Senate Democrats, led by Sen. Patty Murray, are pushing to increase the Affordable Care Act's subsidies as part of a stabilization bill being renegotiated with Sen. Lamar Alexander. This would mean increasing the amount of financial assistance people receive, as well as making it available to more people.
...“We’re interested in both expanding access to subsidies and increasing their value. You’ve got two different sets of populations that will be impacted in different ways depending on how cost sharing” is structured, a Democratic aide told me.
Welp. In the end, enough Democrats joined Republicans in both the U.S. Senate and House to pass a massive spending bill in the dead of night. Donald Trump signed it into law early this morning.
Needless to say, I'm not happy at all about a major missing piece of the bill: The DREAM act, which would protect around 690,000 young adults who were brought to the United States as children, was not part of the bill. The Dems in the Senate were able to lock in a formal immigration debate which will presumably be focused in large part on DACA and the Dreamers, but there was no such guaranteed baked in on the House side by Speaker Paul Ryan. Personally, I'm pretty disappointed with the 73 Dems who folded on the issue, but the fight isn't over yet.
Most states dropped a bit year over year in 2017 in large part due to the Trump administration cutting off outreach/marketing during the critical final week, but Louisiana saw the worst year over year drop. Why? Well, the most obvious reason was pretty simple: The state expanded Medicaid halfway through the year.
The reality is that as much as everyone complains about the $695 or 2.5% income individual mandate penalty for NOT having qualifying healthcare coverage, the penalty should really be increased. There, I said it. The problem is that if the penalty is significantly less than the amount that the premiums would be, some people will still decide to eat the tax instead of signing up.
UPDATE: (sigh) OK, it looks like the final number for the District of Columbia was slightly too low; I've received official notice from the DC exchange that it was actually 22,584, 115 enrollments higher than the NASHP report pegged it at. The Graph and spreadsheet below have both been updated...
OK, here it is...
This morning Covered California issued their final 2018 ACA Open Enrollment numbers. I was a bit disappointed to discover that instead of beating out last year slightly, they ended up coming about 2.3% short year over year...but there's a very good reason for that: Like Maryland, California not only utilized the full "Silver Switcharoo" strategy with individual market premiums, they actively encouraged current UNSUBSIDIZED on-exchange Silver enrollees to switch to off-exchange Silver plans instead.
Last year Covered CA's 1/31 total hit 1,556,676 (or just under 15,000 enrollees higher). In 2016 they had their all-time high of 1,575,340, so they'd have to have tacked on about 34,000 more over the final 10 days of Open Enrollment this year in order to beat their record.
Now that the 2018 Open Enrollment period is officially over in every state +DC, I've started compiling more detailed demographic breakouts of the data on a state-by-state basis. The official CMS report from the Assistant Secretary for Planning & Evaluation (ASPE) report should be released at some point in the next couple of weeks, but until then, I'll have to settle for whatever reports I can patch together from some of the state-based exchanges.
So far I've dug up final (or near final) data for six states: Colorado, Connecticut, Idaho, Maryland, Minnesota and Washington State. Collectively, these states only represent about 890,000 2018 exchange enrollees, or roughly 7.5% of the 11.8 million total, so I have no idea how representative they are nationally, but it's all I have to work with for the moment.
Maryland was originally one of 3 state-based exchanges which stuck to the "official" half-length, December 15th Open Enrollment Period deadline this time around. However, with just 2 days to go before the original deadline, the MD Health Connection announced that they had decided to bump out their deadline by an extra week after all, through December 22nd.
I want to be clear about something: Much of my data analysis has a bit of snark to it, adding an acrid tinge of dark humor to healthcare, a topic which is often fraught with pain, suffering, grief and sadness. Once in awhile I take pause before twisting the sarcasm knife too much.
This is one of those moments. I'm therefore limiting the snark to the headline only.
Three Januarys ago, Gov. Rick Snyder described a River of Opportunity all Michiganders could enter as long as the state improved third-grade reading proficiency.
“One of the important metrics in someone’s life on the River of Opportunity is the ability to be proficient-reading by third grade,” he said in January 2015. “How have we done? We were at 63% in 2010, and we are at 70% today. … But 70% doesn’t cut it.”
Over the past month or so, former CMS Administrator and healthcare hero Andy Slavitt has been urging people to fill out a sparsely worded, cryptic online form if they're interested in "making our nation's health care system work better for all Americans."
There are too many agendas that aren’t about making health care work for all Americans. We need to put health care over politics again.
Within a month, a major initiative will be announced that I and many Americans will come together for. If interested... https://t.co/7BBDUS2J8u
From Alleigh Marre, HHS Dept. National Spokesperson, less than an hour ago (h/t Kimberly Leonard for the heads up):
"Even Charles Gaba, the author of ACAsignups.net admits in his analysis, “The simple truth is: Yes, full-price, unsubsidized premiums for individual market healthcare policies probably have doubled since 2013…” His analysis of the report drives home that Obamacare’s one-size-fits all mandates and regulations have driven up prices for all."
NOTE: The last few paragraphs of this post have been reformatted for clarity only.
All of Twitter is abuzz with this tweet (since deleted) by Republican Speaker of the House Paul Ryan:
A secretary at a public high school in Lancaster, PA, said she was pleasantly surprised her pay went up $1.50 a week ... she said [that] will more than cover her Costco membership for the year. https://t.co/yLX1Bod1j0
Idaho is one of only 2 state-based exchanges which stuck with the "official" December 15th deadline for the 2018 Open Enrollment Period (the other was Vermont). Unfortunately, they haven't released an official, detailed demographic breakout report yet, but they did discuss some relevant stats in their December board meeting...which, as it happens, took place on December 15th, which means it's still missing a bit of final data. For now this is the best I can do:
d) Enrollment Update
Mr. Kelly said YHI’s goal in enrollments is to be flat year-over-year, and it is within reach. When we look at average enrollments for 2017 of around 90,000 Idahoan’s, we appear to be ahead of that for 2018. As of this morning, we have almost 96,000 enrollments. This week alone, we have gained over 6,000 enrollments, way ahead of our growth for the same time last year. We also had well over 2,100 calls into the support center yesterday.