END OF 2018 OPEN ENROLLMENT PERIOD (Connecticut & Maryland)

Time: D H M S

Michigan

This is the first post I've written since Friday, partly because I had my kid's Lego® Robotics League event all day Saturday, partly because I came down with a 24-hour (I hope) flu yesterday.

Anyway, some not-so-cheery news to report today:

MICHIGAN WAIVER PUTS CMS IN TOUGH SPOT — The federal waiver Michigan needs to extend its Medicaid expansion has put CMS in a bind — either approve controversial conditions or let the program end next spring. Pro’s Rachana Pradhan writes, “The 2013 Michigan law expanding Medicaid included a provision requiring CMS to approve a waiver with drastically conservative changes by the end of this year. The waiver would require Medicaid enrollees earning above the poverty line to make a choice after four years of Medicaid coverage: Either enroll in a private subsidized plan on HealthCare.gov, or stay in Medicaid and pay up to 7 percent of household income toward health care costs — notably higher than the 5 percent ceiling CMS has held other states to.” If the waiver isn't approved, Medicaid expansion coverage is scheduled to end in April.

Since today's just filled with wonderful news for 418,000 Kentucky residents who are very likely to lose Medicaid coverage, I figured I might as well toss this on the fire as well:

It appears that East Lansing-based Consumers Mutual Insurance of Michigan could wind down operations this year as it is not participating in the state health insurance exchange for 2016.

But officials of Consumers Mutual today are discussing several options that could determine its future status with the state Department of Insurance and Financial Services, said David Eich, marketing and public relations officer with Consumers Mutual.

Consumers Mutual CEO Dennis Litos said: "We are reviewing our situation (financial condition) with DIFS and should conclude on a future direction this week.”

Well I'll be damned. Given all the tea leaf/entrail-reading that I've had to do in some states to try and piece together the weighted average rate increases for 2016 (usually due to missing enrollment/market share data for the companies participating), it's a pleasant surprise to see that my own state of Michigan has posted the approved rate hikes without any gobbledygook:

Individual market to increase on average 6.5%, small group 1.0%

FOR IMMEDIATE RELEASE - August 18, 2015

LANSING - Michigan consumers and small businesses will experience lower increases in the cost of their 2016 health insurance plan than those in many other states, according to the Michigan Department of Insurance and Financial Services (DIFS). DIFS reports that the average approved rate changes on a premium weighted basis increased by 6.5 percent for the individual market and 1 percent for the small group market.

Nice job by Amy Lynn Smith over at Eclectablog today:

Once again, the Affordable Care Act (ACA) is proving its critics wrong. Opponents of the ACA, or Obamacare, have been falling all over themselves proclaiming that an influx of new patients will overburden the healthcare system, creating a dire doctor shortage.

At least in Michigan, that’s proven to be absolutely false.

A new University of Michigan study shows that the availability of primary care appointments actually improved for people with Medicaid in the first months after the state launched the Healthy Michigan Plan, the state’s Medicaid expansion under the ACA. What’s more, it remained mostly unchanged for those with private insurance.

This AP article provides snippets about a handful of states; it'd be nice if they just released the actual report so we could see the hard expansion numbers (as opposed to the total increase numbers, which are still obviously useful but don't distinguish between traditional Medicaid and ACA expansion enrollees):

In Kentucky, for example, enrollments during the 2014 fiscal year were more than double the number projected, with almost 311,000 newly eligible residents signing up. That's greater than what was initially predicted through 2021. 

...At least 14 states have seen new enrollments exceed their original projections, causing at least seven to increase their cost estimates for 2017, according to an Associated Press analysis of state budget projections, Medicaid enrollments and cost details in the expansion states. A few states said they could not provide original projections.

As I noted at the end of April, after climbing at a furious pace every week for months on end, Michigan's implementation of the Affordable Care Act's Medicaid expansion provision (aka "Healthy Michigan") plateaued at around 600,000 enrollees back in February, and then bobbled around the 600K level for several weeks straight. As I noted at the time, I'm still checking this figure weekly, but it has never deviated far from that number--sometimes a bit higher, sometimes lower.

As of June 30th, it stood at 606,779. 600K seems to be the level that ACA Medicaid expansion can be expected to stay at for the forseeable future.

So, with all the fuss & bother over the imminent King v. Burwell decision, what's the deal here in the Wolverine state?

