Sunday Night Short Cuts (Retro Edition)

And yet another batch of ACA/healthcare stories...some over a month old...which fell through the cracks:

As we’ve said many times before, it really pays for returning customers to the Obamacare insurance marketplaces to shop around for a 2015 health plan. Recent data from the federal government shows that a surprising number of people are doing just that.

More than 30 percent of federal marketplace customers who re-enrolled for 2015 did so by actively returning to and picking a plan, according to Health and Human Services Secretary Sylvia Mathews Burwell. That’s still less than half of all customers, but it far exceeds what you might expect based on consumer behavior in other public health insurancemarketplaces.

Health care reform advocates who struggled for decades to pass Obamacare left the job half-undone.

They failed to sell it. They also underestimated the unrelenting intensity and duration of the opposition that makes the law so vulnerable to legislative and legal challenges even now, nearly five years after its passage.

The White House and its allies are trying fresh messaging strategies for 2015 enrollment, including a lower-key sales pitch and narratives from real people who are happy with their coverage. Those success stories didn’t exist before coverage began one year ago.

Yet the messaging missteps and rhetorical guerrilla war since 2010 have taken their toll. Obamacare is now working better — but it’s still not popular. Come January, it will be under renewed attack by the incoming Republican majority in Congress, a majority attained partly by the GOP’s persistent opposition to the health care law.

The Arizona Supreme Court ruled Wednesday that a lawsuit challenging the legality of the state’s Medicaid expansion could proceed, dealing a setback to one of Gov. Jan Brewer’s signature initiatives less than a week before she leaves office.

Ms. Brewer was one of a few Republican governors who sought to expand Medicaidbenefits at the state level, a crucial provision of President Obama’s federal health care law.

North Carolina Gov. Pat McCrory says he will talk to President Barack Obama about shaping a state-specific health care plan, an indication the Republican leader is testing the conditions under which the state might expand Medicaid coverage for the poor.

McCrory said he'll meet with Obama and the state's two Republican U.S. senators on Tuesday in an effort "to be allowed to devise a North Carolina solution to health care for families," the GOP governor told about 800 business leaders Monday at a gathering organized by the state's bankers association and chamber of commerce.

More than half of the 2014-2015 enrollment period for the Affordable Care Act, best known as Obamacare, is in the books, and the enrollment figures on the surface look very encouraging.

To be clear, Obamacare is about more than just enrollment figures. For one thing, in order for the health reform law to be successful, it'll need people that enroll to actually continue paying their premium. This is the only way that medical care costs get spread out over a greater swath of the public, which is needed to control medical care cost inflation. However, between April and mid-October, for instance, around 1 million people stopped paying for their health insurance. The program will need to minimize this attrition in 2015 and beyond in order to be successful.

(I should note that while this is an excellent overview overall, the data point above--"1M stopped paying"--is incorrect. By my best calculations, around 900K of the original 8.02 million enrollees never paid at all, due to either changing their minds, being double-counted or glitch-accounts, clerical errors and the like. The actual number who stopped paying by the end of the year appears to be around 360K).

After President Obama’s Affordable Care Act was enacted in 2010, Republicans at both the state and federal levels seemed to speak with one voice in flatly rejecting it.

But in subsequent years, though most Republican governors remained critical of the health care law, nine accepted a central but optional element, expanding Medicaid programs to cover many more low-income residents of their states. At least four others, urged on by hospitals and business groups, will try to do so this year.

A prominent opponent of the Affordable Care Act says that unlike many other states, Oregon can easily sidestep a Supreme Court challenge he helped engineer.

Michael Cannon, director of health policy studies for the libertarian-leaning Cato Institute, has for years been laying the groundwork for a legal challenge that the U.S. Supreme Court will hear in March.

Like many working Americans, Lisa Gray thought she had good health insurance.

That was until she was diagnosed with leukemia in mid-2013, and the self-employed businesswoman made a startling discovery: Her health plan didn't cover the chemotherapy she needed. "I thought I was going to die," Gray, 62, said recently, recalling her desperate scramble to get lifesaving drugs.

Through a mix of temporary measures, doctors and patient advocates managed to keep Gray stable for a few months.

But it was a new health plan through the Affordable Care Act that Gray credits with saving her life. The plan, which started Jan. 1, 2014, gave her access to the recommended chemotherapy. Her cancer went into remission in the fall.