Time: D H M S

Today must be Healthcare Survey day. First it was the Kaiser Family Foundation's monthly tracking poll; now comes the Commonwealth Fund, which has released their own survey results regarding the Affordable Care Act and healthcare coverage in general:

To gauge the perspectives of Americans on the marketplaces, Medicaid, and other health insurance issues, the Commonwealth Fund Affordable Care Act Tracking Survey interviewed a random, nationally representative sample of 2,410 adults ages 19 to 64 between November 2 and December 27, 2017, including 541 people who have marketplace or Medicaid coverage. The findings are compared to prior ACA tracking surveys, the most recent of which was fielded between March and June 2017. The survey research firm SSRS conducted the survey, which has an overall margin of error is +/– 2.7 percentage points at the 95 percent confidence level.

Covered California’s Executive Director Addresses Harvard Study on Impact of Eliminating Individual Mandate on Enrollment and Premium

SACRAMENTO, Calif. — Covered California Executive Director Peter V. Lee issued the following statement in connection with the Harvard Medical School Study, “Eliminating the Individual Mandate Penalty in California: Harmful but Non-Fatal Changes in Enrollment and Premiums,”published in Health Affairs. The Harvard study, conducted by a team lead by Dr. John Hsu, is the first national effort to measure the potential impacts of removing the individual mandate penalty based on surveying actual California consumers about their likely actions in the face of there being no penalty.

Back in January, I wrote:

Millions of people who failed to make sure they were enrolled in ACA-compliant healthcare coverage are going to file their tax returns this spring thinking that they don't have to pay a penalty for not doing so only to discover that the penalty is still in effect.

Then, next spring (assuming the IRS sticks to its guns on the issue and there's no further legislative changes made), anyone who didn't #GetCovered for 2018 are also going to have to pay the penalty (which, again, is either $695 per adult/$348 per child or 2.5% of their household Modified Adjusted Gross Income).

The damage caused by the mandate being repealed to the individual market risk pool (and rate premiums) will be felt this November, when people start shopping around for 2019 coverage...but the actual "benefit" (i.e., those who don't get covered not having to pay the mandate penalty) won't show up until spring 2020.

The Kaiser Family Foundation runs a highly respected monthly national tracking poll on healthcare issues. Their latest was just released, and while there's a bunch of interesting stuff included, there are two main takeaways. Here's the first:

The February Kaiser Health Tracking Poll finds a slight increase in the share of the public who say they have a favorable view of the Affordable Care Act (ACA), from 50 percent in January 2018 to 54 percent this month. This is the highest level of favorability of the ACA measured in more than 80 Kaiser Health Tracking Polls since 2010. This change is largely driven by independents, with more than half (55 percent) now saying they have a favorable opinion of the law compared to 48 percent last month. Large majorities (83 percent) of Democrats continue to view the law favorably (including six in ten who now say they hold a “very favorable” view, up from 48 percent last month) while nearly eight in ten Republicans (78 percent) view the law unfavorably (unchanged from last month).

I noted a few weeks ago that as many as 9 states are ramping up plans to reinstate one version or another of the ACA's just-repealed Individual Mandate. I concluded:

My only advice is that if they do take the political risk of imposing a mandate penalty, at least make sure it's more stringent than the one which was just repealed--I'd probably recommend making it something like the same cost as the least-expensive Bronze plan available on the exchange after whatever tax credits they'd otherwise have applied.

Well, I don't know about the details, but it looks like the District of Columbia, at least, is full-steam ahead:

DC Health Benefit Exchange Authority Executive Board Recommends Policies to Protect Health Insurance for District Residents
Friday, February 23, 2018

This just in...I used to track the monthly Medicaid/CHIP reports pretty religiously, but the total numbers have actually stayed fairly stable month to month for the past year or so (mainly because the states which expanded Medicaid under the ACA have mostly "maxed out" by now). This should start changing in Maine later this year as they voted to expand the program via ballot initiative last November, and Virginia may end up expanding Medicaid to up to 400,000 people there as well later this year.

In the meantime, here's where things stood as of the end of 2017, according to CMS:

Highlights from the December 2017 Report

Medicaid and CHIP Total Enrollment

From the About page of the Art as Social Inquiry website:

Art As Social Inquiry combines art and advocacy as a way to engage audiences. Theresa Pussi Artist BrownGold is the painter/writer/performance artist behind Art As Social Inquiry.

"I have often wondered why so many good people have such different and divisive opinions. Art As Social Inquiry asks the questions: Are we our opinions? Or are we something more? Then what? What is beyond the emotional charge of our opinions? And how do we get there?"

Art As Social Inquiry — an artist-at-work painting portraits of real people whose lives embody the social issues of the day, issues like access to healthcare, immigration, how we die. The artist also uses songwriting and performance art, two more art-making tools, to help us see ourselves in the bigger world, and the opinions we cling to.

Our opinions affect our actions. Art As Social Inquiry unearths those opinions.

