Charles Gaba's blog

Back in January, I wrote:

Millions of people who failed to make sure they were enrolled in ACA-compliant healthcare coverage are going to file their tax returns this spring thinking that they don't have to pay a penalty for not doing so only to discover that the penalty is still in effect.

Then, next spring (assuming the IRS sticks to its guns on the issue and there's no further legislative changes made), anyone who didn't #GetCovered for 2018 are also going to have to pay the penalty (which, again, is either $695 per adult/$348 per child or 2.5% of their household Modified Adjusted Gross Income).

The damage caused by the mandate being repealed to the individual market risk pool (and rate premiums) will be felt this November, when people start shopping around for 2019 coverage...but the actual "benefit" (i.e., those who don't get covered not having to pay the mandate penalty) won't show up until spring 2020.

The Kaiser Family Foundation runs a highly respected monthly national tracking poll on healthcare issues. Their latest was just released, and while there's a bunch of interesting stuff included, there are two main takeaways. Here's the first:

The February Kaiser Health Tracking Poll finds a slight increase in the share of the public who say they have a favorable view of the Affordable Care Act (ACA), from 50 percent in January 2018 to 54 percent this month. This is the highest level of favorability of the ACA measured in more than 80 Kaiser Health Tracking Polls since 2010. This change is largely driven by independents, with more than half (55 percent) now saying they have a favorable opinion of the law compared to 48 percent last month. Large majorities (83 percent) of Democrats continue to view the law favorably (including six in ten who now say they hold a “very favorable” view, up from 48 percent last month) while nearly eight in ten Republicans (78 percent) view the law unfavorably (unchanged from last month).

I noted a few weeks ago that as many as 9 states are ramping up plans to reinstate one version or another of the ACA's just-repealed Individual Mandate. I concluded:

My only advice is that if they do take the political risk of imposing a mandate penalty, at least make sure it's more stringent than the one which was just repealed--I'd probably recommend making it something like the same cost as the least-expensive Bronze plan available on the exchange after whatever tax credits they'd otherwise have applied.

Well, I don't know about the details, but it looks like the District of Columbia, at least, is full-steam ahead:

DC Health Benefit Exchange Authority Executive Board Recommends Policies to Protect Health Insurance for District Residents
Friday, February 23, 2018

This just in...I used to track the monthly Medicaid/CHIP reports pretty religiously, but the total numbers have actually stayed fairly stable month to month for the past year or so (mainly because the states which expanded Medicaid under the ACA have mostly "maxed out" by now). This should start changing in Maine later this year as they voted to expand the program via ballot initiative last November, and Virginia may end up expanding Medicaid to up to 400,000 people there as well later this year.

In the meantime, here's where things stood as of the end of 2017, according to CMS:

Highlights from the December 2017 Report

Medicaid and CHIP Total Enrollment

From the About page of the Art as Social Inquiry website:

Art As Social Inquiry combines art and advocacy as a way to engage audiences. Theresa Pussi Artist BrownGold is the painter/writer/performance artist behind Art As Social Inquiry.

"I have often wondered why so many good people have such different and divisive opinions. Art As Social Inquiry asks the questions: Are we our opinions? Or are we something more? Then what? What is beyond the emotional charge of our opinions? And how do we get there?"

Art As Social Inquiry — an artist-at-work painting portraits of real people whose lives embody the social issues of the day, issues like access to healthcare, immigration, how we die. The artist also uses songwriting and performance art, two more art-making tools, to help us see ourselves in the bigger world, and the opinions we cling to.

Our opinions affect our actions. Art As Social Inquiry unearths those opinions.

Not sure when this was posted, but the trendline is interesting...according to the first chart, Colorado ended 2017 down only 16.3% from their total OE4 enrollment number (161,568 QHP selections).

The cumulative enrollment numbers are also important: During the entire off-season (from 2/01/17 - 12/31/17), 41,387 people selected QHPs via Special Enrollment Periods (SEPs), or roughly 124 per day. Of course, technically speaking the last day of SEP enrollment for 2017 should have been 11/15/17 (for coverage starting December 1st), but it looks like a few hundred people slipped in after that.

Colorado's SHOP enrollment, meanwhile, hovered right around the 3,000 person mark all year.

Press Release: NY State of Health Releases County-Level Enrollment Data

Feb 27, 2018

ALBANY, N.Y. (February 27, 2018) -- NY State of Health, the state’s official health plan Marketplace, today released county-level enrollment data as of January 31, 2018, showing that overall enrollment increased in each of New York’s 62 counties. Total enrollment in the Marketplace is now over 4.3 million people, reflecting an increase of 700,000 people (19 percent) from 2017.  Many upstate counties saw significant enrollment gains in the last year.

“Consumers from Chautauqua to Suffolk and every county in between are shopping for health plans through the Marketplace,” said NY State of Health Executive Director, Donna Frescatore. “With affordable premiums and a robust choice of plans, NY State of Health is where New Yorkers go to get covered.”

 

(Yes, I'm Jewish. Yes, hearing Michelle Bachmann mangle the pronounciation of "chutzpah" makes my teeth itch, but it's hilarious).

Late last night, Texas Attorney General Ken "don't confuse me with Bill" Paxton announced that he, along with 19 other state Attorneys General, is suing the federal government (again) over the Affordable Care Act:

Texas is suing the federal government over President Barack Obama's landmark health law — again.

In a 20-state lawsuit filed Monday in federal court, Attorney General Ken Paxton argued that after the passage of the GOP's tax plan last year — which also repealed a provision of the sweeping legislation known as "Obamacare" that required people to have health insurance — the health law is no longer constitutional.

 

Please watch the full video above before reading this entry.

I've been debating about whether to post this for several days now.

My son is on the Autism spectrum. His case is fairly low-level/high-functioning (mostly in the Aspergers Syndrome category, I believe), and most of the time it's not all that noticeable, but it's definitely an issue in certain circumstances...and the video above gives a perfect example.

I've made one or two vague references to a member of my immediate family being in need of mental health services and physical therapy (he also has a mild case of cerebral palsy), but haven't gone into specifics before. This is partly because it wasn't really necessary to the point I was making, but mainly because my wife and I are very protective of our son and don't want him to grow up thinking of himself as an "Aspie" or whatever the label is; he's just himself. However, he's old enough now that I decided to ask him if he's OK with my mentioning it publicly, so here we are.

In 2018, unsubsidized premiums for ACA-compliant individual healthcare policies have shot up by around 30% on average nationally. Around 18 points of this (60% of the total) is due specifically to policy decisions by the Trump Administration and Congressional Republicans, primarily the cut-off of Cost Sharing Reduction reimbursement payments and the (accurate, as it would later develop) anticipation, by some carriers, of the ACA's individual mandate being repealed.

What about 2019, however? The 2-3 points tacked on out of concern for the mandate being repealed was only a small portion of the full impact insurance carriers expect it to have, and of course there's the further undermining of the ACA via Donald Trump's "Short Term" and "Association Plan" executive orders. Finally, there's the impact of what is assumed to be another year of the advertising/outreach budget being starved by the Centers for Medicare & Medicaid.

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