END OF 2018 OPEN ENROLLMENT PERIOD (42 states)

Time: D H M S

Arkansas

Last week I estimated the overall weighted average rate increases for the Arkansas individual market at "between 4-5%", with a rough estimate of around 4.6%.

Today, Arkansas Times reporter David Ramsey has provided the exact market share numbers for Arkansas. When I plug these in, the weighted average comes in a bit higher, at 4.98%:

HOWEVER, according to Ramsey, the Arkansas Insurance Division says that the actual weighted average is only 4.4% overall.

There could be any number of reasons for the discrepancy; it's possible that there's a few additional minor off-exchange carriers who I've missed, or there could be rounding errors/etc. In any event, these are all just estimates anyway, so I'll go with AID's official 4.4% figure.

Yes, I'm back. From what I can tell, the major Obamacare/health insurance-related stories while I was out were a) Scott Walker/Marco Rubio finally releasing their proposed "replacement plans" (such as they are) for the ACA, and b) the approved 2016 rate changes for ACA-compliant individual/small group policies across a whole mess of states (technically all 50 states +DC had to be finalized as of 2 days ago, but it'll still take awhile to dig up all of them, since many news stories & reports may leave out off-exchange plans, increases of less than 10% and/or actual market share for weighting purposes).

I'm ignoring the Walker/Rubio story for the moment, mainly because they're both complete jokes, but will write up something about that later. For now, let's dive into the approved 2016 rate change story, starting with Arkansas.

IMPORTANT: See this detailed explanation of how I've come up with the following estimated maximum requested weighted average rate increases for this state.

As explained in the first link above, I've still been able to piece together rough estimates of the lowmid-range and maximum possible requested average rate increase for the Arkansas individual market. Note: While the table & methodology for Arkansas are the same as most of the other states I've posted on, there's one important difference here; see below for details:

Again, the full explanation is included here.

I was kind of hoping that this morning's Gallup uninsured rate news would include a monthly update for July; instead, it only runs through the end of June, the same quarterly survey results that they released a month ago. Then again, things probably didn't change much in July.

Instead, this time they've broken the numbers out by state:

WASHINGTON, D.C. -- Arkansas and Kentucky continue to have the sharpest reductions in their uninsured rates since the healthcare law took effect at the beginning of 2014. Oregon, Rhode Island and Washington join them as states that have at least a 10-percentage-point reduction in uninsured rates.

THIS JUST IN...

CMS today conditionally approved Delaware and Pennsylvania to operate State-based Marketplaces (SBMs)" #kingvburwell @charles_gaba

— Dan Mangan (@_DanMangan) June 15, 2015

Obama administration has approved Pennsylvania and Delaware’s blueprints to become state-based ACA exchanges next year.

— Dylan Scott (@dylanlscott) June 15, 2015

Hmmm...the headline looks bad, but when you read further it's clearly a matter of perspective more than anything else:

Maryland's health insurance exchange improperly billed the federal government $28.4 million, a Department of Health and Human Services audit reported Friday.

An inspector general's probe found a lack of oversight and internal controls, not criminal wrongdoing, was the cause of the exchange's problems since the marketplace opened in 2013.

Two late-breaking news items, one negative, the other potentially positive:

Arkansas: The good news a few weeks ago was that newly-elected Republican Governor Asa Hutchinson did not kill off AR's unique "private option" Medicaid expansion program as many had feared; instead, he actually proposed extending it pretty much as is for another 2 years, to the relief of decent folks, and the state legislature seemed to be OK with that (another surprise).

The bad news today is that, while the program looks safe for 2 more years...the same legislation kills the program after the 2 years are up:

LITTLE ROCK, Ark. (Reuters) - Governor Asa Hutchinson of Arkansas has signed legislation that will end by 2017 the state’s innovative but controversial adaptation of the Affordable Care Act, which has provided nearly 190,000 residents with health coverage.