Not sure when this was posted, but the trendline is interesting...according to the first chart, Colorado ended 2017 down only 16.3% from their total OE4 enrollment number (161,568 QHP selections).

The cumulative enrollment numbers are also important: During the entire off-season (from 2/01/17 - 12/31/17), 41,387 people selected QHPs via Special Enrollment Periods (SEPs), or roughly 124 per day. Of course, technically speaking the last day of SEP enrollment for 2017 should have been 11/15/17 (for coverage starting December 1st), but it looks like a few hundred people slipped in after that.

Colorado's SHOP enrollment, meanwhile, hovered right around the 3,000 person mark all year.

Press Release: NY State of Health Releases County-Level Enrollment Data

Feb 27, 2018

ALBANY, N.Y. (February 27, 2018) -- NY State of Health, the state’s official health plan Marketplace, today released county-level enrollment data as of January 31, 2018, showing that overall enrollment increased in each of New York’s 62 counties. Total enrollment in the Marketplace is now over 4.3 million people, reflecting an increase of 700,000 people (19 percent) from 2017.  Many upstate counties saw significant enrollment gains in the last year.

“Consumers from Chautauqua to Suffolk and every county in between are shopping for health plans through the Marketplace,” said NY State of Health Executive Director, Donna Frescatore. “With affordable premiums and a robust choice of plans, NY State of Health is where New Yorkers go to get covered.”


(Yes, I'm Jewish. Yes, hearing Michelle Bachmann mangle the pronounciation of "chutzpah" makes my teeth itch, but it's hilarious).

Late last night, Texas Attorney General Ken "don't confuse me with Bill" Paxton announced that he, along with 19 other state Attorneys General, is suing the federal government (again) over the Affordable Care Act:

Texas is suing the federal government over President Barack Obama's landmark health law — again.

In a 20-state lawsuit filed Monday in federal court, Attorney General Ken Paxton argued that after the passage of the GOP's tax plan last year — which also repealed a provision of the sweeping legislation known as "Obamacare" that required people to have health insurance — the health law is no longer constitutional.


Please watch the full video above before reading this entry.

I've been debating about whether to post this for several days now.

My son is on the Autism spectrum. His case is fairly low-level/high-functioning (mostly in the Aspergers Syndrome category, I believe), and most of the time it's not all that noticeable, but it's definitely an issue in certain circumstances...and the video above gives a perfect example.

I've made one or two vague references to a member of my immediate family being in need of mental health services and physical therapy (he also has a mild case of cerebral palsy), but haven't gone into specifics before. This is partly because it wasn't really necessary to the point I was making, but mainly because my wife and I are very protective of our son and don't want him to grow up thinking of himself as an "Aspie" or whatever the label is; he's just himself. However, he's old enough now that I decided to ask him if he's OK with my mentioning it publicly, so here we are.

In 2018, unsubsidized premiums for ACA-compliant individual healthcare policies have shot up by around 30% on average nationally. Around 18 points of this (60% of the total) is due specifically to policy decisions by the Trump Administration and Congressional Republicans, primarily the cut-off of Cost Sharing Reduction reimbursement payments and the (accurate, as it would later develop) anticipation, by some carriers, of the ACA's individual mandate being repealed.

What about 2019, however? The 2-3 points tacked on out of concern for the mandate being repealed was only a small portion of the full impact insurance carriers expect it to have, and of course there's the further undermining of the ACA via Donald Trump's "Short Term" and "Association Plan" executive orders. Finally, there's the impact of what is assumed to be another year of the advertising/outreach budget being starved by the Centers for Medicare & Medicaid.

Presented with minimal comment:

(CNN) A top official at the Department of Health and Human Services has been placed on administrative leave after a CNN KFile inquiry while the agency investigates social media postings in which he pushed unfounded smears on social media.

Jon Cordova serves as the principal deputy assistant secretary for administration at HHS. A KFile review of Cordova's social media accounts found that he pushed stories filled with baseless claims and conspiracy theories, including stories that claimed Gold Star father Khizr Khan is a "Muslim Brotherhood agent" and made baseless claims about Sen. Ted Cruz's personal life.

"Principal deputy assistant" is probably just a gussied-up name for a low-level flunkie, right?


Back in June 2016, the Obama Administration rightly clamped down on "Short-Term Plans", limiting them to, you know, a "short term"...no more than 3 months out of the year, while also making them non-renewable; that is, you couldn't get around the 3-month limit by simply renewing the policy every three months:


The students of Marjory Stoneman Douglas High School are not screwing around:

EMMA GONZALEZ: Well what we have set up right now we have a website, March for Our Lives. We're going to be doing a march in March on Washington where we get students all over the country are going to be joining us. These kids are going to make this difference because the adults let us down. And at this point I don't even know if the adults in power who are funded by the NRA I don't even think we need them anymore because they're going to be gone by midterm election. There's-- there's barely any time for them to save their skins. And if they don't turn around right now and state their open support for this movement they're going to be left behind. Because you are either with us or against us at this point.