I've been shouting from the rooftops that auto-renewing your ACA policy is a bad idea, for a variety of reasons, since at least June.

Now it turns out there's another good reason to read the fine print before just blindly renewing (and this is a Good Thing®):

The benefit packages of lower-cost bronze and silver-level health plans — sold through the state's health insurance exchange — aren't as expensive as they might seem at first, they say.

Carolina Coleman, the project's research director, and John Connolly, the nonprofit's deputy director, say that many consumers who focus only on their high deductibles may be missing some gems hidden in their existing policies.

...With out-of-pocket costs rising, Weinberg of the Bay Area Council says, patients need to take a more active role in navigating their benefits.

In The Hill yesterday, Elise Viebeck posed 5 reasonable questions about the upcoming 2nd Open Enrollment period, set to run from 11/15/14 - 2/15/15:

  • Is HealthCare.gov ready?
  • Are three months enough?
  • What are consumers hearing?
  • What about cancelled plans?
  • Who will take the fall for problems?

Fair enough. I have my own questions to add to these, however:

Will the House GOP Commerce & Energy Committee finally admit that yes, around 90% of all QHP enrollees are actually paying for their first month's premium?

Will Avik Roy finally admit that yes, the majority of QHP enrollees are newly enrolled?

Between my son being sick for the past 4 days (he's better now, thanks!), losing my internet connection for 2 days (it's back up now, thanks!) and just generally being swamped with work, I don't have time to give these stories the attention they deserve, but they're all worth checking out:

D.C.’s health exchange is still hampered by delays, glitches 11 months after launch

While Democratic partisans tout the latest conventional wisdom that Obamacare is finally going strong, the experience of many ordinary people who apply for it says otherwise.

The ongoing delays and irritation that consumers endure while navigating the District’s health insurance exchange offer a window into the reality on the street.

More health insurance options increase choice — and possibly confusion

Between my son being sick for the past 4 days (he's better now, thanks!), losing my internet connection for 2 days (it's back up now, thanks!) and just generally being swamped with work, I don't have time to give these stories the attention they deserve, but they're all worth checking out:

McAuliffe unveils 10-step plan to expand health coverage for Virginians

Beyond that [the 25,000 people being added to Medicaid], the strategy seeks to chip away at the ranks of the uninsured, by enrolling them in programs they already qualify but haven't signed up for. The state will launch a website to help Virginians enroll in health care coverage through existing programs such as Medicaid and will step up efforts to sign up more Virginians for the federal health insurance exchange, HealthCare.gov.

Bill Straub: Kentucky GOP’s rendition of ‘I’m Against It’ may hit sour note on health care

Between my son being sick for the past 4 days (he's better now, thanks!), losing my internet connection for 2 days (it's back up now, thanks!) and just generally being swamped with work, I don't have time to give these stories the attention they deserve, but they're all worth checking out:

Health Insurance: Enrolling Rural America

Americans living in rural areas will be a key target as states and nonprofit groups strategize how to enroll more people in health law insurance plans this fall.

Though millions of people signed up for private insurance or Medicaid in the first year of the Affordable Care Act, millions of others did not. Many live in rural areas where people “face more barriers,” said Laurie Martin, a RAND Corp. senior policy researcher. Brock Slabach, a senior vice president at the National Rural Health Association, said “the feds are particularly concerned about this.”

More legislators want to shut down Cover Oregon

That's 156 more QHPs in the past 6 days, and 5,681 more added to Medicaid:

latest enrollment numbers

September 8, 2014

Health Coverage Type Total Enrollments
Medical Assistance 196,027
MinnesotaCare 70,893
Qualified Health Plan (QHP) 54,510
TOTAL 321,430

Woo-Hoo! My son's fever finally broke, and my internet service is back on; things are looking up!

I can post a couple of updates now:

At the end of July, Connect for Health Colorado had enrolled just over 140K people in QHPs via the individual exchange, plus around 2,400 small business employees/dependents in SHOP plans.

As of the end of August, these numbers are up to 143,524 and 2,470 respectively.

 

a) My son has a 102° fever & is home sick from school
b) My ISP connection is down and I'm posting this from my iPhone
c) I'm swamped with work from my day job and have to focus on that the best I can
d) All of the above

If you picked d), Mazel Tov!

Back in action tomorrow (I hope).

My last official update of Medicaid expansion in Arkansas (via their "private option" system) had the number at 192,210 as of 8/08. They've added nearly 13,000 more since then:

Thru 8/31 205,097 Arkansans have gained coverage via the "private option" for Medicaid expansion.

— David Ramsey (@ArkDavey) September 8, 2014

UPDATE: More details from Ramsey re. the 205K breakdown:

  • 172,761 are enrolled in private QHP plans via Medicaid funding (the "private option" part)
  • 21,496 were routed over to "regular" Medicaid due to the specifics of their situation
  • 10,840 are still being processed; they're covered by Medicaid until their status is resolved

The headline certainly seems like a Bad Thing, as does the opening paragraph...

