SEN. TOOMEY: “Now, one way to force it is to force insurance companies to provide health insurance coverage for someone as soon as they show up, regardless of what condition they have, which is kind of like asking the property casualty company to rebuild the house after it’s already burnt down.”
Now, aside from the obvious callousness of this statement, there's a couple of important problems with his comparison:
Politically, the big unknown is whether or not Paul Ryan and Mitch McConnell will get away with trying to pin the blame for this on the Democrats/the law itself. That's why they've been pushing the "Obamacare is already in a death spiral!" claim hard for the past few weeks, even though it quite simply isn't.
...So, if this does end up in a worst-case scenario, Trump's "stop enforcing the mandate altogether!" order here could end up causing that death spiral even if the GOP doesn't technically end up repealing anything legislatively. The carriers would start announcing that they're bailing next year as soon as this spring (remember, the first paperwork for 2018 exchange participation has to be filed in April or May), and McConnell/Ryan would simply say, "See?? We told you it was collapsing all by itself! We didn't touch nuthin'!!"
As has been obvious for some time now, the early projections by the Congressional Budget Office back in the pre-exchange days of 2010 - 2013, which foresaw ACA exchange enrollment heading into the 20-million-plus range by this point, obviously not only never came to pass, but are unlikely to do so anytime in the near future under the current legal/healthcare policy structure. There are several reasons for this ranging from legitimate problems with the structure of the ACA itself to Republican obstruction, but the two most obvious errors the CBO made in their projections were:
The last time Covered California released enrollment data, they gave a hard number for new enrollees (258,158) but left the number of people renewing their policies a bit vague ("approximately 1.3 million"). I later learned that the actual number of renewals had been rounded up, so I'm assuming it's actually around 1.27 million; this gives a total of 1.53 million QHP selections as of January 3rd.
Today, CoveredCA issued another update, touting a new enrollee survey which concludes that in California, at least, people don't seem to be shying away from enrolling in spite of the ugly ACA repeal rhetoric coming out of Washington, DC:
Covered California Enrollment Continues at Strong Pace; New Research Suggests ACA News Coverage Is Not Deterring Consumers
In Arkansas, 70,404 people enroll in private exchange policies as of the end of January. I estimate around 50,000 of them would be forced off of their private policy upon an immediate-effect full ACA repeal, plus another 331,000 enrolled in Arkansas' "Private Option" ACA Medicaid expansion program for a total of 380,000 residents kicked to the curb.
As for the individual market, my standard methodology applies:
Plug in the 2/01/16 QHP selections by county (hard numbers via CMS)
Adjust for 1/31/17 QHP selections based on hard CMS data.
Knock 10% off those numbers to account for those who never end up paying their premiums
Multiply the projected effectuated enrollees as of March by the percent expected to receive APTC subsidies
Then knock another 10% off of that number to account for those only receiving nominal subsidies
Whatever's left after that are the number of people in each county who wouldn't be able to afford their policy without tax credits.
The Medicaid expansion data comes directly from state data.
Back on December 15th, I posted an entry entitled "I cannot guarantee accurate federal data after 1/20/17", in which I warned that given Trump's never-ending stream of bullshit and the fascistic overtones of the impending Trump Administration, the odds were pretty high that once they took over, all data from the federal government would likely become highly suspect. Cooking the books, doctoring the data, flat-out purging vast quantities of information...all of this was possible.
Federal Workers Told To Halt External Communication In First Week Under Trump Staff have been told to stop talking to Congress and the press.
WASHINGTON ― Multiple federal agencies have told their employees to cease communications with members of Congress and the press, sources have told The Huffington Post.
Oh. Well, I'm sure that was just a sheer coincidence, right? No doubt Aetna will clear this up with an unequivocal statement to put any speculation to...
From Peter Sullivan of The Hill:
Asked if the DOJ’s actions on the merger had any relation to Monday’s announcement, Aetna spokesman TJ Crawford did not directly say yes or no.
Economix is a graphic novel by Michael Goodwin, illustrated by Dan E. Burr, that explains the economy. More than a cartoon version of a textbook, Economix gives the whole story of the economy, from the rise of capitalism to Occupy Wall Street. Economix is published by Abrams Comic Arts.
Today he contacted me to inform me that he's using some of my data as part of his latest project: A bona fide 20-page comic book which explains, in laymans terms, the basics of the ACA, how Paul Ryan/Tom Price's replacement plan would work and why their replacement pretty much sucks eggs.
Here's a low-resolution version of the first page (which also just happens to be where he included my data) to give you a taste of what it's like. I'm absolutely floored and honored to play a small role in disseminating this information in such a user-friendly way:
I've recently updated the enrollment numbers out of Idaho, Connecticut and New York. None of them have moved the needle much, but the latest New York number did finally goad me into making a decision: Going forward, I'm going to start including Basic Health Plan enrollments in my Open Enrollment Period totals.
I'll still be separating them out, since the "official" number which is generally counted by everyone (including myself) only includes exchange-based Qualified Health Plans (QHPs)...but unlike standalone dental plans, BHPs are full medical insurance policies, enrolled in via the ACA exchanges, and while they may resemble Medicaid in some aspects, they aren't in either category or funding source. Furthermore, BHPs are also "cannibalizing" quite a few enrollees who would otherwise be enrolling in QHPs anyway, so it's important to recognize their impact on the numbers.
It's Back! Okay, folks, it's time to call your legislators, because the Drazkowski bill is back, and the GOP is giving it a full hearing TODAY!
This is the bill that would allow insurance companies to sell policies that do not cover chemotherapy, diabetes treatments, mental health services, maternity care, and many more benefits that are currently required to be covered by MN law.
The photo included is the Minnesota Statute 62Q, which is the statute that is being amended with this bill. These are the services that would be allowed to no longer be covered.
