END OF 2018 OPEN ENROLLMENT PERIOD (41 states)

Time: D H M S

Arkansas

Just two weeks ago, Sen. Mark Pryor (D-Ark.) surprised much of the political world with a powerful television ad. Though the conventional wisdom was that Pryor, facing a tough re-election fight, would avoid talking about the Affordable Care Act, but the senator neverthelessdid the opposite, boasting about the benefits he’s delivered for Arkansans through the ACA.
 
...Would Pryor back down? As it turns out, no. MaddowBlog received an exclusive first look at the Pryor campaign’s new campaign ad, which is the second spot in which the Arkansas senator boasts about ACA benefits.

BLAM! The infamous "$700B cut from Medicare!!" lie has been festering since well before the 2012 presidential election. The $700 billion in question refers to savings from cutting waste, fraud and abuse from the Medicare system (this is a good thing, folks).

Kudos to Sen. Pryor for debunking this garbage head on.

Greg Sargent has more:

A few days ago, David Ramsey of the Arkansas Times reported about a leaked document with the proposed & approved private QHP premium rate changes for 2015. At the time, he calculated the weighted average of the approved rates to be a drop of around 3.5% overall.

Today he reports that the official rate approvals have now come out, and while there was a slight error in the original numbers, the final weighted average is still excellent news: An overall weighted drop of 2%:

Insurance companies have proposed a net reduction in premiums of 2 percent next year for the Arkansas Health Insurance Marketplace, the health insurance exchange created by the Affordable Care Act. The Marketplace includes all of the plans used for the private option, the state's unique plan which uses Medicaid funds to purchase private health insurance for low-income Arkansans.

That "private Medicaid option" factor is important as well, because...

The Invisible Hand of the Free Market slaps "ACA = Socialism!" claims upside the head, Part 8

Carriers have submitted proposed 2015 rates for the Arkansas Health Insurance Marketplace — the health care exchange created via the Affordable Care Act — to AID for review. According to information previously available online via the Arkansas Insurance Department, the news is good: if the proposed rates are approved, they will lead to an overall decrease in insurance rates on the Marketplace. 

...Blue Cross Blue Shield, which currently has the largest market share on the marketplace, proposed a rate increase of zero...Celtic, selling in Arkansas as Ambetter, which currently has the second largest market share, proposed a rate decrease of 12 percent. Finally, QualChoice, which has the smallest market share, proposed a rate increase of 5 percent.

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:

When we last checked in on Arkansas, they had enrolled 185,000 people in their unusual "Private" Medicaid option program via the ACA. That number has since grown to over 192K:

According to the latest information released by the Department of Human Services today, 192,210 Arkansans have gained coverage via the private option, the state's unique version of Medicaid expansion which uses Medicaid funds to purchase private insurance for low-income Arkansans. This includes both beneficiaries enrolling in a private plan and those deemed medically needy and routed to the traditional Medicaid program (around 11 percent of the total). 

In this case it's important to note that these folks have actually gained coverage already. That is, this doesn't include people still "in process" etc. With appx. 225,000 Arkansans eligible for the program, that means AR has reached over 85% of the total possible.

OK, that may seem like an awkward way of shoehorning the Halbig decision into what's otherwise a simple state-level enrollment update entry, but the two are joined at the hip, since the state in question (Arkansas) happens to be one of those being run through Healthcare.gov:

A total of 185,000 persons have enrolled in expanded Medicaid and another 40,000 have bought insurance in the Obamacare exchange—together nearly half of all the previously uninsured citizens in Arkansas. When the new governor takes office, some 215,000 will be enrolled in expanded Medicaid alone. Will Hutchinson and, indeed, most Republican legislators want to end medical coverage for so many of their neighbors and constituents?

More positive Medicaid news out of Arkansas (the 75% figure refers to those fully enrolled, but it's actually a bit higher: 76.4%. If you go by "determinations" it's even better, over 83% of the total eligible):

DHS spokeswoman Amy Webb said the figures released cover the month of May.

“Over 187,000 have been determined eligible. Just over 172,000 of those have already completed the enrollment process and now have full access to their private health insurance coverage. Overall we estimate that about 225,000 Arkansans would be eligible for the program so we’re about 75 percent there,” said Webb.

(I should note that the KFF estimates Arkansas' Medicaid-expansion-eligible number at more like 281K, but those are rough numbers and this woman is from the actual state program speaking so I'll defer to her on it).

When I last checked in on the state of Arkansas' unusual "private Medicaid option" a month ago (which uses Medicaid money to pay for private exchange QHPs...basically a QHP with a 100% subsidy, but still counted as Medicaid instead), the tally stood at around 155,000.

