment Period in 2013-2014...but they announced over a year ago that they're following Nevada's (and Idaho's) lead in splitting off onto their own full exchange, starting in 2021.

Second, as I reported back in August, there was an unusual development on the New Mexico ACA individual market:

CHRISTUS HEALTH PLAN LOSES QUALIFIED HEALTH PLAN STATUS

Monday's Washington Post includes an excellent story by Annie Linskey, Jeff Stein & Dan Balz titled, appropriately enough, "How a fight over health care entangled Elizabeth Warren — and reshaped the Democratic presidential race":

In mid-November, a few dozen of the country’s most influential advocates of Medicare-for-all were reviewing details of Sen. Elizabeth Warren’s plan to finance the proposed government-run program when they learned that she had unexpectedly changed her position.

I haven't written anything about Pennsylvania's surprisingly bipartisan decision to break off of the federal ACA exchange at HealthCare.Gov onto their own state-based exchange since June:

After some last-minute drama in one state and a surprising lack of drama in another, both New Jersey and Pennsylvania have officially passed bills allowing them to each establish their own ACA exchanges and enrollment platforms, splitting off from the federal exchange and HealthCare.Gov:

Pennsylvania:

Pennsylvania is poised to roll out its own online health insurance exchange to take the place of the one run by the federal government for the state's residents since 2014, saying it can save money for hundreds of thousands of policy-buyers.

Over the past few years, more and more of the state-based exchanges have shifted from waiting until the end of Open Enrollment to officially report auto-renewals of existing enrollees...to going ahead and auto-renewing everyone up front, and then subtracting those current enrollees who actively cancel their renewals.

This has caused a bit of confusion, since the exchanges don't always make it clear who's being counted and when.

Case in point: Access Health CT, Connecticut's ACA exchange. Last year they reported 12,777 enrollees during the first two weeks of Open Enrollment...and also noted that there were another 85,000 existing enrollees who hadn't yet actively renewed their policies as of 11/18.

This year, their press release page states the following:

Qualified Health Plans (QHP):

  • Net Total QHP Enrollment: 98,131
  • 2020 OE Acquisition Summary: 7,344

Overall Volume

For the past two weeks, along with other noteworthy Open Enrollment data numbers, I've been scratching my head over what the deal is in Mississippi:

Once again, Maine remains the worst-performer year over year, mostly due to their expansion of Medicaid. Idaho isn't listed because they're a state-based exchange and haven't reported any data yet. Mississippi, on the other hand, continues to be the top out-performer vs. last year, which is interesting because there doesn't seem to be any particular reason for it.

Unlike some states, Mississippi hasn't implemented any additional subsidies, a mandate penalty or a reinsurance program of any sort. They haven't had any new carriers join the ACA market, nor have any of them left. I don't think either of the carriers on the exchange have significantly expanded their territory or changed their offerings that much either...in fact, average premiums are essentially flat year over year.

In other words, by all rights, Mississippi should be performing almost exactly as they did last year...but enrollments are up 15.5% to date. Huh.

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