Charles Gaba's blog

UPDATE 8/27/15: I've been writing up a whole mess of *approved* state rate updates today; look for this entry to be updated on Friday.

Recently, Richard Simpkins (aka icowrich) gave me the idea to take the known state-wide 2016 rate increase requests and go a step further, by plugging the weighted average rate increases for each state into a spreadsheet and then running a weighted average based on each state's proportion of the total U.S. population, like so (scroll to bottom of this entry for links to analysis for each state):

Remember that University of Michigan study I posted about last week which claimed that in spite of all the predictions by ACA opponents that expanding Medicaid would make it impossible for enrollees to actually make a doctor's appointment, the opposite ended up being the case?

A new University of Michigan study shows that the availability of primary care appointments actually improved for people with Medicaid in the first months after the state launched the Healthy Michigan Plan, the state’s Medicaid expansion under the ACA. What’s more, it remained mostly unchanged for those with private insurance.

Well, apparently the Michigan results are not an outlier:

I very rarely write much about Medicare here, partly because I just don't have time to cover every aspect of the healthcare system, partly because Medicare is only impacted by the ACA indirectly for the most part. However, there's been two recent developments which are worth noting:

First, that "indirect impact" I just mentioned has resulted in the Medicare Hospital Insurance Trust Fund, previously expected to run out of money just 2 years from now, now being expected to be solvent through 2030 thanks to the ACA bending the cost curve:

The slowing growth of healthcare costs has extended Medicare's projected lifespan 13 years beyond projections made in 2009, the last report issued before the passage of the Patient Protection and Affordable Care Act.

The Medicare Hospital Insurance Trust Fund will have "sufficient funds to cover its obligations until 2030," the Medicare Board of Trustees said Wednesday in its annual financial review of the $613 billion program.

The CMS Dept. has quietly released their latest monthly Medicaid/CHIP enrollment report through the end of May...which happens to line up almost perfectly with what I was expecting:

  • Over 71.6 million individuals were enrolled in Medicaid and CHIP in May 2015. This enrollment count is point-in-time (on the last day of the month) and includes all enrollees in the Medicaid and CHIP programs who are receiving a comprehensive benefit package.
  • 509,082 additional people were enrolled in May 2015 as compared to April 2015 in the 51 states that reported comparable May and April 2015 data.
  • Looking at the additional enrollment since October 2013 when the initial Marketplace open enrollment period began, among the 49 states reporting both May 2015 enrollment data and data from July-September of 2013, more than 12.8 million additional individuals are enrolled in Medicaid and CHIP as of May 2015, more than a 22 percent increase over the average monthly enrollment for July through September of 2013. (Connecticut and Maine are not included in this count.)

This may seem a bit antlclimactic after today's big California news...unless you happen to live in Maine.

A big shout-out to Amy Fried for the heads up re. this story about Maine's 2016 rate requests:

Most Mainers buying Affordable Care Act insurance will see modest increases in their premiums for 2016, below the national average and much lower than the double-digit increases projected in some cities by a recent study of initial rate filings.

About 80 percent of the 75,000 Mainers purchasing ACA marketplace insurance have a plan through Lewiston-based Community Health Options – formerly Maine Community Health Options. The ACA marketplace, operated on the Web as healthcare.gov, is where those without insurance – often part-time or self-employed workers – can obtain subsidized benefits.

This Just In...

FOR IMMEDIATE RELEASE Media Line: (916) 206-7777 July 27, 2015

COVERED CALIFORNIA HOLDS RATE INCREASES DOWN FOR SECOND CONSECUTIVE YEAR

Average Increase Is 4 Percent; Consumers Who Shop Can Lower Their Premium by an Average of 4.5 Percent

SACRAMENTO, Calif. — Covered California announced its rates for 2016 and unveiled which health insurance companies will be offering plans through the marketplace. The statewide weighted average increase will be 4 percent, which is lower than last year’s increase of 4.2 percent and represents a dramatic change from the trends that individuals faced in the years before the Patient Protection and Affordable Care Act.

When I last checked in on Pennsylvania's year-late-but-certainly-welcome addition to the ACA Medicaid expansion club, newly inaugurated Governor Tom Wolf was in the process of replacing his predecessor's poorly-conceived, overly-complicated "Conservative version" of the expansion program with "official" Medicaid expansion to up to 600,000 state residents. At the time (early May), they had hit roughly 250,000 people.

I'm happy to report that according to today's Pittsburgh Post-Gazette, the dust has settled on the transition, and enrollment has been on a tear, with the tally now standing at roughly 439,000 Pennsylvanians.

About 439,000 Pennsylvanians have enrolled in expanded Medicaid, which provides health insurance coverage to the poor and disabled, since the beginning of the year, according to figures released last week by the state’s Department of Human Services.

I posted this back in January, but given Mike Huckabee's comments yesterday (which he's actually using as an official campaign slogan today, I might add...)

...it seems appropriate to repost it today.

So, late last night the New York Times posted another story about Hillary Clinton's email which included this headline...

Criminal Inquiry Sought in Hillary Clinton’s Use of Email

...and this lede passage:

"...into whether Hillary Rodham Clinton mishandled sensitive government information on a private email account she used as secretary of state."

An hour or so later, they changed the headline to this...

Criminal Inquiry Is Sought in Clinton Email Account

..and the wording of the passage was changed to this:

"...into whether sensitive government information was mishandled in connection with the personal email account Hillary Rodham Clinton used as secretary of state."

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