Well, first of all, here's what's at risk if the Supreme Court rules for the plaintiffs, Congress fails to pass a simple tweaking of the law to resolve the issue and the state administration fails to "establish" an exchange which passes muster with regard to the minimum legal definition required:

Right off the bat, I want to clarify that I might have misread some of the numbers here; while some states provide the per-company average rate change requests in a nice, simple table format, I had to wade through a mountain of forms at the SERFF Filing Access Database to hunt all of these down, and there seems to be little consistency from company to company about the formatting of the documentation, etc etc. It's possible that I've confused a Small Group filing for an Individual one, for instance, and I may have misunderstood the current enrollment number for one or two companies. Finally, in one case (Physicians Health Plan), their 2016 rate request seems to have been redacted for some reason. Fortunately, they only appear to have around 600 enrollees anyway, which means any change in their rates would barely move the state-wide needle at all anyway.

With those caveats out of the way, assuming I have these numbers straight, here's what it looks like...and remember, these are requested changes only; they still have to be approved:

...it could actually be several hundred dollars lower.

A week ago I posted a story in which I busted Michigan State Senator Patrick Colbeck for blatantly spewing nonsense numbers about the ACA in an Op-Ed in the Detroit News.

Yesterday, my follow-up story, about the Detroit News allowing Colbeck to go back in and correct some (but not all) of his insanely false factual garbage a solid 10 days later (while failing to give any indication about just how absurdly wrong he had been in the first place) went viral, generating more visitors than any other story I've posted in months.

After an all-day saga, the end result was that the Detroit News finally posted a "correction" notice...except they did so in such a disingenous way (and so long after the original editorial was publshed) as to be nearly meaningless.

After months of never-ending growth, "Healthy Michigan", aka MI's implementation of the Affordable Care Act's Medicaid expansion provision, has officially stabilized at around 600,000 enrollees:

The reason it's bobbling around the 600K mark, of course, is because of normal "churn" as people move onto/off of the program as they gain/lose jobs, move into/out of the state, give birth/lose family members and so forth.

A few weeks ago, the Detroit News posted a story gushing praise all over Michigan's implementation of the Affordable Care Act's Medicaid expansion provision, known locally as "Healthy Michigan", and somehow managed to not mention the ACA once until the 9th paragraph...and even then, failed to explain the connection between the two (as in, HM only exists because of ACA).

A couple of days ago, the editiorial board of the News posted an editorial which correctly calls for the renewal of Healthy Michigan, which requires a federal waiver once a year (I think) in order to continue because it includes modifications from simply increasing the eligibility threshold to 138% of the Federal Poverty Level.

For months now, Michigan's implementation of the Affordable Care Act's Medicaid expansion provision has defied expectations, enrolling far more than the 477K - 500K expected. A couple of weeks ago it managed to break the 600,000 mark, peaking at 603,681 people, and I've been wondering for quite awhile when the growth might finally stop.

The answer appears to be, "the first week of April":

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 573,115
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of April 6, 2015 
*Updated every Monday at 3 p.m.

Hey, journalism and political spinmeisters! Here's a great example of what not to do (if you're the former) and what to do (if you're the latter)!

Check out this story from the Detroit News about the success of Michigan's implementation of the Medicaid expansion provision of the Affordable Care Act, aka "Healthy Michigan":

Detroit — On the eve of the first anniversary of the Healthy Michigan Plan, Gov. Rick Snyder said Tuesday more than 603,000 Michiganians have enrolled since the expanded Medicaid Program launched on April 1, 2014.

Mazel Tov!! Over 600,000 Michiganders enrolled in a program enabled by and paid for by Obamacare! I'm sure they'll mention that in the 2nd paragraph, right?

The number exceeds by more than 100,000 people the two-year enrollment projections made prior to the program’s launch. The Healthy Michigan Plan provides health insurance to low-income working people for a minimal cost.

OK...maybe not. Perhaps the third paragraph?

And there we have it: The "Healthy Michigan" program, the Wolverine State's implementation of ACA Medicaid expansion, has broken the 600,000 enrollee mark:

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 603,681
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of March 30, 2015 
*Updated every Monday at 3 p.m.

Michigan continues to astound. Remember, the official estimates of how many Michiganders are eligible for ACA Medicaid expansion ranged from 477K - 500K.

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 596,246
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of March 23, 2015 
*Updated every Monday at 3 p.m.

That's as much as 25% higher than the number supposedly eligible for the program.

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