Republican lawmakers in Utah voted in a closed-door meeting on Tuesday to shelve a plan to provide health care for about 95,000 of the state’s poor.
After months of negotiations earlier this year, the Health Reform Task Force unveiled a scaled down of the Healthy Utah plan for Medicaid expansion called Utah Access Plus. Under the new plan, the federal government would pick up about $450 million. An additional $50 million would be funded by taxes on doctors, hospitals, pharmaceutical companies and other medical providers.
On Tuesday, the Republican caucus gathered behind closed doors to determine whether it would allow the new proposal to move forward. According to KUER, lawmakers decided to kill the plan, leaving the future of Medicaid expansion uncertain in Utah.
Strike That: Apparently the Republicans immediately followed up crushing the spirits of 95,000 of their fellow Utahns by...eating birthday cake.
President Barack Obama's landmark health care reform law -- one of the most contentious political issues of the past six years -- received all but no attention during the Democratic debate Tuesday tonight. But considering that all five Democrats on the stage were supporters of the Affordable Care Act, perhaps it's not surprising that CNN opted to raise issues more likely to provoke confrontation.
Unfortunately, I don't have time to write about most of that today, as I'm concentrating exclusively on a Special Project: My Official 2016 Open Enrollment Projection piece...which isn't quite ready yet.
It's fitting that I'm working on that story today, however...because today happens to also be the 2nd anniversary of this website!
While their reports have always been comprehensive, they were also a bit confusing. Thankfully, starting with their June report, they've made the appropriate data points a bit more obvious. While the QHP selection total is still confusing, the effectuated number (which is really more relevant at this point) is the combination of APTC/CSR + non-APTC/CSR enrollees, or 74,583 + 59,617 = 134,200 people as of the end of June.
A couple of weeks ago, both Louise Norris and I crunched the South Carolina data and came up with different estimates of the weighted average requested 2016 rate hikes for the ACA-compliant individual market. She used a worst-case scenario and estimated it to be around 16.8%; I took a slightly more optimistic approach and came up with 15.2%.
As you can see, even though there are only 5 carriers operating on the ACA exchange and another 5 offering policies off-exchange only, the overall average is still 15.9% either way:
Ever since I laid into Congressional Republicans on Friday for deliberately sabotaging the funding program for the ACA's CO-OP Risk Corridor program last December, several people have correctly pointed out that, while having federal funds cut for this program cut off was certainly a major factor in at least one of the CO-OPs going under (the Kentucky Health CO-OP), there was a different policy change--made nearly 2 years ago--which may also contributed to their financial woes (and which may have played a role in some of the other 4 CO-OPs which fell apart prior to the risk corridor debacle hitting home a week or so ago).
The Massachusetts Health Connector held their monthly board meeting last week and have released their September dashboard report with a whole mess of demographic data for Baystate-obsessed nerds to revel in.
Effectuated QHPs have reached 179,470 enrollees...a whopping 38.930 higher (28%) than at the end of Open Enrollment.
While the national effectuation number is likely around 3% lower today than it was in March (9.9 million vs. 10.2 million), in Massachusetts it's 45% higher. There's two main reasons for this, both connected to "ConnectorCare", which is unique to Massachusetts. ConnectorCare consists of the same low-end Qualified Health Plans that anyone can purchase (ie, they're still counted as QHPs in the national tally), except that in addition to the federal Advanced Premium Tax Credits (APTC), enrollees in ConnectorCare also receive additional state-based financial assistance, making them even more attractive to enrollees. In addition, however, unlike "normal" APTC or Full Price QHPs, which are limited to the official open enrollment period for most people, ConnectorCare enrollment, like Medicaid/CHIP, is open year round. That makes a dramatic difference, as you can see below; the vast bulk of the net QHP enrollment increase since March is thanks to ConnectorCare additions.
In addition, MA is the only state I know of which actively reports their attrition numbers--that is, so far this year they've had just 17,246 people drop their QHP policies, meaning a total of 196,716 people have selected a plan and paid at least their first monthly premium.
Assuming a 90% payment rate (confirmed for Massachusetts back in April), this also suggests that the cumulative QHP selection total should be roughly 218,000 people to date, which is only significant to me and The Graph.
But wait, there's more! Look below and you'll see a whole mess of pie charts, bar charts and line charts, breaking out everything from Metal Level selections and Market Share by Provider to SHOP enrollments (5,562 lives covered as of October 1st) and even Dental Plans!
This may seem like common knowledge now, but in 2014, it felt like I was one of the only people who recognized that there were millions of people enrolling in ACA-compliant policies off of the ACA exchanges, directly via the insurance carriers themselves. My best estimate for 2014 was that in addition to the 7 million or so exchange-based individual market enrollees, there were another roughly 8 million people who enrolled off-exchange (although several million of those were in non-ACA compliant policies).
This time around, however, the victim (well, in addition to its current enrollees) is a private company, albeit a not-for-profit one: WINhealth Partners:
We’re a not-for-profit managed care company founded by professionals, and we’re changing the way that healthcare works for you – because we believe your insurance should help you to be at your best in life.
The nonprofit, consumer-governed health plans were included in the law as an alternative to the so-called public plan option. Modeled on successful health insurance cooperatives such as Group Health Cooperative in Washington, the CO-OPs were designed to broaden the coverage options available to consumers, inject competition into highly concentrated health insurance markets and provide more affordable, consumer-focused alternatives to traditional insurance companies.
To help these new plans find footing, the health law offered low-interest loans that were tied to a number of requirements designed to differentiate CO-OPs from traditional insurers (which were barred from the program). Recipients were required to:
