Charles Gaba's blog

I don't write much about Rhode Island outside of the actual Open Enrollment Period each year, and I almost never write about the ACA's "SHOP" (Small Business Health Options Program...which should really be labelled SB-HOP) these days (the program has never enrolled more than perhaps 200,000 people nationally at most)...but both the state and the program could use a little love, so what the heck:

HealthSource RI for Employers enrolls its 700th small business

RUMFORD, RI (March 6, 2018) – HealthSource RI for Employers today announced it has hit a major milestone. The health insurance marketplace for small employers has now enrolled its 700th small business. These 700 local businesses reflect over 5,200 Rhode Islanders.

SOME GUY, OCTOBER 2017:

With the 2018 Open Enrollment Period coming up just 5 days from now, it's time to put this to bed: After 6 months of painstaking research and analysis, I've compiled a comprehensive analysis of the weighted average rate changes for unsubsidized ACA-compliant individual market policies in 2018, including both the on- and off-exchange markets. It's already been confirmed by a different analysis by healthcare consulting firm Avalere Health, which used a completely different methodology to arrive at the exact same conclusion: The national average increase is between 29-30%, ranging from as low as a 22% average premium drop in Alaska (thanks to their successful reinsurance program) to as high as a painful 58% increase in Virginia.

Interesting timing of this, coming right on top of the other ACA stabilization/improvement bill introduced by the House Democrats today:

From Sen. Baldwin's official Senate website:

U.S. SENATOR TAMMY BALDWIN AIMS TO BLOCK PRESIDENT TRUMP’S PLAN TO ALLOW INSURERS TO SELL JUNK PLANS WITH LEGISLATION TO GUARANTEE PROTECTIONS FOR PRE-EXISTING CONDITIONS

“The Fair Care Act is an opportunity for lawmakers to keep their word on guaranteed protections for pre-existing conditions.”

WASHINGTON, D.C. – Following the Trump Administration’s recent proposed rule allowing insurance companies to once again sell ‘junk’ health care plans, U.S. Senator Tammy Baldwin today announced new legislation to block the rule and guarantee protections for people with pre-existing conditions.

UPDATE: Late last night I was able to dig up the actual legislative text of the bill introduced by the House Democrats yesterday; after reading over the details, I've decided that it's a strong enough package overall that, in software terms, it would be considered a full version upgrade (2.0) as opposed to "only" a service pack/point upgrade (1.5). I've therefore changed the headline to reflect this.

I've also updated some sections fo the analysis below to include the details from the text itself.

A little under a year ago, I posted a lengthy list of 20 recommendations for repairing, improving and strengthening the Affordable Care Act, entitled "If I Ran the Zoo". Here's a summary list of all 20:

“But the plans were on display…”
“On display? I eventually had to go down to the cellar to find them.”
“That’s the display department.”
“With a flashlight.”
“Ah, well, the lights had probably gone.”
“So had the stairs.”
“But look, you found the notice, didn’t you?”
“Yes,” said Arthur, “yes I did. It was on display in the bottom of a locked filing cabinet stuck in a disused lavatory with a sign on the door saying ‘Beware of the Leopard.”

--Douglas Adams, The Hitchhiker's Guide to the Galaxy

Over a year and a half ago, I noticed that aside from the usual names being listed as insurance carriers offering individual market policies in various states (Humana, Molina, Blue Cross Blue Shield, etc), there was one other name which kept popping up over and over again: "Freedom Life":

Over the past few weeks,I've posted partial 2018 Open Enrollment Period demographic data from Connecticut, Idaho, Maryland, New York and Washington State. Still missing are final wrap-up reports from the other 7 state-based exchanges...as well as The Big One: The official report from the Assistant Secretary for Planning and Evaluation (ASPE).

The 2014 ASPE report was released on May 1st, 2014...just 17 days after the first, tumultuous 2014 Open Enrollment Period ended (only 12 days, really, since the report actually ran through April 19th, 2014 even though the "overtime" period technically ended on April 15th).

Two weeks ago the United States House of Representatives voted to pass HR 620, officially titled the "ADA Education and Reform Act", with 225 members of Congress voting Yea and 192 voting Nay.

While the vote was mostly along party lines, I was saddened to see that a dozen Democrats joined 213 Republicans to vote for it...putting it over the top.

What would H.R. 620 actually do? I don't know a whole lot about disability advocacy, I admit, but according to the American Civil Liberties Union:

The so-called “ADA Education and Reform Act”weakens the Americans with Disabilities Act and undermines one of the key goals of the law.

via Raw Story:

Sen. Orrin Hatch (R-UT) on Thursday called supporters of the Affordable Care Actsome “of the stupidest, dumbass people I’ve ever met” during a speech before the American Enterprise Institute.

We […] finally did away with the individual mandate tax that was established under that wonderful bill called ‘Obamacare,’” Hatch said, according to Fox News 13. “Now, if you didn’t catch on, I was being very sarcastic.”

“[The Affordable Care Act] was the stupidest, dumbass bill that I’ve ever seen. Now, some of you may have loved it. If you do, you are one of the stupidest, dumbass people I’ve ever met. This was one—and there are a lot of ’em up on Capitol Hill from [that] time,” Hatch added.

Matt Whitlock, a spokesman for Hatch, defended the senators comments, telling Fox News 13, “The comments were obviously made in jest, but what’s not a joke is the harm Obamacare has caused for countless Utahns.”

Today must be Healthcare Survey day. First it was the Kaiser Family Foundation's monthly tracking poll; now comes the Commonwealth Fund, which has released their own survey results regarding the Affordable Care Act and healthcare coverage in general:

To gauge the perspectives of Americans on the marketplaces, Medicaid, and other health insurance issues, the Commonwealth Fund Affordable Care Act Tracking Survey interviewed a random, nationally representative sample of 2,410 adults ages 19 to 64 between November 2 and December 27, 2017, including 541 people who have marketplace or Medicaid coverage. The findings are compared to prior ACA tracking surveys, the most recent of which was fielded between March and June 2017. The survey research firm SSRS conducted the survey, which has an overall margin of error is +/– 2.7 percentage points at the 95 percent confidence level.

Covered California’s Executive Director Addresses Harvard Study on Impact of Eliminating Individual Mandate on Enrollment and Premium

SACRAMENTO, Calif. — Covered California Executive Director Peter V. Lee issued the following statement in connection with the Harvard Medical School Study, “Eliminating the Individual Mandate Penalty in California: Harmful but Non-Fatal Changes in Enrollment and Premiums,”published in Health Affairs. The Harvard study, conducted by a team lead by Dr. John Hsu, is the first national effort to measure the potential impacts of removing the individual mandate penalty based on surveying actual California consumers about their likely actions in the face of there being no penalty.

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