Charles Gaba's blog

Subtle, aren't they?

Another week, another HHS press release assailing Obamacare, which the agency is responsible for overseeing. pic.twitter.com/GpuDOnhKO6

— Margot Sanger-Katz (@sangerkatz) May 12, 2017

Over the past year or so, Andrew Sprung of Xpostfactoid, Michael Hiltzik of the L.A. Times and I have repeatedly noted that as much as most insurance carriers may be griping about the individual market, their bread and butter is generally in other divisions, including the large group market but especially Managed Medicaid and Medicare Advantage:

The expansion of Medicaid benefits, thanks largely to the Affordable Care Act, helped increase enrollment in private health plans by 3.4 million in the last year,according to a new report from consulting firm PwC.

...PwC said 73% of Medicaid beneficiaries — or 54.7 million of the 75.2 million Americans covered by the health benefit program for the poor – are enrolled in private plans that contract with the Medicaid program.

...But the growth in the last year wasn’t as fast as 2015 when health plans added more than 8 million Medicaid beneficiaries as more states agreed to expand such coverage under the ACA.

I'm not sure what the original source for this is, but the following initial filing deadlines were provided by Stephen Holland via Twitter. I've already posted analyses of the Virginia, Maryland and Connecticut filings. The California and Oregon filings are supposed to have been submitted already but don't appear to be publicly available yet. In addition, it's my understanding that in many states the rates can still be adjusted/resubmitted until as late as August 16th, so I'm not really sure how useful these dates are anyway, but it's at least a guideline.

Headline pretty much says it all:

May 11, 2017 - 21% Of U.S. Voters Approve Of Revised GOP Health Plan, Quinnipiac University National Poll Finds; Voters Reject Trump Tax Plan Almost 2-1

Only 21 percent of American voters approve of the Republican health care plan passed by the U.S. House of Representatives last week, a slight improvement over the 17 percent who approved of the first health care plan in March, according to a Quinnipiac University national poll released today. Overall, the current health plan goes down 56 - 21 percent.

Apparently throwing $8 billion (over 5 years) to the junk pile gave it a 4 point increase. I wonder what would happen if they restored the $840 billion (over 10 year) that the bill takes away from Medicaid?

Except for an anemic 48 - 16 percent support among Republicans, every listed party, gender, educational, age and racial group opposes the plan, the independent Quinnipiac (KWIN- uh-pe-ack) University Poll finds.

Hardly surprising given they made good on their "Give us our merger or we're out of here!" threat last year, followed by further drop-outs from both Iowa and Virginia announced for next year over the past few weeks, but the final Aetna shoe has just dropped:

.@Aetna will not offer on- or off-exchange individual plans in DE or NE for 2018, and at this time has completely exited the exchanges.

— T.J. Crawford (@TJatAetna) May 10, 2017

T.J. Crawford is apparently Aetna's head of media relations, so yeah, that seems pretty definitive.

A bit more courtesy of Peter Sullivan of The Hill:

KIMMEL: "Will the Senate make sure that the millions of children that count on Medicaid don't lose access to medical care because this House bill would cut, they say $880 billion, mostly to benefit wealthy Americans?"

CASSIDY: "Let me answer your question first technically...then more broadly...and then more broadly yet. Most children are covered under the CHIP program, and so they are gonna get the coverage they need. That's almost independent from Medicaid. Under Medicaid itself, though, clearly, if we're gonna fulfill President Trump's sort of "Contract with the American People", that people would maintain their coverage, Medicaid will be a part of that."

I'm not even gonna get into the fact that Donald Trump's word is as worthless as a diploma from Trump University. I'm just gonna focus on the bold section above.

 

Yep, that's pretty much a glimpse of the GOP's plans for Medicaid enrollees.

@Neoavatara @xpostfactoid @sangerkatz @larry_levitt We discussed last March. Public Option does no good if you're murdered by secret police.

— ☪️ Charles Gaba ✡️ (@charles_gaba) September 27, 2016

@Neoavatara @xpostfactoid @sangerkatz @larry_levitt Single Payer will be helpful after his Nazi thugs have beaten you up.

— ☪️ Charles Gaba ✡️ (@charles_gaba) September 27, 2016

UPDATE 6/5/17: NO SITE UPDATES UNTIL WEDNESDAY, AS I'LL BE TRAVELLING TO/FROM D.C. FOR THE 2017 NIHCM FOUNDATION HEALTHCARE DIGITAL MEDIA AWARDS DINNER...

OK, this really isn't news (it's been public for several weeks now), but I was recently selected as one of seven finalists in the 3rd Annual NIHCM Foundation Health Care Digital Media Awards:

The National Institute for Health Care Management (NIHCM) Foundation is a nonprofit, nonpartisan organization dedicated to improving the health of Americans by spurring workable and creative solutions to pressing health care problems.

...The NIHCM Foundation Health Care Digital Media Award recognizes excellence in digital media that improves understanding of health care topics through analysis grounded in empirical evidence. The three-year-old award carries a $10,000 prize and is judged by an independent panel of experts:

Last month I wrote up a list of 20 fixes/improvements to the ACA, many of which wouldn't cost taxpayers a dime. One fo them was...

12. LEGALLY TIE MEDICARE ADVANTAGE/MANAGED MEDICAID CONTRACTS TO EXCHANGE PARTICIPATION.

Andrew Sprung, Michael Hiltzik and I have all written about this before. I have no idea whether it's even legally feasible/practical or not, but if so, it makes a lot of sense to me: Remember, many of the same carriers whning about losing hundreds of millions of dollars on the individual market are simultaneously making billions of dollars in profit off of their other divisions...which include fat federal and state contracts to manage Medicare and/or Medicaid plans. If they want to play in the managed care sandbox, make exchange participation a requirement as well. I'm not saying they should have to treat it as a loss leader--they'd still be able to raise their premiums at an actuarially responsible rate as appropriate--but they should have to at least participate.

Another very nice scoop by Sarah Kliff of Vox.com:

News: Tennessee’s empty shelf problem appears to be fixed! Blue Cross of TN will sell coverage in Knoxville area.

— Sarah Kliff (@sarahkliff) May 9, 2017

BCBS of TN says they’ll sell coverage in the 16 Eastern TN counties that had no carrier signed up for 2018. https://t.co/g3dkqU4G1m

— Sarah Kliff (@sarahkliff) May 9, 2017

Here's the full text of the letter; emphasis mine:

May 9, 2017

Dear Commissioner McPeak,

We appreciate getting to meet with you and your team yesterday to update you on BlueCross’s position relative to the individual Marketplace for Tennessee as the first deadline for 2018 approaches.

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