2020 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Shades of John "OMG!! Papa Johns will be forced to raise prices by 14¢ a pizza!!" Schnatter in Chicago this week...

The Chicago Cubs denied an assertion by the Chicago Sun-Times on Friday that the tarp debacle earlier in the week against the San Francisco Giants happened because the club short-staffs the grounds crew at Wrigley Field in order to avoid paying health insurance.

The short version: The nasty storm last week ended up making Wrigley Field unusable because the grounds crew was shorthanded. According to the Sun-Times, the reason they were shorthanded is because the team management slashed their hours in order to avoid having to pay for (gasp! the horror!) healthcare coverage for the staff.

As writer David Brown notes, if true, this is pretty slimy behavior for two reasons:

If a grounds crew person needs to work at least 130 hours a month to meet the requirements for health care, that's the cost of doing business. But the Cubs have gone on the cheapsince being sold by Sam Zell, and it's not just in the free-agent market. 

OK, technically this is only the 2nd separate entry under the "Invisible Hand Slaps!" moniker, but I've posted 5 updates to the original one and it started to get unwieldy, so I'm calling this "Part 7" instead:

UnitedHealth Group Inc. will apply to sell Obamacare plans in 24 states next year, vastly broadening the footprint of the nation’s largest insurer, which had stood largely on the sidelines during the law’s first year.

UnitedHealth  UNH  is expanding its reach sixfold, from just four states where it is participating in plans offered under theAffordable Care Act.  The Minnetonka, Minn.-based insurer plans to offer coverage in such states as Florida, Louisiana, Michigan, North Carolina, Ohio, Pennsylvania and Texas.

Last night I posted about MI-11 GOP Congressional candidate David Trott, who spewed a litany of tired old bald-faced lies about the ACA.

This morning I received the following from a friend, regarding 2 Republican candidates for local/state office: Hugh Crawford (term-limited state representative, running for county commission...and hoping to swap places with his wife, who's currently a county commissioner running for his state rep seat) and Mike Kowall (state Senator running for re-election):

Last night was a candidates forum at Fox Run, the Novi retirement community. Candidates for the State House, State Senate, and County Commission were there. During the Q&A a question was raised whether the candidates supported Obamacare.

Both Hugh Crawford and Mike Kowall answered this way: "I don't like Obamacare, I would have voted against it, but I very much support Governor Snyder's Healthy Michigan Initiative, which brought the state over $400 Million in Federal Money."

It's no secret that I'm a progressive Democrat. It's also no secret that I live in the metro Detroit area (although I'm actually in MI-09, Sandy Levin's district, not MI-11). Obviously I'm a bit on the biased side when it comes to local Congressional races. All that said, MI-11 Republican candidate and foreclosure attorney David Trott (best known for kicking old ladies out of their homes) gave a newspaper interview recently which was jaw-droppingly full of nonsense when it comes to (among other subjects) the Affordable Care Act.

For starters, the question itself was disgustingly biased:

Many American families experienced sticker shock when the first monthly premium arrived for health insurance under the Affordable Care Act. Many also now have high deductibles that make them wary of getting medical care at all. What would you do too bring down costs and improve medical care?

...but Trott decided to one-up his interviewer in the gall department:

When I updated the Minnesota exchange numbers just a few days ago, they stood at 53,647 QHPs & 240,654 Medicaid/CHIP enrollees...or 294,301 total.

Just 3 days later, the MNsure exchange has tacked on almost 5,800 more people, breaking through the 300,000 mark:

More Than 300,000 Minnesotans Enroll in Quality Health Coverage Through MNsure

ST. PAUL, Minn.—MNsure today announced that 300,085 Minnesotans have enrolled in comprehensive, affordable health insurance coverage through the state health insurance marketplace.

“I’m proud to announce today that more than 300,000 Minnesotans have enrolled in health insurance through MNsure,” said MNsure CEO Scott Leitz. “During the State Fair, we hope to help even more Minnesotans find comprehensive, affordable coverage that meets the needs of their families or small businesses. Be sure to visit us in the Health Fair 11 building and bring your questions about MNsure.”

Whoops...found even more slightly-outdated ACA-related articles worth noting...

OREGON: Cover Oregon officials hope to repair broken state health insurance exchange for 2016

For those who assume Cover Oregon will go away when the federal government takes overthe state exchange's job of enrolling people in health coverage, think again.

Even as Oregon works on hooking up to the federal website by November, some Cover Oregon board members hope the engagement with Uncle Sam will be only a one-year affair.

I found one quote in particular to be a bit of an eyebrow-raiser:

But the idea is controversial on both sides of the political aisle in Salem.

"Hell, no," says Sen. Brian Boquist, R-Dallas. He thinks Oregon should leave the job to the federal exchange and Cover Oregon as a stand-alone agency should go away. "Cover Oregon, the whole structure is bad from beginning to end. I don't trust the federal government. But I do trust the federal government more than I do the state of Oregon."

The story itself is noteworthy mainly because it suggests that the ACA's individual mandate may be having a positive impact, as Wal-Mart reports that "far more" of their employees have enrolled in the company's healthcare program than they expected this year.

What strikes me, however, is how CNN Money is acting as though this is somehow a bad thing, since it "hits" their corporate profits for $500 million:

Health care costs hit Wal-Mart profit

Wal-Mart Stores says far more of its workers are signing up for its health care coverage than it expected.

Because of that, the world's largest retailer will earn less in the current fiscal year than it had previously promised investors.

While the requirement that employers provide health coverage has yet to take effect under Obamacare, the requirement that individuals have coverage has prompted people to compare plans available to them at work with plans offered on government exchanges.

Um, yup. That's exactly how it's supposed to work.

Interesting story (originally via Kaiser Health News) about a little-known provision of the Affordable Care Act which gives CMS (Centers for Medicare & Medicaid Services, a sub-section of the HHS Dept.) a $10 billion R&D/incubator budget over a decade to try out different methods for delivering healthcare and payments in a more efficient manner:

The law created the Center for Medicare and Medicaid Innovation to launch experiments in every state, changing the way doctors and hospitals are paid, building networks between caregivers and training them to intervene before chronic illness gets worse.

One example: George Washington University's $1.9 million award to improve care and cut costs for at-home dialysis patients. Another: CareFirst BlueCross BlueShield's $24 million grant to reduce unnecessary hospital visits for chronically ill Medicare patients.

The center's 10-year, $10 billion budget is the largest ever devoted to transforming care. In several states the office is working to overhaul medicine for nearly all residents -- not just those with government Medicare and Medicaid coverage.

Still clearing out my in box, but I'm at least able to devote a full entry to each story this morning. This one is from more than a week ago but still very noteworthy:

One of the nation’s largest hospital operators,Tenet Healthcare THC -0.12% (THC), last week opened a window into the differences for patients and hospital financial coffers between those states with Medicaid dollars and those without.

“In our five states that expanded Medicaid in 2014, we benefited from a significant migration of patients from uninsured into Medicaid with a 54% decline in uninsured admissions and a 27% decline in uninsured outpatient visits,” Tenet chief executive Trevor Fetter said during the company’s second-quarter earnings call last week.

In case you think this is just "cherry-picking" from a single hospital corporation, here's a similar story from back in May (when Medicaid expansion enrollment was significantly lower):

Took me awhile to get to this story: Like Michigan, New Hampshire is a late addition to the ACA Medicaid Expansion club, having just started the program on July 1st. The initial number doesn't sound impressive until you realize that only 50,000 people are eligible for it in the state to begin with:

"It makes you happy to be able to offer people something," said Paula Smith, who as a counselor for the Affordable Care Act or Obamacare has had to tell some people that they have too much income for the new federal health-care marketplace.

..."We called her back and told her we could help her now," Smith said.

As of the end of the day Friday, Aug. 8, the state says 9,399 people have signed up for the New Hampshire Health Protection Program since enrollment began July 1. Actual coverage starts this Friday, Aug. 15.

New Hampshire officials have estimated that about 50,000 people the state are eligible for expanded benefits under Medicaid, the federal health program for people with lower incomes.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick hits:

IDAHO: New Idaho exchange will grab its 76K Obamacare customers without feds’ help

Idaho officials say they’re tired of waiting on files  from the federal government and have figured out a way to transfer the state’s 76,000 Obamacare customers from the federal marketplace to its state-run portal this fall.

Your Health Idaho said it had hoped to leverage federal information to set up existing enrollees on their own web platform.

Instead, it has asked the state’s health and welfare agency to use its eligibility system to figure out who is eligible for government subsidies under the Affordable  Care Act. It will also work with insurance carriers to determine who signed up for coverage and needs an account on the state exchange, which is set to launch in time for the overhaul’s second sign-up period on Nov. 15.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick hits:

HEALTHCARE.GOV: Lack of Back End Software for Federal Exchange

One of the big news stories in 2013 and early 2014 was the botched launch of the federal Exchange (and several key state Exchanges), which led to many Americans having to wait to be enrolled in an ACA-sanctioned health plan.  Although some technical snafus have been addressed, many still remain.  For example, a top White House official told Congress recently that the automated system to send payments to insurance companies is still under development, and didn't offer a completion date. The lack of an electronic verification process is only one part of the "backend" of the software that is still problematic five years after the Act was passed.

NEVADA: After health care debacle, Gov. Brian Sandoval reluctantly extends Nevada’s ties with Xerox

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

KENTUCKY: Women leading Kentucky health: Kynect’s Banahan excited to reach even more people

First in a series of profiles about KY women in charge of the state exchange:

Energy exudes from Carrie Banahan when she talks about her work with others to bring affordable health care to more than half a million Kentuckians.

“I worked all my life to see this happen, that we can provide affordable health insurance to people, and it has actually happened,” she said. “I am thrilled that we are actually helping people in Kentucky. It is the highlight of my career.”

Banahan is executive director of the Kentucky Health Benefits Exchange, which the state has branded as Kynect, partly to avoid identification with the pejorative nickname Obamacare. She shares the credit for its success.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

MARYLAND: An Amazing Healthcare Revolution Is Happening In Maryland — And Almost No One's Talking About It

The Maryland ACA exchange has been one of the "middle-tier" models in my view; not an utter disaster like the ones in Oregon or Massachusetts, but still riddled with technical problems like the ones in Minnesota & Vermont. However, the state has apparently had a different healthcare-related initiative which has been a huge success so far:

Through innovative methods and a data-centric approach, Western Maryland Regional Medical Center, has become the cornerstone in Democratic Gov. Martin O'Malley's ambitious makeover of the state's healthcare programs.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

ARKANSAS:

Mark Pryor shows Democrats how they should campaign on the Affordable Care Act in a red state. You don't have to mention Obamacare (which technically doesn't even exist), you don't have to even mention the Affordable Care Act. You do have to personalize what the law actually means for real people with real medical issues which were fixed or improved by the law:

Read more on this ad & angle from Greg Sargent of the Washington Post.

VERMONT:

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