The impending King v. Burwell Supreme Court decision will cast an even larger shadow over the ACA over the next 2 months (the decision is expected to be announced in June), as exchanges in 6 of the 14 states running their own (State-Based Marketplaces, or SBMs) are at risk of either being abandoned, dissolved or otherwise moved over to the federally-run Healthcare.Gov exchange:
The federal government is threatening to take over Hawaii's health insurance exchange within months and has restricted grant money to support operations of the Hawaii Health Connector.
Jeff Kissel, the Connector's executive director, told lawmakers at a briefing Thursday that if the exchange created by the Affordable Care Act does not get state funding soon, the federal government will abolish Hawaii's marketplace and run it directly.
NewsBusters, for those who aren't familiar with it, is a right-wing nutjob "news/expose" site which prides itself on "exposing and combating liberal media bias". Think of them as the poor man's Breitbart and their fan base as that of Free Republic with less frothing at the mouth. I'm rather proud to say that they even posted a hit piece on me about a year ago.
Obamacare Penalty Starts Hitting Taxpayers, Nets Ignore in 91% of Stories
According to the February 18, Washington Post, as many as six million Americans faced the “unwelcome surprise” of a penalty 2015. Of course, many people might not have suffered that shock if the broadcast news networks had discussed the penalty more. But ABC, CBS and NBC evening newscasts failed to mention the tax penalty in 91.1 percent of stories (41 of 45) about the Affordable Care Act between October 1, 2014, and April 5, 2015.
Rhode Island's ACA exchange hasn't suffered from the technical glitches which are still causing problems for some states (particularly Vermont and Minnesota), but HealthSource RI does have one major problem to deal with: Funding. It's a small state with a smaller customer base for the exchange; 31,500 enrollees isn't a lot of people to cover the costs. As a result, the Governor of Rhode Island has come up with a healthcare policy tax idea which is being batted around.
The article goes into the pros and cons of the tax as opposed to simply dropping the exchange altogether and moving to Healthcare.Gov. Aside from the biggest and most obvious downside of doing so (King v. Burwell), it's also not certain that making the move would actually save any money, since HC.gov still takes some bucks to run:
Hey, remember the story from earlier about how ACA Medicaid expansion in Montana (which failed by 1 vote due to a comedy of errors resulting in a Democratic state legislator who supported the effort inadvertantly voting against it) is back on the table again and looks poised to finally go through?
Well, apparently the Koch Bros and their puppet organization, "Americans for Prosperity" (AFP), are also aware of this and have been lobbying, screaming and generally making a nuisance of themselves throughout Montana in an attempt to prevent this from happening (because God knows that 45,000 - 70,000 low-income Americans having healthcare coverage would be a horrible thing for some reason or another).
In fact, they've been so obnoxious about their efforts that the people of Montana, generally considered a fairly "red" state which you'd think would be partial to their position, have pretty much asked them to GTFO and go pound sand:
For obvious reasons, aside from whatever #ACATaxTime bump comes out of the next week or so, things will likely be pretty quiet and steady for The Graph for the rest of the year...assuming, of course, that the Supreme Court shoots down the King v. Burwell plaintiffs. If the King plaintiffs win, all bets are off and every line on the right half of the extended graph below (to the right of June) will probably look very different.
That major caveat aside, assuming that my (recently corrected) projections prove to be reasonably on the mark, this is what I'm expecting private QHP enrollments via the ACA exchanges to look like for the rest of 2015. The year should wrap up with roughly 13.7 million total QHP selections; of those, around 12.0 million will likely pay their first premium; and of those, roughly 10.0 million will likely still be enrolled (effectuated) as of December.
Here's the numeric table from which the extended graph data comes (click for higher-res version):
I'm back from a short vacation to Chicago (we had a blast, thanks for asking...visited the Shedd Aquarium, Adler Planetarium and Museum of Science & Industry), so obviously my in box has built up quite a bit of ACA news over the past week.
It'll take awhile to sift through everything, but in the meantime there are some state-specific developments which stand out:
MONTANA: A couple of years back, Montana held a vote on the ACA Medicaid expansion provision. It was a tight vote, but should have passed...unfortunately, one state legislator accidentally voted the wrong way on the bill. Seriously:
Some states have declined to expand Medicaid because they oppose Obamacare. Others worry about the financial burden of expanding the entitlement. But there appears to be only one state where the Medicaid expansion failed due to a Democratic legislator accidentally voting against it.
For months now, Michigan's implementation of the Affordable Care Act's Medicaid expansion provision has defied expectations, enrolling far more than the 477K - 500K expected. A couple of weeks ago it managed to break the 600,000 mark, peaking at 603,681 people, and I've been wondering for quite awhile when the growth might finally stop.
Beneficiaries with Healthy Michigan Plan Coverage: 573,115
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)
*Statistics as of April 6, 2015
*Updated every Monday at 3 p.m.
The Massachusetts Health Connector board held their monthly meeting today, which included an updated enrollment report which is chock-full of all sorts of data-nerd charts and graphs; a bonanza for folks like myself. Best of all, it runs all the way through 3/31, making the the most up-to-date report I have for any state at the moment.
Tax Experts Team Up with Covered California To Urge the Uninsured To Get Health Care Coverage
More Than 18,000 Californians Have Taken Advantage of Limited Special-Enrollment Opportunity; Consumers Are Encouraged to Sign Up by April 30
...“The Affordable Care Act is clear: All who can afford health insurance must buy it, and the good news is that it is more affordable than ever before,” said Covered California Executive Director Peter V. Lee. “It’s important for Californians without health coverage to sign up now to avoid the increasing tax penalty they will face in 2015 if they remain uninsured.”
Lee said that more than 18,000 consumers have taken advantage of the special-enrollment opportunity since it began Feb. 23.
I'll be on vacation most of Passover/Easter week. If something really important happens I'll try to post about it, but otherwise don't expect much until Friday the 10th.
Chag Semeach and Happy Easter to those who celebrate!
