Charles Gaba's blog

NEW INSURER GAINS MEMBERS

A new competitor entered the Idaho market this year, with a different business model. The Mountain Health CO-OP is Idaho's first Consumer Operated and Oriented Plan - a type of nonprofit organization authorized by the Affordable Care Act and supported with federal seed money.

The co-op's first year in Idaho yielded about 19,000 members by mid-March, with an additional 2,700 who hadn't yet paid their premiums. Most enrolled through the state exchange.

Mountain Health CO-OP expects to charge premiums high enough to allow it to avoid losing money, said spokeswoman Karen Early. "We are trying to have the lowest administrative cost we can," she said. The co-op expects its overhead and profits to be "well under" the 20 percent allowed by the law.

Thanks to HonestyinGov for giving me a heads up (via Twitter) to this Wall St. Journal article by Stephanie Armour the other day regarding a new survey (and several interviews with tax preparers) which claims that overall, those who will owe a tax penalty for not being insured last year and are still uninsured this year are not likely to go ahead and enroll during the 2015 tax filing season currently ongoing:

Major tax-preparation firms say many customers are paying the penalty and not getting health insurance. It is still early, since the special enrollment period launched Sunday, but research also suggests that many people who lack health insurance will pay the penalty and not get covered this year.

Only 12% of uninsured people would buy policies if informed of the penalty, according to a survey of 3,000 adults polled through Feb. 24 by McKinsey & Co.’s Center for U.S. Health System Reform.

Over on another comment thread, one ACA Signups regular is trying to parse out the question of "newly insured" vs. "previously insured" enrollees as they relate to both the ACA exchanges as well as Medicaid expansion. He admits to being surprised that I'm comfortable stating that "only" about 5-6 million of the current exchange enrollees are "newly insured" as opposed to "previously insured". I tried to explain both the numbers as well as the methodology headaches, but also decided this issue is worthy of a full entry, so here goes:

Meet Bob. Bob is married with 2 kids. In 2013, Bob was 64, his 2nd wife was 42, their son from Bob's first marriage was 24 and their daughter together was 15.

Bob had quite a year in 2014.

In December 2013, Bob and his wife, who had been uninsured for the past year, discovered that they qualified for Medicaid thanks to the ACA's expansion provision in their state. Their 15-year old daughter was already enrolled in the CHIP program, and their son was scrimping by on a junk "policy". Bob and his wife enrolled in Medicaid, effective January 1st.

Here's another one of the "A-list" talking points that ACA critics have been lobbing for several years now: Supposedly, egregious regulations for employer-basd healthcare coverage would "force" thousands of large/medium-sized companies to drop their coverage entirely, throwing their employees over to the heatlhcare exchanges and taking the $2,000 per head tax hit for not providing coverage instead.

Hmmm...looks like I overshot the mark a bit this time around, but still impressive growth in Medicaid/CHIP enrollment:

From the report:

  • The 51 states (including the District of Columbia) that provided enrollment data for January 2015 reported nearly 70 million individuals were enrolled in Medicaid and CHIP.6 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.
  • 394,023 additional people were enrolled in January 2015 as compared to December 2014 in the 51 states that reported comparable January 2015 and December 2014 data.7

(And yes, the "51 states" wording is CMS's, not mine)

I don't have a subscription to the WSJ, so I can only quote the first couple of paragraphs, but do I really need any more than that?

Paul Ryan Urges State Lawmakers Not to Set Up Health-Insurance Exchanges

Ways and means chairman says GOP is moving ahead on alternative to health law

WASHINGTON—Rep. Paul Ryan urged state lawmakers to resist setting up state insurance exchanges if the Supreme Court rules that key parts of the Affordable Care Act can only continue if they do so.

“Oh God, no…The last thing anybody in my opinion would want to do, even if you are not a conservative, is consign your state to this law,” the Wisconsin Republican told state legislators Thursday during a conference call organized by the...

Earlier today, the CMS/HHS Dept. held a press call to discuss the #ACATaxTime Special Enrollment Period for people who missed the open enrollment deadline this year, had to pay the non-coverage tax penalty last year and "didn't know" about the penalty until it was too late. They also discussed the exciting world of the 1095-A tax form. That's the one you fill out if you received federal ACA exchange policy tax credits for 2014; you have to reconcile what you thought your income would be with your actual income to see whether you have to pay anything back or receive a higher credit.

As you may recall, there was a bit of a problem with roughly 820,000 of the 1095-A forms; they had the wrong benchmark plan listed, which screwed up the formula used to calculate the subsidy for the tax filer, so they originally told those folks to hang tight until they received the corrected form.

Over at The Huffington Post, Jonathan Cohn lays out the potential carnage if the King v. Burwell plaintiffs receive a favorable ruling from the Supreme Court...and why it would be far, far worse than the 2 million or so people whose noncompliant policies were cancelled at the end of 2013 & 2014.

The Freakout From An Obamacare Ruling Could Be Unlike Anything We've Seen

This is the first time I've updated The Graph in awhile, for an obvious reason: Since the end of Open Enrollment (including the "Waiting in Line" extension period) there's only been a tiny smattering of data updates, from Colorado, DC, Maryland, Massachusetts, Minnesota and Rhode Island...and only 2 of those include any of March. Slim pickings indeed. Of course, the #ACATaxTime Special Enrollment Period kicked off on the 15th in most states, so things should have picked up, but unless the HHS Dept. surprises me, you're not likely to hear anything official about it until after April 30th (and possibly not even then). (Update: Yay! They'll issue some sort of enrollment update next week after all!)

Still, based on the snippets of data I do have since 2/22, along with last year's off-season pattern and some educated guesswork for the tax season SEP, here's where I think things should stand as of Monday, March 23rd, 2015...otherwise known as the 5 year anniversary of the Affordable Care Act being signed into law by President Obama (make sure to click the image for a higher-resolution version):

As a website developer and website hosting provider, I'm speechless:

D'Oh! D.C. Health Link allows its Web domain to expire

The domain name for D.C. Health Link's website was allowed to expire for 49 minutes earlier this week.

A D.C. website development company discovered the problem Tuesday morning as it tried to use D.C. Health Link's web page for its own employees' coverage. D.C. Health Link, the District's Affordable Care Act exchange, is operated by the D.C. Health Benefit Exchange Authority and has come under fire recently for technical and usability issues.

I can't even...

(sigh) For those who aren't familiar with how domain name registrations work, renewing one takes literally seconds to do, only has to be done once per year, costs a whopping $10 or so per year, and can easily be set up to either autorenew every year or you can register the domain for up to 10 years at a time.

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