What’s next: Alexander and Collins are hoping to get this proposal included in the omnibus spending bill Congress needs to pass this week. We should find out soon whether it's in or out.
I just did a light analysis of how many people would be helped or hurt by CSR funding in 2019 in Rhode Island, and concluded that at least 28% of exchange enrollees would see their premiums increase if CSR funding was restored, while only perhaps 2-3% would see their premiums drop.
So there you have the enrollment results of full-bore on-exchange silver-loading of CSR costs in one state. In all, 49,993 on-exchange enrollees with incomes up to 400% FPL chose plans other than silver. About 48,000 of them were subsidized. That's 31.2% of all enrollees, within striking distance of Aron-Dine's upper bound of 36% for all marketplace enrollees.
HealthSource RI, Rhode Island's ACA exchange, released preliminary 2018 Open Enrollment data awhile ago, but this morning they released their final, official demographic data breakout, and there's a lot going on here:
HealthSource RI sees 5% enrollment increase and nation leading lowest benchmark plan cost
State-based marketplace sees rise in enrollment of “young invincibles”
Under the Guise of “Health Insurance Stabilization,” Congress Should Not Axe Financial Help for Low-Wage Families
In negotiations over stabilizing the individual health insurance market, lawmakers are considering slashing federal health care assistance for low- and moderate-income consumers by more than $27 billion a year. In dollars terms, this would be a greater blow than completely eliminating, in one stroke, the Low-Income Home Energy Assistance Program, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the Child Care and Development Block Grant, the Community Development Block Grant, and federal grant programs for community-based mental health services and substance abuse prevention and treatment.
Health insurers and the Trump administration face a court decision shortly that will determine whether the government must pay insurers billions of dollars despite Republican efforts to block payments they view as an industry bailout.
Insurers have filed roughly two-dozen lawsuits claiming the federal government reneged on promises it made to pay them under the Affordable Care Act.
...It could also shape the outcome of other insurer lawsuits that would leave the government potentially owing as much as roughly $20 billion in past and future payments. Those cases, legal experts say, amount to the largest civil lawsuits ever.
Between the lines: This doesn't solve the partisan dispute over abortion language, as it'd bar plans that offer abortion coverage from receiving federal subsidies. But it hints that there's Republican support behind a set of policy changes that could substantially lower premiums ahead of the 2018 elections.
I wrote an extensive piece about the way abortion coverage is currently handled for ACA exchange policies back in October 2017:
Yesterday I came out against the pending ACA stability package because one of the 5 proposed provisions should be a flat-out dealbreaker for Democrats (the abortion ban), while another one is would hurt more people than it helps (CSR funding).
Today, I need to explain the problem with CSR funding in a bit more detail but to also note a new twist which makes it even more complicated...as well as taking note of a sixth provision being thrown into the mix by the GOP which, again, should be a dealbreaker for Democrats.
First up: CSR funding.
I'm on the record as being strongly in favor of a bill recently proposed by House Democrats Frank Pallone, Jr., Richard Neal and Bobby Scott which would repair, strengthen and expand the ACA in a half-dozen ways while also preventing or reversing another half-dozen types of sabotage of the ACA by the Trump Administration. Here's the full list of what would be included in what I've shorthanded "ACA 2.0":
As long as I'm snarking on Washington's exchange for getting so excited over what appear to be pretty minor tweaks (to the average Joe, anyway), I might as well also give a shout-out to Connect for Health Colorado as well, which just posted this tidbit:
To Our Valued Stakeholders,
We took an important step forward this week with our board’s decision to move ahead on building a new eligibility system. With our own system, we will be able to provide customers a better application and enrollment experience and at the same gain more control and predictability for IT expenses.
A simplified path for enrolling with financial help can be expected to help us grow enrollment while getting more Coloradans the Advance Premium Tax Credit and Cost Share Reduction benefits that they are eligible to receive. We will continue to support Health First Colorado (Medicaid) enrollments and ensure that customers are routed to the right program, whether they begin at our site or with the PEAK application.
Sens. Lamar Alexander and Susan Collins have proposed a market stabilization package that would include funding for the Affordable Care Act's cost-sharing reduction subsidies for three years, three years of federal reinsurance at $10 billion a year, additional ACA waiver flexibility for states, and expanded eligibility for "copper" plans.
Alexander presented the plan yesterday to America's Health Insurance Plan's board of directors, adding that if Democratic leadership supports the bill, “it’ll be law by the end of next week." Alexander has long said the package should be included on the omnibus spending bill.
Exit Poll of PA-18 Shows Lamb Won Big On Health Care
Date: March 14, 2018
Public Policy Polling conducted a telephone exit poll election survey of voters who cast ballots in Pennsylvania’s 18th Congressional District special election yesterday. Voters who voted in the contest were asked about the role of health care in their decision.
The exit poll shows that health care was a top priority issue to voters in this district and that voters believed Democrat Conor Lamb’s views were more in step with theirs.
In 2016, voters in this district backed Donald Trump by 20 points, but last night they backed a Democrat for Congress in a referendum on the health care plans of the Republican Congress:
