OK, this is kind of beating a dead horse since the Alexander-Collins bill is dead anyway, but just for completeness sake:
Last week I pointed out that aside from everything else that's problematic about the abortion restriction language included in the A-C bill, it would also have run into a big legal problem because three states (California, New York and Oregon) legally mandate that major medical healthcare policys cover abortion, in direct opposition to the A-C provision which would deny federal subsidies, CSR assistance or reinsurance funds to...any healthcare policy which covers abortion.
OLYMPIA, Wash. (AP) — Gov. Jay Inslee has signed a measure that requires Washington insurers offering maternity care to also cover elective abortions and contraception.
The Washington Health Benefit Exchange today announced that 209,802 customers used Washington Healthplanfinder to purchase a Qualified Health Plan (QHP) for 2018 coverage during the most recent open enrollment period. This total is a nearly three percent increase over last year and is 50 percent higher than the number of enrollees recorded following the first open enrollment period in 2014.
A year ago I wrote up my own "wish list" of 22 recommendations for fixing, improving, strengthening and expanding the Affordable Care Act (it's officially 20 items but two of them really should have been split into two entries apiece). I called it "If I Ran the Zoo", and it received quite a bit of praise, even though I didn't come up with most of them myself; it was mostly a compilation of ideas which had been floating around progressive healthcare wonk circles for awhile.
In any event, now that the Republican "ACA stabilization bill" (Alexander-Collins) appears to be dead and buried, I figured it might be helpful to line up both the House and Senate versions of the ACA 2.0 bills to see how they compare to each other as well as to my own list of recommendations.
NOTE: I've modified the headline to clarify that it's CSR reimbursements which are dead, not the actual CSR subsidies. Those eligible for CSR assistance will still receive it from the insurance carriers..it's just that the carriers aren't/won't be reimbursed for doing so. In response, they've jacked up the premium rates on others to cover their losses.
As I understand it, this means that unless a standalone bill of some sort passes, there will be no significant legislative changes to the ACA exchange/individual market status for the 2019 Open Enrollment Period at the federal level...and that's extremely unlikely to happen this year.
The House ACA 2.0 bill would check off a half-dozen or so of the 20 items on my (now outdated) wish list of ACA fixes/improvements...but also includes another half-dozen provisions on top of that (many of the additional items would cancel out Trump/GOP sabotage efforts which hadn't even happened when I wrote my "If I Ran the Zoo" wish list a year ago).
A few days ago I warned Congressional Democrats that while I agree that appropriating CSR reimbursement payments at this point would be a net negative move thanks to the clever Silver Load/Silver Switcharoo workaround developed last year, there's one possible cloud surrounding that silver lining, so to speak: What if the Trump Administration were to attempt to put the kibosh on Silver Loading altogether?
I don't know the legality of such a move, mind you, but It has been thrown around the rumor mill of late, so I figured I should remind them to keep that possibility in mind.
New legislation will allow Vermont insurers to load cost of CSR only onto on-exchange silver plans for 2019
For 2018 coverage, Vermont, North Dakota and the District of Columbia were the only states that didn’t allow insurers to add the cost of cost-sharing reductions (CSR) to premiums after the Trump Administration cut off federal funding for CSR. In most states, insurers were allowed to either add the cost of CSR to all silver plan premiums, to all on-exchange silver plan premiums, or, in a few cases, to all metal-level plan premiums. But in Vermont, North Dakota and DC, insurers simply had to absorb the cost of CSR, estimated at $12 million a year in Vermont.
It's not about healthcare. It's not about "freedom". It's not about "tyrrany". It's not about "choice". It's about a tiny cadre of absurdly wealthy plutocrats being upset about a tiny fraction of their hoard being used to help out the least-fortunate among us. Via the Congressional Budget Office (graph via Axios):
Minnesota's 2018 Open Enrollment Period was a month longer than the official half-length period pushed by HealthCare.Gov, but was still over 2 weeks shorter than it had been in prior years, ending on January 14th, 2018. Even so, they reported a slight increase in year-over-year policy enrollees, ending OE5 with 116,358 QHP selections.
Typically, you'd see the official QHP selection number drop off noticeably by the end of the first quarter...usually by around 13% or so. Roughly 10% of those who select policies don't ever actually pay for their first monthly premium, and another 2-3% generally drop off after only paying for the first couple of months.
We released our End of Open Enrollment report this week, our most detailed look at the impact we are having across Colorado. This year, you will see that more of our customers are receiving help through the Advance Premium Tax Credit – 69 percent, compared to 61 percent last year – and the average level of monthly tax credit help climbed to $505 from $369 last year.
Not surprising...the 34% average rate increases (about 6 points of which is due specifically to CSR reimbursement payments being cut off...much lower than most states) meant that a lot more people qualified for tax credits in the first place, and of course the amount of credits went up accordingly...a bit more, actually (37% on average).
