Charles Gaba's blog

Head's up, readers...next week, for the third year in a row I'll be attending the Families USA Health Action conference in Washington, D.C...and for the first time, I'll actually be on one of the panels:

Friday, January 24th, 2:00pm-3:15pm • Workshops / Session 4

WHAT'S NEXT? COVERAGE AND AFFORDABILITY OPPORTUNITIES IN RED, BLUE, AND PURPLE STATES

Description: A surprisingly broad range of resources and options are available to streamline enrollment and to lower consumers’ health care and coverage costs in the individual market. Learn about promising, innovative strategies tailored to fit very different political conditions.

Speakers:

  • John-Pierre Cardenas, MSPH, Independent Health Policy Adviser, formerly Maryland Health Benefits Exchange
  • Charles Gaba, ACASignups.net
  • Heather Howard, J.D., Center for Health & Wellbeing, Woodrow School of Public and International Affairs, Princeton University
  • Holly Hernandez, Harris Health

Moderator: Stan Dorn, J.D., Families USA

via Covered California...

he commemoration of Dr. King’s 91st birthday will include parades in both Los Angeles and Sacramento where Covered California will participate.

Covered California representatives, including executive director Peter V. Lee, will join members of Charles Drew University of Medicine and Science in participating in Los Angeles’ Kingdom Day Parade.

In addition, Covered California staff will join thousands of others in Sacramento’s March for the Dream parade.

Covered California is committed to ensuring that the rich diversity of people in the state have access to quality health care.

Open enrollment is underway, and people have through Jan. 31 to sign up for coverage and see if they are eligible for financial help.

SACRAMENTO, Calif. — Covered California will help celebrate the 91st birthday of Martin Luther King Jr. on Monday, by having a contingent of leaders honor the civil rights icon by participating in parades in both Los Angeles and Sacramento.

 

I've written several times before about how health insurance risk pools work. I even whipped up a crude video explainer about them a couple of years back. The healthiness or lack thereof of a given risk pool is the biggest factor involved in determining how expensive or inexpensive insurance policy premiums will be.

This year, my own family became a perfect example of this. Unlike most health insurance horror stories you often hear about, the final results in our case are positive...although we did go through a brief panic attack period before getting there.

My wife and I are both self-employed, and have a few recurring medical issues. We have one child, a teenager with Asperger's syndrome and a (fortunately fairly mild) case of cerebral palsy, which means long-term physical therapy and some other recurring medical expenses. Since we'd max out the deductible on a Silver plan each year, we've been enrolled in an ACA exchange Gold HMO plan since 2015. It's expensive even with partial subsidies, but we don't want to risk a major hole in coverage if at all possible.

This just in via Connect for Health Colorado:

DENVER — Nearly 167,000 Coloradans signed up for a health insurance plan through the state’s official Marketplace by the end of the Open Enrollment period, according to preliminary data released today by Connect for Health Colorado.

Among the 2020 plan selections, about 20 percent are by customers who are new to Connect for Health Colorado and 80 percent are returning customers. 

“This has been another successful Open Enrollment period,” said Chief Executive Officer Kevin Patterson. “Now the work continues to increase access, affordability and choice for residents. We are fully engaged with partners at the state and in the legislature to advise and help implement innovative approaches to lower the cost of health care and increase choice.”

Note: Photo of John Conyers used at the request of the thread author. Thread reposted with permission.

About a week and a half ago, a die-hard Bernie Sanders supportern named David Klion posted something I found pretty offensive. I already wrote about that.

However, in the wake of that back & forth, a Twitter follower of mine, a woman of color who goes by the handle @Kamalaallday, posted an angry rant which I felt lent a lot of insight as to why many in the black community aren't nearly as keen on "Medicare for All" as envisioned by Sanders and other M4All activists as you might expect.

I already knew about some of her complaints and concerns below, but not all of it. Instead of putting words in her mouth, I'm just gonna let her speak for herself.

I've embedded the first tweet directly, but have converted the rest of the thread into bullets and reworked the structure (putting half-sentences together and adding paragraph breaks, etc.) for easier readability, but have otherwise left her entire thread as is. I strongly advise that folks read it all...food for thought:

via Christine Stuart of CT News Junkie:

The calculation doesn’t include the last day of open enrollment, but Access Health officials reported Thursday that enrollment was down 2.7% in 2020.