Today, that number has risen another 15,000 people and now stands at over 170K, or over 75% of the 225,000 estimated Arkansas residents eligible for the program:

According to testimony today from the Arkansas Department of Human Services, 170,033 people through the end of April have been deemed eligible and gained coverage under the private option, the state's unique plan using Medicaid funds to purchase private health insurance for low-income Arkansans. This likely means that the policy has already made a significant reduction in the rate of uninsurance in the state. The private option has also made the Arkansas Health Insurance Marketplace as a whole dramatically younger, which could help lead to lower premiums in the future. Details below the jump. 

So, the absurd GOP House Energy & Commerce Committee Report which claimed that only 67% of exchange QHP enrollees are paid up has been thoroughly demolished by not just myself, but pretty much every other legitimate news media outlet there is (which leaves out FOX News, I'm afraid). In addition to only running through 4/15 (when 38% of the total QHP payments weren't even due yet), it only counted 160 of the 300+ insurance providers on the ACA exchanges, among many other ludicrous methodological flaws.

However, something did just occur to me. Take another look at their state-by-state breakout (which, again, only includes states on the Federal exchange...and even then, leaves out Idaho and New Mexico for reasons unknown), and there's several states which I find rather interesting:

This AR update is noteworthy for being the first enrollment update I've received which actually includes a reference to...myself!

Through yesterday, almost 45,000 Arkansans have selected plans on the Arkansas Health Insurance Marketplace, the new marketplace created by Obamacare, according to information released today by the Arkansas Insurance Department (see county  by county map above). Open enrollment is now closed, though people who submitted a paper application by April 7 have until the end of the month to enroll and pick a plan. We may also see this number creep up in the next few weeks as the carriers continue to receive data from the feds. 

LITTLE ROCK - Arkansas officials say nearly 70 percent of those eligible have signed up for health coverage under the state's compromise Medicaid expansion program.

The Department of Human Services said Monday that 155,567 people have applied and been determined eligible for the state's "private option" program, which uses federal Medicaid funds to purchase private health insurance for the poor. DHS estimates that 225,000 Arkansans qualify for the program that was approved last year as an alternative to the Medicaid expansion envisioned under the federal health care law.

Hmmm...my own calculations (based on KFF estimates) has Arkansas down as having around 281,000 people "eligible for Medicaid" who aren't currently insured, but that may just mean that the 56K difference are potential  "woodworkers". In any event, this is still huge news.

Through April 6, 41,402 Arkansans have purchased plans on the Arkansas Health Insurance Marketplace, the new marketplace created by Obamacare, according to information released yesterday by the Arkansas Insurance Department (see county  by county map above). As in the rest of the country, Arkansas saw a surge in enrollment recently, with more than 7,800 people signing up in the last two weeks. But while national enrollment in the marketplaces across the country hit initial projections, Arkansas will fall well short. 

...This does not include enrollment in the private option, the state's policy for Medicaid expansion which purchases plans on the Marketplace for folks that make less than 138 percent of the federal poverty level 

I posted an Arkansas update last night, but here's another...and the "private Medicaid option" numbers are either a little higher or a lot higher depending on the number you use; the wording from the AR DHS is confusing:

233,676 – Total number of private option applicants from state and federal levels.

Of those, 149,666 have been determined eligible for the private option so far and will begin receiving coverage.

Of those determined eligible for the private option, 106,324 have completed the enrollment process (as of 3/21/14). An additional 14,969 have been determined to be better served by traditional Medicaid for a total of 121,293 people who have fully completed the enrollment process. 

It sounds like there's 28,373 who are still in the middle of paperwork or something, but the DHS is quite clear that one way or another all 150K will be enrolled in either the "private option" or "standard Medicaid", so I'm going with the higher number until they clarify otherwise. I normally err on the side of caution, but in this case the "will begin receiving coverage" is part of an official DHS press release.

One more update tonight, out of Arkansas...nothing shocking either way, about a 21% increase over the February daily average; takes the projection down a smidge but nothing significant:

LITTLE ROCK, Ark. (AP) - Arkansas officials say more than 33,500 people have signed up for the health insurance exchange set up under the federal health law, well below the numbers they hoped to see before the enrollment deadline next week.

State officials on Thursday said the signup for the exchange, a marketplace where consumers can select health plans, has lagged in comparison to enrollments in the state's "private option" compromise Medicaid expansion. More than 106,000 people have signed up for the private option, the state's program using federal Medicaid funds to purchase private insurance for the poor.

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