David Ramsey has the full skinny on the unpleasant situation in Arkansas, where their "private option" Medicaid expansion program, which was always weird with a beard to begin with, is very much at risk of collapsing altogether:

Well, here we go again. The legislature is once again ready to debate the private option – the state’s unique version of Medicaid expansion, which uses funds available via the Affordable Care Act to purchase private health insurance for low-income Arkansans. Gov. Asa Hutchinson will take a long-awaited position on the policy in a speech at UAMS tomorrow morning. Then it will be up to the legislature. Health insurance for more than 200,000 Arkansans is at stake. Here are some keys to remember as the debate unfolds tomorrow and in the coming weeks. 

The short version: The AR program has to be re-approved by the legislature every year, and requires a 75% majority to do so, so it's a wonder that it's survived this long, frankly.

Talking Point Memo reports:

The Associated Press reported Sunday that newly elected Republican. Gov. Asa Hutchinson is expected to address the program, which uses Medicaid dollars to pay for private coverage, in a speech this week. Arkansas's plan must be re-approved every year.

The program is contending with Hutchinson and a batch of newly elected Republican lawmakers who ran against it. The funding must be approved by three-fourths of the state legislature every year. As TPM previously reported, getting approval in 2014 required a significant amount of horse-trading and deal-making under Democratic Gov. Mike Beebe.

...Even if Hutchinson agrees to keep the so-called private option, he is expected to propose more conservative-minded changes. Senate President Jonathan Dismang told the AP that Medicaid expansion "is not going to exist in its current form."

How many people are we talking about here? Oh, just 218,000 or so.

The good news: Enrollment in the ACA private Medicaid option program is up to 218K, about 7,000 higher than it was as of mid-October.The bad news: With the state legislature & governor's office being completely overrun by Republicans, the future of the program isn't looking great:

The other day I noted that Republican Congressman Tom Cotton of Arkansas, currently in a heated battle with U.S. Senator Mark Pryor to take Pryor's seat, is proposing not only stripping healthcare from the 200,000 people in his state who have gained healthcare this year thanks to the Affordable Care Act's Medicaid expanion provision (the "private option" in AR) as well as 40,000 people who are paying for policies via the ACA exchange, but is going even further by pushing for half of the pre-Obamacare Medicaid/CHIP budget to be slashed.

This would effectively result in up to 20% of the state's entire population losing their healthcare coverage...every one of whom is either poor or barely middle-class at best.

Well, that number just went up a bit more:

First, I just want to take a minute to note that over the past year, I've discovered that while there's lots of good reporting on the ACA nationally, there are certain states which have one particular person who's the "go to" journalist for all things Obamacare-related.

In Connecticut, it's Arielle Levin Becker. In Vermont, Morgan True. In Kentucky, it's Joe Sonka. In Colorado, it's Louise Norris. In Oregon, it's Nick Budnick. And in Arkansas, it's David Ramsey:

Boy, this syndrome of Republicans seemingly forgetting that repealing Obamacare would mean that hundreds of thousands of the very people they're hoping will vote for them would have their shiny new healthcare coverage torn away from them seems to be spreading fast. I'm calling it "repealnesia".

First it was Joni Ernst, who wants to castrate 100,000 or more of her fellow Iowans by cutting their healthcare coverage out from under them with no plan on how (or whether) to replace it.

Then it was Kentucky's Mitch McConnell, who popped his head out to play an Obamacare-ACA-kynect shell game last night.

Now there seems to be a serious case of Cottonmouth down in Arkansas:

Well, well, well; imagine that...

While Obamacare attacks continue to fade, health reform’s success is even forcing some Republicans to acknowledge the law is having positive effects.

The latest example comes from Iowa’s third congressional district, where David Young (R) is facing former state Sen.Staci Appel (D) to replace retiring-Rep. Tom Latham (R-IA) in a toss-up seat.

...BORG: Did you favor the expansion of Medicaid, which was included in Obamacare?

YOUNG: It seems to be working in Iowa. I would make sure in any regards to Medicaid they would have some kind of flexibility.

...Still, Young was asked twice by Borg whether he would support repealing Obamacare, as has been the Republican mantra for the past four years. Both times, Young refused to say he wanted to do so.

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

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