An estimated 106,376 Connecticut residents enrolled with either ConnectiCare or Anthem Health Plans. That’s fewer than the estimated 111,066 who signed up for coverage last year.

I'm not sure where she gets 2.7%...that's a 4.2% drop year over year. They tacked on another 200 or so per day over the final week or so...if you assume a small surge on the final day they might top out at 107K, which would be perhaps a 3.7% drop.

A few more useful data nuggets:

It was the fourth year in a row that there was a drop in customers qualifying for federal tax credits to off-set the cost of the monthly premiums. An estimated 69% of those who enrolled this year are eligible for a subsidy. That’s a drop from 78% in 2016.

Last May, New Jersey Democratic legislators were pushing through over a dozen bills which would effectively lock in nearly all of the ACA's "Blue Leg Protections", as I refer to them, at the state level. The main reason for this, of course, is to replicate federal ACA protections for enrollees just in case the U.S. Supreme Court does ultimately strike down the Affordable Care Act (or at least strikes down the consumer protection parts of it).

Well, I kind of lost track of the status of those bills over the summer and fall, but apparently most of them passed through both the New Jersey state House and Senate because just moments ago, NJ Governor Phil Murphy issued the following press release:

via New York State of Health:

Certified In-Person Assistors Provide Enrollment Opportunities at MLK Day Events Across the State Leading up to January 31 Enrollment Deadline

ALBANY, N.Y. (January 16, 2020) – NY State of Health, the State’s official health plan Marketplace, today announced participation in several Dr. Martin Luther King, Jr. Day events being held throughout the State. Certified In-Person Assistors will be at events celebrating the legacy of Dr. Martin Luther King, Jr. to ensure New Yorkers have access to high-quality, affordable health care and to answer questions regarding enrolling or re-enrolling through the Marketplace. All events are open to the public.

“We are excited to meet New Yorkers at events celebrating Dr. Martin Luther King, Jr. to help them find a quality, low-cost health plan during Open Enrollment,” said NY State of Health Executive Director Donna Frescatore. “Enrollment in a 2020 Qualified Health Plan runs through January 31, and our participation in these events offers New Yorkers another opportunity to complete the enrollment process.”

This Just In via Covered California:

Covered California Continues to See Strong Interest and Reminds Consumers That Penalty Is Back for 2020 as Open-Enrollment Deadline Approaches

  • More than 269,000 consumers have newly enrolled during the current open-enrollment period, which continues in California through Jan. 31.
  • A new law requires Californians to have health insurance in 2020 or face a penalty when they file their taxes with the Franchise Tax Board in 2021.
  • The penalty can be $2,000 or more for a family of four.
  • New research shows that many Californians, particularly the uninsured, are unaware of the new penalty or the new financial help that is available for the first time this year.

SACRAMENTO, Calif. — Covered California announced new data as it approaches the final two weeks of the annual open-enrollment period and reminded consumers about the new state penalty and additional financial help that went into effect with the new year.

As of Saturday, Jan. 4, more than 269,000 consumers had newly signed up for health insurance through Covered California during the current open-enrollment period, which is an increase of 18 percent above the number of consumers who had enrolled at this time last year. In addition, more than 1.15 million existing Covered California members have renewed their coverage for 2020.

via the DC Health Link, where DC residents can still #GetCovered until January 31st:

  • Latino leaders to discuss state of enrollment opportunities at 6th Annual Hispanic Leadership Health Forum; Enrollment and outreach events scheduled throughout DC

Despite national studies showing the Latino community saw the biggest drops in uninsured rates thanks to the Affordable Care Act (ACA), the uninsured rate for Latinos continues to be significantly higher than in other minority communities, according to a United States Census report.

DC Health Link, in partnership with the Mayor’s Office of Latino Affairs (MOLA), the Greater Washington Hispanic Chamber of Commerce and many community-based organizations, will host its annual, action-packed week of intensive enrollment and outreach activities during its Annual Hispanic Enrollment Week of Action. DC Health Link is using this Week of Action to accelerate outreach efforts to promote, educate and motivate Latino enrollment in quality, affordable health insurance. The Hispanic Enrollment Week of Action runs through January 19, 2020.

