Not sure how I missed this yesterday; thanks to Steve C. for the heads' up:

The Obama administration on Thursday plans to issue much-anticipated instructions for Americans to reenroll for next year in the new federal health insurance marketplace — a set of rules intended to make it easy for consumers but that nevertheless will require some people to reapply through HealthCare.gov to preserve their subsidies or coverage.

Under the rules, people will need to do very little to remain in their health plans if their incomes and covered family members are not changing and their plans are offered again for 2015.

All 17 of the insurance companies participating in the federal ACA exchange this fall for Year Two of open enrollment have released their preliminary rate requests for 2015. It's important to stress preliminary, since the rates still have to be approved by the HHS Dept. Update: State insurance commissioner.

There could be some sticker shock, but some welcomed price cuts as well, when consumers go shopping for insurance this fall on the Michigan Health Insurance Marketplace, according to numbers the state released earlier today.

Overall, it appears that Michigan’s proposed average rate increase of just 2.2% is modest compared to changes in some other states, according to an ongoing analysis by consultant PricewaterhouseCoopers that so far has compared insurance pricing on more than a dozen state marketplaces.

That means the average premium cost in Michigan — $326.74 — remains lower than the national average premium of $360.

...At least four companies propose boosting premiums 9% or more, while others plan to slash those monthly costs by double-digit percentages. (See table: 2015 Michigan health insurance rates)

I gave a general overview of the reasoning behind my 200K - 300K per month off-season QHP enrollment estimate a couple of weeks ago, but I didn't get around to actually plugging the numbers into a spreadsheet and running the calculations until today. Here's where things currently stand:

As you can see, just as I did with my enrollment period projections (which were consistently proven to be 99%+ accurate), I'm using the data provided by the state-run exchanges since April 19th as the basis for my "off-season" projections. Unfortunately, not only is the HHS Dept. refusing to provide their monthly enrollment reports during the off season (which I've ranted about several times), but New York isn't doing so either (I already asked), and so far there's no word from California, Connecticut, Rhode Island or Vermont.

Only 58 more QHPs but, interestingly, 104 more people on SHOP plans...

Connector Updates for June 21, 2014

32,802 Applications completed in the Individual Marketplace
9,586 Individuals and families enrolled in the Individual Marketplace
643 Employers applied to SHOP Marketplace
965 Employees and dependents enrolled via SHOP Marketplace

Over the years there have been a whole mess of court cases challenging the ACA, either en masse or sections thereof, and most of them have either been dismissed or absorbed into the law. The most famous of these was NFIB v. Sebelius, otherwise known as "the SCOTUS decision which upheld the ACA overall but made Medicaid expansion optional instead of mandatory."

Basically, the SCOTUS ruled that Congress couldn't enforce the individual mandate using a financial penalty, but it was all good because it isn't really a penalty, it's a tax, which Congress has every right to impose. Yup, the entire law hung in the balance over the semantics of a single word, which happens more often in court cases than you'd think.

However, there's still a half-dozen assorted cases left to be decided, and while most of them nibble around the edges of the law, one of them could potentially cause an epic clusterf*ck if it's successful: Halbig v. Burwell.

Three stories which didn't seem worthy of their own full blog entry but each of which are pretty interesting...

Washington State, 06/25/14: Kreidler calls for health insurers to end discrimination based on gender identity

OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler is asking all health insurers doing business in Washington state to end discrimination in health insurance based on gender identity and related medical conditions.

In a letter sent to health insurers this morning, Kreidler reminded health insurers that exclusions and denials of coverage on the basis of gender identity are against the Washington Law Against Discrimination (RCW 49.60) and the federal Affordable Care Act (Section 1557).

...“Transgender people are entitled to the same access to health care as everyone else,” said Insurance Commissioner Mike Kreidler. “Whether specific services are considered medically necessary should be up to the provider to decide on behalf of their patient.”

Good.

I contacted the NY State of Health exchange a couple of weeks back and spoke a couple of times with a very nice media relations woman who explained that yes, a highly-detailed, comprehensive enrollment report would be released sometime in late June, but that no, it wouldn't include any information about exchange enrollment since the end of the first Open Enrollment period (ie, the extension period which ended on April 15th).

She said that she'd see about trying to get "off season" enrollment data back on the agenda, but just like the HHS Dept. running 36 other states, it looks like NY has decided not to bother. This leaves me crossing my fingers that California will release their off-season data sometime soon; since CA handles almost 20% of the total enrollments by itself, that (combined with the other half-dozen state exchanges providing regular updates) should be enough to extrapolate for the rest of the country. NY is the 2nd largest exchange, however, so it would've been helpful if they'd done so as well.

Not much time to post today, but remember all the fuss & bother about how the ACA was going to cause massive increases in healthcare spending? Yeah, about that...

Pretty much everyone was stunned to see Q1 GDP growth slashed to -2.9% from an earlier estimate of -1.0%.

The revision largely boils down to one thing: healthcare spending.

"Two thirds of the revision is in consumption, cut to +1.0% from +3.1%," said Pantheon Macroeconomics Ian Shepherdson. "Almost all of this huge hit is in the healthcare services component, cut to -1.4% from +9.1%."

According to the BEA, healthcare spending went from adding 1.01 percentage points to subtracting 0.16 from the headline GDP growth number.

"So much for the BEA's initial view that the start of Obamacare triggered a surge in spending on healthcare," said Shepherdon. "The press release offers no detail on what triggered this massive revision."

Yesterday I tore apart a rather idiotic story by Sharyl Attkisson at the Daily Signal in which she bullshits her way through various ACA numbers, culminating in a completely absurd "infographic" which I helpfully corrected for her (so far she has yet to thank me for the assist).

Today I see that Hannah Bleau of the Daily Caller picks up Attkisson's ball o' crap and runs with it. I really don't have time to do another takedown today, so instead I'll just present two screen shots.

The first is the headline itself:

Um...no, Ms. Bleau, there has been no survey released which has made any such claim whatsoever. The Kaiser Family Foundation survey you're referring to states that 57% of the people who enrolled in QHPs via the ACA exchanges were previously uninsured. That is, 57% of the 8.02 million people who enrolled via the exchanges, or around 4.6 million (or, if you subtract those who haven't paid their first premiums yet, around 4.1 million).

There's a TON of amazing news out of Oregon today, but I only had room for the most stunning one in the title above. Trust me, this is chock full 'o goodness:

For all the hits Oregon has taken over their website, they continue to calmly, quietly, manually add more and more people to their exchange rolls:

Medical enrollments through Cover Oregon: 315,825
Total private medical insurance enrollments through Cover Oregon 1: 89,744              

Oregon Health Plan enrollments through Cover Oregon: 226,081

Net private medical: 81,369
Net private dental: 15,461

This is a net increase of another 1,029 QHPs and another 14,151 Medicaid enrollees since June 12...or up 21,436 QHPs since the end of Open Enrollment on 4/19 (330 per day on average).

It's worth remembering that Oregon started the year with only about 559,000 uninsured people in the entire state. Add in the 128,434 "Fast Track" Medicaid enrollees and you have a whopping 444,000 people covered one way or the other.

(sigh) OK, I saw a reference to this piece of fiction from The Daily Signal (a front for the right-wing Heritage Foundation...you know, the same guys who pretty much created the Affordable Care Act in the first place, but later changed their tune when their own plan was implemented by a Black Democrat) earlier today, but wasn't planning on responding to it since a) I already have addressed pretty much every one of their BS claims as recently as yesterday and b) if I spent the time it took to rebut every piece of feces that comes across my line of sight, I'd likely have a shingles relapse as a result.

A second nice DC find today by contributor deaconblues; as he put it, "so much for the triple-digit increases predicted by the Republicans"...

The D.C. Department of Insurance, Securities and Banking received proposed health insurance plan rates to sell on the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2015.

Four major insurance companies – Aetna, CareFirst BlueCross BlueShield, Kaiser Permanente and UnitedHealthcare – have proposed rates for individuals, families and small businesses.

 UnitedHealthcare proposed rate decreases of eight percent for all of their 2015 plans; Aetna and Kaiser Permanente proposed a mix of rate increases and decreases resulting in a slight overall net decrease for Aetna and a slight overall net increase for Kaiser; and CareFirst proposed rate increases for all plans. Most of the individual plans and all small business or “SHOP” plans reflect increases greater than 10 percent.

While that last item about CareFirst raising rates over 10% puts a damper on the good news, it may not be final:

When we last checked in with the DC exchange, I had to do an estimated breakdown between QHPs, SHOP and Medicaid enrollments of around 11,100, 14,200 and 22,700 respectively.

Today they released the actual totals, which are shoved around a bit from my estimates:

From October 1, 2013 to June 11, 2014, 48,188 people have enrolled through DC Health Link in private health plans or Medicaid:

  •  11,582 people enrolled in private health plans through the DC Health Link individual and family marketplace;
  •  23,008 people were determined eligible for Medicaid coverage through DC Health Link; and
  •  13,598 people enrolled through the DC Health Link small business marketplace.

So, QHPs are about 600 higher than I thought, SHOP about 600 lower and Medicaid about 300 higher. Not bad!

Seriously, don't ACA opponents ever get tired of being wrong about...everything?

Hot off the presses...

PRINCETON, NJ -- Five percent of Americans report being newly insured in 2014. More than half of that group, or 2.8% of the total U.S. population, say they got their new insurance through the health exchanges that were open through mid-April.

These data are based on Gallup Daily tracking interviews with more than 31,000 adults conducted between April 15 and June 17. Those who say they have health insurance were asked if their policy was new for 2014, and if so, whether they obtained their policy through a state or federal health exchange or in some other way. The exchanges officially closed on March 31, although people who indicated they had begun the process prior to that date were allowed to continue to enroll through April 15.

So, let's see here. The Gallup poll only includes adults over 18, so...

My 8-year old son and his best friend, just walking down the sidewalk together.

Some moments are just too perfect.

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