Purging the In Box 4: ACA stories I don't have time to do full write-ups on

Those who signed up for insurance during the first year of health care reform may think they can avoid open enrollment this fall, but that may not be the best choice because of a tax credit formula in the federal law.

Since federal subsidies are based on a formula that reflects the cost of certain insurance plans, and those costs have actually gone down for 2015, some people will see the amount the federal government contributes toward their insurance go down as well.

More than 350,000 more Oregonians received subsidized or government-paid health coverage last year than the year before, due to expanded income standards for the Oregon Health Plan as well as new tax credits to reduce private health plan premiums.

But receiving those funds is risky business, despite new government health insurance exchanges that were supposed to make enrolling online easy. Many of those people using government help ended up with the kind of insurance they didn't want, or faced other problems. Some will even owe money at tax time.

For the second year of the Health Insurance Marketplaces, five states made changes to their Marketplace website:




  • Individuals, families, and small businesses will now apply for 2015 coverage at www.healthcare.gov.

New Mexico:


Gov. Peter Shumlin is “hopeful” that Vermont’s health care exchange website will be online in time for the open enrollment period that begins Nov. 15. But he didn’t sound certain Friday that his team will make the deadline.

“I’ve been discouraged so many times by this website that I’ll believe it when I see it,” Shumlin said on Vermont Edition Friday. “What I’ve been told by my folks who are working really hard on this is that we’ll be ready for open enrollment on Nov. 15.”

As my colleague Margot Sanger-Katz notes, a Supreme Court ruling against the Obama administration in King v. Burwell would cause significant disarray in health insurance markets, by denying subsidies to anyone buying health insurance on the individual market in states that rely on the federal health insurance exchange.

Just because some insurance markets would become a mess does not mean Republicans and Democrats would come back to the table to fix them.

“Even if the website’s not perfect on Nov. 15, [the government] will be ready to start making fixes in real time,” Corlette said.

Insurers in Florida agree, including the state’s largest, Florida Blue. “We anticipate a smoother enrollment process in year two of the marketplace,” according to an email from Jon Urbanek, senior vice president of health insurance markets at Florida Blue.

Enrollment is particularly important in Florida, which has the nation’s third-highest rate of uninsured people under 65, and in Miami-Dade County, where 33 percent of residents were uninsured in 2012, the most recent year for which data were available.

The Supreme Court announced that it would take up a challenge to Obamacare that, if successful, could essentially dismantle the law in 36 states. Ezra Klein explains how King v. Burwell could strip millions of health insurance.

Hagler told his 12 staffers he would give them money starting in May to buy their own insurance, coverage likely to be better than what he could offer. He joined a growing number of small-business owners who are forgoing coverage and paying staffers more to compensate for the lost benefits. Health insurer Wellpoint said last month its roster of small businesses has shrunk by 12 percent so far this year. Nearly 3 percent of 1,600 small businesses surveyed by the Society for Human Resource Management plan to give employees subsidies next year so they can buy their own coverage on private insurance exchanges.

But here's the rub: Obamacare didn't create high-deductible plans. Instead, it's helping shine a spotlight on a trend that long predated it - a push to give consumers "more skin in the game" to slow the overall rise of health-care costs. It's even helping to curb that trend.

It’s time for Democrats to come down out of the hills on health care reform and take on the Republican attacks of the Affordable Care Act. Nearly 90 percent of the 45,000 ads that mentioned the Affordable Care Act during this election cycle were attacks; the minuscule number that weren’t cannot be characterized as a defense of the A.C.A. But why do Democrats seem content to take this abuse of health care reform on the chin?

U.S. insurers planning to sell 2015 Obamacare health plans expect at least 20 percent growth in customers and in some states anticipate more than doubling sign-ups.

In interviews with Reuters, half a dozen privately held and non-profit health insurers around the country say they are expecting this growth based on interest from potential customers they are hearing about through their call centers, sales forces and brokers.