Well, there's two more rather interesting developments to the Risk Corridor mess.
...This fall, more than a dozen health insurers representing 800,000 people have dropped out of the ObamaCare exchanges, many out of fear that the administration no longer has the cash to cushion their losses in the costly early years of the marketplace.
In 2014, Open Enrollment officially ended on March 31st, but they allowed a 2-week "overtime" period for people who had started the process before the end of March but weren't able to complete it. The true deadline ended up being April 15th, although the official, final ASPE report ended up tacking on 4 more days (thru April 19th) for whatever reason. The final report was released 12 days later, on May 1st, 2014.
Last year, Open Enrollment officially ended on February 15th, but they tacked on a one-week "overtime" period, so the true deadline ended up being February 22nd. The official, final ASPE report was released 16 days later, on March 10th, 2015.
This year, Open Enrollment officially ended on January 31st, although the final Weekly Snapshot Report for the federal exchange tacked on 1 extra day (February 1st), so I assume that will be included. That means it's been 24 days so far, and the ASPE report hasn't been released as of yet...
To the best of my knowledge, the entire U.S. individual health insurance market should be roughly 19 million people this year. Of that, around 12 million are, of course, ACA exchange-based (I'm lopping off 700K to account for those who didn't pay their first premium, dropped out after the first month or otherwise aren't actually enrolled at the moment).
The other 7-8 million or so are off-exchange...people who enrolled directly through their insurance carrier, bypassing the ACA exchanges. Since off-exchange enrollees don't qualify for federal tax credits, the vast majority of these folks (a good 95% or more, I'd imagine) earn too much to receive them (officially over 400% of the Federal Poverty Line; realistically, some are in the 300-400% FPL range). The rest of them are presumably either undocumented immigrants, people who still don't know about the tax credits via the exchanges, or weren't able to find an exchange-based policy which they were satisfied with, even with the tax credits.
However, even then there are 4 different types of off-exchange policies:
*(OK, not really; I'm not the only one who was suggesting this, but it some people really do seem to think that I have dictatorial control over CMS...)
I guess the question here is just how much verification the HHS Dept. and/or the assorted state-based exchanges are doing of these claims. In cases like getting married/divorced, giving birth, becoming a citizen or getting out of jail, I would imagine the verification should be pretty easy. However, the "Tax Penalty Ignorance" exception was pretty much based on an honors system, and I don't know how easy/difficult it is for the feds to "verify" that your income has increased/decreased substantially...at least, not until you file your taxes the following year, which could be up to a year after the claim is made.
...So, what's the solution to this, assuming the problem is widespread? Well, I can think of some obvious tweaks to the rules, almost all of which involve simply reducing grace periods:
5. It can be kept and substantially improved, which is what Hillary Clinton is now proposing.
6. It can be kept and substantially improved, while also laying the groundwork for a series of gradual, longer term steps towards universal, comprehensive single payer (or similar) plan, which is what I'm proposing ("longer term" defined as 10-20 years, possibly longer).
7. It can be kept in place for now (along with Medicare, Medicaid, employer-sponsored insurance, the VA/TriCare, etc.) but replaced in the short term ("short term" defined as "within the next 5 years"), which is what Bernie Sanders is proposing.
8. It (along with Medicare, Medicaid, employer-sponsored insurance, the VA/TriCare, etc.) can be immediately replaced on January 20, 2017, which is what some Hillary supporters are trying to claim that Bernie Sanders is proposing, but which he isn't.
INDIVIDUAL AND FAMILY ENROLLMENT • As of February 20, 2016:
36,004 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.
The majority of these individuals are 2015 HSRI enrollees that were auto-renewed into a 2016 plan.
8,657 of the 36,004 individuals have selected a plan for 2016 coverage, and are new to HSRI this year or returning after being enrolled with HSRI at some point during a prior year.
33,920* of the 36,004 individuals are enrolled in 2016 coverage through HSRI, and have paid their first month’s premium.
*The number of paid enrollments is expected to increase as payments for March coverage are made by today’s deadline and processed over the next several days.
Actually, two of the data points (private QHPs and BHP enrollment) aren't very different from what I already knew. However, there's some interesting news on the Medicaid & Child Health Plus side:
Rate of Uninsured Drops to Lowest Level in Decades
ALBANY, N.Y. (February 23, 2016) - NY State of Health, the state’s official health plan Marketplace, today announced more than 2.8 million people have signed up for health insurance as of January 31, 2016, the end of the 2016 open enrollment period. Since the Marketplace opened in 2013, the number of uninsured New Yorkers has declined by nearly 850,000. According to recently released data by the Centers for Disease Control and Prevention, the rate of uninsured declined from 10 percent to 5 percent between 2013 and September 2015 and is at its lowest level in decades.
As I've noted before, one of the biggest hurdles to overcome when considering moving to Single Payer healthcare is that at least a half a million people currently work directly for health insurance carriers, plus (I'm guessing) another couple million in directly related services. While I do support moving to SP eventually, any plan which replaces the current private insurance industry would have to also take into account what would happen to those people.
Clinton revives support for health care 'public option'
Hillary Clinton wants to bring back the public option, offering a competing vision to Bernie Sanders’ support for a more progressive health care system.
Clinton's campaign has updated its website to note her continued support for the government-run health plan that was dropped from Obamacare during the law's drafting. The idea was popular among progressives who prefer a single-payer plan -- like the one Bernie Sanders is touting.
...A new version of Clinton’s campaign website suggests she won't try to push the public option through Congress, but instead will work with governors using existing flexibility under Obamacare "to empower states to establish a public option choice." That may be a reference to a waiver program taking effect in 2017 that lets states assert greater control over their health care systems.
If she's serious about this, this could be very interesting indeed.
About 8,000 CT exchange customers didn’t pay first bill
About 8,000 people who signed up for coverage through the Connecticut’s health insurance exchange missed the deadline for their first payment and lost coverage, exchange CEO Jim Wadleigh said Monday.
“This number is bigger than we were anticipating,” Wadleigh said. Just over 116,000 people signed up for private insurance through Access Health CT, the state’s exchange, during the open enrollment period that ended Jan. 31. “The fact that all these customers have not made their first payment was kind of a shock to even us.”
