Wednesday Short Cuts, Part 2

  • The California Assembly has approved a bill to designate pregnancy as a qualifying life event to allow women to purchase health plans through Covered California outside of the regular open enrollment period. The bill is now set for review by the state Senate.
  • In New York, three separate bills have been drafted with the same goal, in a bid to increase the odds that a version will be passed.
  • Moves like the one in California could influence federal policy on the issue, suggests Christina Postolowski, health policy manager at Young Invincibles. 

The SCOTUS decision in King v. Burwell is expected the last week in June. Although it is possible the decision could be effective immediately, it is widely presumed that a decision in favor of the Petitioners will include a delayed effective date. In the meantime, the Republican Party needs a plan. Eight million people cannot lose their health insurance, including mothers mid-pregnancy and cancer patients mid-treatments.

Wherever one stands on health policy and federal spending, basic humanity requires a glide path to whatever comes next. On the Affordable Care Act, the Republican Party may be winning the minds of the American voter, but on this issue, it better find a heart if it hopes to regain the White House next year.

But some health policy leaders in Maine don't think Collins' proposal makes much sense. "When I read the act, it really reminds me of the movie Back to the Future," says Dr. Wendy Wolf.

Wolf is president and CEO of the Maine Health Access Foundation. She says while the Patient Freedom Act retains some of the more popular reforms under the federal health law, like protecting those with pre-existing conditions and allowing children to stay on their parents' insurance plans until age 26 - it eliminates the requirement that all health plans provide certain essential health benefits. These include things like prescription drugs, maternity care, and chronic disease management.

"If you eliminate that, it means we are then in a race to whittle benefits to eventually just have bare bones policies," Wolf says, "and we know in Maine that's what the majority of individual policy holders had prior to the Affordable Care Act, which was an average of about a $15,000 deductible plan."

Red-state Kentucky’s broad embrace of Obamacare has been a comforting success story for the White House. But now the Affordable Care Act is the central issue in the state’s off-year governor’s race, and a Republican victory could be a portent for 2016, when GOP presidential contenders will run on a renewed vow to repeal the act.

Silver State Health Insurance Exchange Communications Officer Janel Davis says Nevada's transition has brought some improvements.

"Enrollment is through the federal platform and it minimizes potential issues with our prior system which was failing to capture and share data,” she told PBN. "It gives you the ability to window shop for plans without creating an account, and the enrollment process is much much easier.”

If the U.S. Supreme Court rules for the plaintiff later this month in the case of King v. Burwell, 7.5 million Americans stand to lose their Obamacare tax credits. Such a ruling would make it illegal to sell subsidized Patient Protection and Affordable Care Act (ACA) coverage on the federal insurance exchange website that runs on an Amazon EC2 cluster. But it will still be legal (read: ACA-compliant) to sell subsidized Obamacare insurance on a state run exchange using the same SaaS exchange application on a separate EC2 cluster.

It would be tragic at this point to reverse course and put millions of Americans at risk of disease and death from inadequate heath care or potential bankruptcy from inability to pay staggeringly high medical bills while disrupting insurance markets that depend on large enrollments to stabilize prices.