A week or so ago, I noted that Republicans in my home state of Michigan have come up with a clever way of having their (chocolate) cake and eating the (vanilla) cake too. As first noted by Nancy Kaffer of the Detroit Free Press:
Although HB 897 threatens to end Medicaid benefits for hundreds of thousands living elsewhere in the state, it includes exemptions for people who live in counties with an unemployment rate of more than 8.5%, like the ones Schmidt represents.
Live in Detroit? You're out of luck.
The city's unemployment rate is higher than 8.5%, but the unemployment rate in surrounding Wayne County is just 5.5% — meaning Detroiters living in poverty, with a dysfunctional transit system that makes it harder to reach good-paying jobs, won't qualify for that exemption. The same is true in Flint and the state's other struggling cities.
As of today, there are 12 states which operate their own full ACA exchanges, including their own board of directors, marketing budget, bylaws and tech platform for their enrollment website. 34 states have offloaded just about all of that to the federal exchange, HealthCare.Gov. And then there are five states which are in between: They have their own state-based exchange...but their tech platform is basically piggybacked onto the federal exchange: Arkansas, Kentucky, Nevada, New Mexico and Oregon.
Arkansas and New Mexico always planned on moving off of HC.gov onto their own full exchange platform but never got around to doing so. Kentucky's ("kynect") was working perfectly well from day one, and only made the move to the federal platform after three years because new GOP Governor Matt Bevin decided he didn't like it for whatever reason. New Mexico and Oregon, meanwhile, had such major technical problems at launch that they scrapped their sites after the first year and moved to the Mothership. (As an aside, Hawaii also scrapped their exchange site after the second or third year, but they shut down their entire state-based exchange and moved everything to HC.gov).
Northam signs healthcare bill to provide relief to Virginia entrepreneurs
Published Wednesday, Apr. 11, 2018, 12:42 pm
Gov. Ralph Northam signed a new healthcare bill into law that will provide relief to many small business owners currently struggling with the Central Virginia insurance premium crisis.
Members of local advocacy group Charlottesville For Reasonable Health Insurance had provided testimony at the Virginia General Assembly and organized an email campaign, helping to ensure passage of the bill through the legislative session. Introduced by Sen. Creigh Deeds and effective July 1 2018, SB672 will allow self-employed people to take advantage of the much more affordable health plans in the small group business marketplace, without having to hire employees.
The Basic Health Program is one of the more obscure provisions of the Affordable Care Act. Very few people outside of the healthcare wonk community know anything about it...unless they live in Minnesota or New York State.
The short version is that it's an optional low-income healthcare program designed for people at the income tier just above Medicaid expansion...138% - 200% of the Federal Poverty Line, or between around $16,600 - $24,100/year for a single adult. In most states people in that income range would be expected to enroll in heavily-subsidized ACA exchange policies. In New York and Minnesota, however, they've instead set up Basic Health Programs (BHPs) for this population instead.
*(No, they aren't paying me anything, and I have no idea whether they're a good or bad company to do business with. I do know they do a reasonable amount of business and they cover most of the country, so their findings are likely reasonably representative).
The lede pretty much says it all:
A new survey by eHealth, Inc. finds that individual and family health insurance consumers are cost-stressed, confused about the state of the Affordable Care Act (ACA) and worried about the future of their benefits. They believe that all health plans should provide rich benefits, but they’re unwilling to shoulder the costs often associated with those benefits. They’re bringing their frustrations over the state of health care to the ballot box in 2018.
Louise Norris is an awesome source for all sorts of healthcare policy/insurance data, but she's especially on top of developments in her home state of Colorado, where she and her husband Jay run a small brokerage outlet.
Today Jay and Louise have a couple of interesting tidbits out of The Centennial State (yeah, I had to look up their nickname myself).
That's (sort of) an 88% retention rate through early May. I say "sort of" because this presumably includes some amount of churn (if 100 people drop coverage and 100 off-season enrollees sign up, that'd be a net change of zero). Even so, it's actually slightly better compared to prior years, when the national effectuation number had usually dropped to around 87% by the end of March.
In Part 2, I go into more detail about the different types of NON-ACA plans available on the individual market, why they mostly stink, and how the repeal of the Individual Mandate Penalty, especially when combined with Trump's yanking away restrictions on "short-term" and "association" plans, will take an existing problem and make it far worse.
Oh, yeah: It involves Dabney Coleman and Morgan Freeman.
Senate uses salary threat to push Medicaid work plan
Lansing — Michigan’s Republican-led Senate is pressuring Gov. Rick Snyder to back sweeping changes to the state’s Medicaid health insurance system, including proposed work requirements and a tougher 48-month benefit limit for the Healthy Michigan plan.
I've trashed CMS Administrator Seema Verma many times for her callous and backward-logic driven push to impose pointless, counterproductive work requirements on ACA Medicaid expansion enrollees. However, it appears that even she has her limits when it comes to treating people terribly:
The Trump administration has drawn a red line on Medicaid cuts. There are some proposals that the Centers for Medicare and Medicaid Services won’t approve.
In a letter on Monday, CMS Administrator Seema Verma told Kansas officials that her agency would not approve the state’s request to impose lifetime limits, which would have capped a person’s eligibility at three years, after which they could no longer be covered by the program.
Verma noted that the administration had approved proposals by other states to cut off benefits for Medicaid enrollees only if they fail to meet certain work requirements.
President Trump is sending a plan to Congress that calls for stripping more than $15 billion in previously approved spending, with the hope that it will temper conservative angst over ballooning budget deficits.
Almost half of the proposed cuts would come from two accounts within the Children’s Health Insurance Program (CHIP) that White House officials said expired last year or are not expected to be drawn upon. An additional $800 million in cuts would come from money created by the Affordable Care Act in 2010 to test innovative payment and service delivery models.
Those are just a handful of the more than 30 programs the White House is proposing to Congress for “rescission,” a process of culling back money that was previously authorized. Once the White House sends the request to Congress, lawmakers have 45 days to vote on the plan or a scaled-back version of it through a simple majority vote.