Thursday, January 16, 2020, 9:00am – 12:30pm

This is the last in my 2020 Democratic Presidential Candidate Healthcare Policy series. In some cases I did wonky, in-depth analyses; in others I've simply given an overview with some notes here and there.

Andrew Yang's falls into the latter category, not because of any bias against him, but simply due to a lack of time on my part to give it a more detailed review.

Officially, Yang supports "Medicare for All", but like several other candidates both now and in the past, this isn't quite the same "Medicare for All" that Bernie Sanders is pushing (and which Elizabeth Warren is mostly still pushing):

We are having the wrong conversation on healthcare.

Instead of addressing the underlying problems driving unaffordability and access, we Democrats are spending all our time arguing over who is the most zealous in wanting to cover Americans. Over who has wanted to do so longer. Over who cares more about the health of Americans.

via the Massachusetts Health Connector:

On Wednesday, January 15, 2020, the Massachusetts Health Connector embarks on a one-day, multi-city tour that includes stops at six locations along the North and South Shore to remind Massachusetts residents there is still time to get 2020 health coverage before Open Enrollment ends January 23.

On Wednesday, January 15, 2020, the Massachusetts Health Connector holds its “Day of Coverage” featuring activities across the Commonwealth designed to help people #GetCovered with health insurance for the new year.“Day of Coverage” activities will be held in Boston, Hyannis, Lawrence, New Bedford, and Lowell.

Open Enrollment is happening now and runs through January 23, 2020. Massachusetts residents who want to enroll in coverage or switch plans to start February 1, must sign up through the Health Connector by January 23rd.

Residents can sign up for coverage at www.MAhealthconnector.org, over the phone at 1-877-MA-ENROLL (1-877-623-6765), or in person through a local navigator organization.

via the official CNN Democratic Debate Transcript (Part 1, Part 2)

PHILLIP: Let's turn to health care, the top issue for Iowa Democrats. Donald Trump is trying to repeal Obamacare, including the protections for pre-existing conditions. We all know that each of you vigorously opposes that. Still, there are some questions about what each of you would do.

This was the only time throughout the entire healthcare portion of the debate that anyone said a peep about the Texas vs. Azar lawsuit...and it wasn't even one of the candidates; it was the moderator.

Senator Sanders, you have consistently refused to say exactly how much your Medicare For All plan is going to cost. Don't voters deserve to see the price tag before you send them a bill that could cost tens of trillions of dollars?

 

With the Texas vs. Azar lawsuit (aka #TexasFoldEm) dangling over everyone's heads like the Sword of Damocles, Kaiser Family Foundation CEO Drew Altman has a short piece up over at Axios which notes that the sick irony of this whole stupid situation is that the ACA itself is clearly doing at least reasonably well without the mandate penalty being in place anyway...completely undermining the entire case of the plaintiffs in the lawsuit:

The ACA is doing fine without a mandate penalty

The Affordable Care Act’s insurance market has not been materially affected by the elimination of the individual mandate penalty — undercutting a key argument in the lawsuit urging the courts to strike down the health care law.

An important reminder from AccessHealth CT...

Close To 20 Percent Of Access Health CT Customers Still Need To Submit Verification Documents To Stay Covered

  • Customers can scan and submit verification documents at Enrollment Fairs, via mail or online
  • Some AHCT customers will receive letters in the mail requesting specific documents to confirm information in their application.
  • Documents can be submitted online, at an Enrollment Fair where documents can be scanned and uploaded immediately or by mail. 
  • Failure to submit documents by the deadline can result in loss of coverage or financial help.

HARTFORD, Conn. (January 13, 2020)—Open Enrollment to sign up for a 2020 health insurance plan through Access Health CT (AHCT) ends at midnight on Wednesday, January 15, 2020. Connecticut residents can still enroll online, over the phone, or in-person at any of our Enrollment Fairs or five Enrollment Locations—and some might need to submit verification documents.

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