Shift in Oregon Health Plan cuts funds to Eugene shelter program

EUGENE — One of the last resorts for mentally ill people in Eugene suffering a crisis will be closed this month after a change in state health care policy took one-third of a shelter's money.

Bummer. See? Obamacare is hurting people...wait, what's that??

Lane County public health spokesman Jason Davis says the expansion of the Oregon Health Plan means there are fewer indigent, uninsured mentally ill people who need short-term crisis housing.

With fewer clients forecast to be in indigent programs, the state is reducing contracts with agencies.

Oh. Never mind.

Reminds me of the "joke" that if Barack Obama cured cancer, Republicans would attack him for hurting oncologists.

The Republicans controlling the Virginia state legislature have been fighting tooth & nail to prevent 400,000 of their fellow Virginians from receiving healthcare, but Democratic Governor Terry McAuliffe has finally found a way to squeeze 25,000 people onto Medicaid anyway by reshuffling the deck of existing executive regulatory rules:

RICHMOND — Gov. Terry McAuliffe (D) on Monday unveiled a plan to insure an additional 25,000 Virginians, a measure that falls far short of his vow to defy the Republican-controlled legislature and find a way to expand coverage to 400,000.

After losing a months-long Medicaid fight in June, McAuliffe declared that he would close the “coverage gap” on his own.

On Monday, he announced a much more modest series of proposals, primarily designed to improve care for people already in Medicaid and boost outreach efforts to people who already qualify for it, but are not enrolled.

The plan would change enrollment criteria for about 25,000 people, including 20,000 who are severely mentally ill and 5,000 children of state employees.

This is a fairly short article. The thing that's noteworthy about my "weighting" is that I had to combine both the individual QHPs as well as VT's SHOP enrollments due to the unique situation in that state (it's a long story). QHPs + SHOP = around 66,600 paid enrollees as of the end of July. Since BCBSVT has 65K of those (over 97%), that gives a weighted average increase of around 7.8%.

Again, the other important things to note are that 1) this is still well below the "double-digit spikes!!" that nay-sayers have been screaming about for the past year, and 2) it's also around 20% lower on average than what the insurers had originally requested (weighted average).

MONTPELIER — People who buy their health insurance through the Vermont Health Connect website are going to be seeing their rates go up.

On Tuesday, the Green Mountain Care Board authorized Blue Cross and Blue Shield of Vermont to increase its rates an average of 7.7 percent while MVP subscribers will see their rates increase 10.9 percent.

Blue Cross, the state’s largest health care insurer with about 65,000 customers enrolled through Vermont Health Connect, had requested an increase of 9.8 percent while MVP asked for 15.3 percent.

Wow! This article is from back in June, but it's a heck of a find; insurance-tracking website HealthPocket ran an extensive study comparing the ACA exchange-based policies against their off-exchange equivalent plans, and their findings were pretty striking (and I'm surprised that this hasn't received more coverage):

Overall the least expensive metal plans from United Healthcare, Aetna, Cigna, and Assurant were significantly more expensive than the least expensive metal plans available on state exchanges. Across the bronze, silver, and gold metal tiers, the least expensive plans offered by the four off-exchange carriers were over 40% more expensive on average than the least expensive plans on the exchanges. This suggests that if these carriers entered new exchanges in 2015, then they would not usually be competitive with the cheapest on-exchange plans unless they substantially lowered their current premiums. It is important to note that these premium costs do not factor premium subsidies, which are only available for on-exchange metal plans.

OK, I don't know what the requested rate changes for 2015 were in Oklahoma, but this appears to be the final word:

Health Insurers Submit Exchange Rates for 2015

OKLAHOMA CITY –Oklahomans shopping for individual health insurance policies through the federal exchange will be able to choose from six different companies offering multiple plans. Rate renewals for 2015 policies range from a decrease of 9.1 percent to an increase of 29 percent. The actual rate for an individual will depend on several factors, including age, geographical location and tobacco use.

“In the second year of the federal exchange, carriers have adjusted their rates to adequately reflect their utilization costs, comply with federal rules on medical loss ratios and reflect revisions to their provider networks,” said Oklahoma Insurance Commissioner John D. Doak.

Thanks to Objective Politics for reminding me of this ugly moment from the 2012 GOP primaries...

The context was a Twitter discussion between LA Times reporter Michael Hiltzik, U of Chicago professor Harold Pollack, and CATO Institute healthcare guru/Halbig co-architect Michael Cannon. "Objective Politics" chimed in with the link to the infamous moment above, which pretty much tells you everything you need to know about the opposing points of view at play in the ACA debate.

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