With the idiotic #TexasFoldEm lawsuit scheduled for oral arguments by the 5th Circuit Court of Appeals this summer, many states have been scrambling to replicate ACA protections for those with pre-existing conditions at the state level, including California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Mexico and more.
In a red state like Louisiana, unfortunately, it's not so easy...the state has a Democratic Governor, but both the state House and Senate are solidly controlled by Republicans. In addition, the Governor, John Bel Edwards, is up for re-election this November, making everything politicized, thus making it likely impossible to get anything useful through this year. Still, Gov. Edwards is trying to do something to mitigate the problem:
The numbers are all fairly small, of course, but a few noteworthy items: DC appears to have an 89% QHP enrollment retention rate as of May from the beginning of the year (they had 18,035 QHP selections as of 1/31/19), which is very good. SHOP enrollment is disproportionately high as always for DC, due to both the fact that they require all small business enrollments in the District to be handled via the exchange and the fact that members of Congress and their staff have to use the DC exchange to enroll in healthcare coverage.
It's important to note that the numbers posted in the tables below include both Vermont's on and off-exchange enrollees in the individual and small group markets. It's also important to note that Vermont (like Massachusetts) merges both the individual and small group markets into the same risk pool for purposes of premium rate settings.
There are four tables...two for the Individual market (raw numbers and percentages) and two for the small group market. Perhaps the most noteworthy line is the "Reflective Silver" enrollments...those are people who took up the "Silver Switcharoo"...basically, unsubsidized individual market enrollees who switched from (or chose) on-exchange Silver plans to off-exchange Silver plans to save money on policies which are identical to the on-exchange Silver version but without the CSR premium load.
DENVER – Coloradans shopping for health insurance through Connect for Health Colorado can now preview health plans and estimate costs on their mobile devices and tablets using the award-winning Quick Cost and Plan Finder tool.
Connect for Health Colorado has optimized the tool for mobile browsing of health insurance plans as part of its technology modernization effort, which includes a suite of tools such as live chat and scheduling a call. Development is also underway to optimize the complete application for mobile devices. Making the technology consistently mobile provides a smoother user experience and supports customers who do not have immediate access to traditional desktops and laptops.
OLYMPIA, Wash. – Gov. Jay Inslee today signed Insurance Commissioner Mike Kreidler’s request legislation to end surprise medical billing, enacting arguably the strongest law in the country to protect consumers from this unfair practice.
OK, this probably won't be the most exciting Congressional hearing in the world, but it's a pretty important one both historically and for practical purposes. Any major healthcare reform bill will have to first be run through the Congressional Budget Office's scoring process...and before the CBO can do that, they first have to lay out the ground rules, which they did earlier this month.
Anyway, you can watch the hearings above; here's the details...which are pretty simple: Three CBO wonks will be testifying and questioned.
Key Design Components and Considerations for Establishing a Single-Payer Health Care System
WARNING: I can not emphasize enough just how many assumptions I'm making here. I could be ABSURDLY off at either end of the scale; the actual cost could turn out to be half as much as I project here...or twice as much. This is purely a crude, early attempt to game out the basic framework for determining the actual cost, and there's a lot of missing data, which means having to make some pretty big assumptions about the current situation, much less projecting things forward.
Your Health Idaho, the only red state standalone ACA exchange in operation since Kentucky's kynect exchange was shuttered a few years back, doesn't post updates very often, but when they do there's usually a few noteworthy items. Back in March they held a semi-annual board meeting which included a few items:
8. OPEN ENROLLMENT 2019 UPDATE
Mr. Kelly said YHI’s effectuations as of the end of January are just over 101,000 and prelim February results at 98,700. There were significant enrollment shifts between the carriers specifically with SelectHealth gaining membership due to a low-price position. Modest growth continues for the dental carriers overall with significant growth for Delta Dental. Strong seasonality is seen in effectuation trends in January and February. And as expected, the average premium is just under $500 which was anticipated with the rate increase of about 5 percent.
NY State of Health Releases 2019 Open Enrollment Report
Essential Plan and Qualified Health Plan Enrollment Reach Record Levels
ALBANY, N.Y. (May 9, 2019)—NY State of Health, the state’s official health plan Marketplace, today released detailed demographic data on the more than 4.7 million New Yorkers enrolled in comprehensive health coverage through the close of the sixth open enrollment period on January 31, 2019. Marketplace enrollment is now at its highest point ever, and Essential Plan and Qualified Health Plan enrollment reached record levels of more than 1 million people.
“It’s evident in the numbers released today that there is high demand for quality, affordable health coverage,” said NY State of Health Executive Director, Donna Frescatore. “The 2019 record enrollment levels are proof that New York’s Marketplace remains strong.”
NY State of Health 2019 Open Enrollment Report Highlights
HR 1884 is actually more of a catch-all collection of a dozen or so smaller, standalone ACA improvement bills, each of which either repairs an ACA provision which has been damaged or sabotaged in the past; protects an existing ACA provision from future sabotage; or strengthens & enhances the ACA going forward.
In early 2018, Maryland state legislators introduced a bill which included a twist on the coverage mandate penalty--those who failed to sign up had another option: They could either pay the penalty or they could choose to have the penalty amount be used to automatically enroll them in the lowest-cost insurance policy available. If they qualified for ACA subsidies, those would even be baked into the equation as well. This was a clever way of softening the blow, while also increasing enrollment and helping out the ACA risk pool.
Over the past year or so I've written numerous entries about Michigan Republicans pushing through an ineffective, inefficient, cruel and pointless work requirement addition to Michigan's implementation of Medicaid expansion under the Affordable Care Act, culminating in this one:
New work requirements for people in Michigan's Medicaid expansion group could cause as many as 183,000 people to lose their coverage.
Anywhere between 9 and 27 percent of the approximately 680,000 people enrolled in the Michigan Healthy Plan - or 61,000 to 183,000 recipients - could be kicked of the rolls.
That's up to three times what was estimated by the House Fiscal Agency when the work requirement bill was passed last year. The work requirements are scheduled to take effect on January 1, 2020.
Long-time readers of this site may remember that I have a "special place" in my heart (more like in the pit of my stomach) for Ralph Hudgens, the now-former Georgia state Insurance Commissioner, ever since I read about this ugly incident way back in 2013:
“Let me tell you what we’re doing (about ObamaCare),” Georgia Insurance Commissioner Ralph Hudgens bragged to a crowd of fellow Republicans in Floyd County earlier this month: “Everything in our power to be an obstructionist.”
After pausing to let applause roll over him, a grinning Hudgens went on to give an example of that obstructionist behavior, this one involving so-called “navigators” who are being hired to guide customers through the process of buying health insurance on marketplaces, or exchanges, set up under the federal program.
Salem, OR—Oregon consumers can get a first look at requested rates for 2020 individual and small group health insurance plans.
In the individual market, seven companies submitted rate change requests ranging from an average 3.2 percent decrease to an average 13.5 percent increase, for an average of 3.3 percent. In the small group market, nine companies submitted rate change requests ranging from an average 0.3 percent decrease to an average 13.1 percent increase, for an average of 8.7 percent.See the chart for the full list of rate change requests.
“It’s early in the process, but we are encouraged to see carriers providing more options to Oregonians by expanding into both rural and coastal communities, and the market stabilizing in spite of uncertainty at the federal level,” said Insurance Commissioner Andrew Stolfi. “Now it is time to start our open and thorough review process that allows Oregonians to provide input on the filings that affect them.”