Charles Gaba's blog

There's been a lot of fuss made about 2015 ACA exchange premium rates not being available at Healthcare.Gov until after the election. The presumption, of course, is that this is being done for political reasons. While this may be true, it could also simply be that there's a lot of different policy figures to plug into the federal system, and some states haven't even finalized their rates yet.

That being said, residents of some states can check out the 2015 premiums now and compare them against their current premium:

IDAHO: Idaho is the only state moving from HC.gov to their own exchange. Idaho residents can check out their 2015 rates directly via the state exchange site.

CALIFORNIA: CoveredCA has 2015 rates available right now as well.

This is absolutely awesome...and extremely frustrating at the same time. Dan Goldberg and his chums at CNY have put together another extremely detailed breakdown of ACA enrollments in New York City, with QHPs, Medicaid and CHIP enrollees sorted out by individual zip code (a pretty herculean task given how many zip codes there are in NYC). Even more interesting (from my perspective, anyway) is that they've managed to get the current enrollment figures--updated through September. Since the NY exchange pointedly informed me back in June that they had no plans to release updated enrollment figures during the off-season at all, this is a huge development from my POV.

The only problem, of course, is that this map only gives the tally for NYC itself (about 8.4 million people total) not the rest of the state (about 19.6 million). Since my data is focused on the state-level numbers, this is frustrating; so close, and yet so far. I suppose I could extrapolate the numbers by multiplying each by 2.3x, but that doesn't work because the demographics are so vastly different between the two.

Anyway, for NYC itself, there's gobs of data-nuggety goodness to be found:

Regular readers may recall my thorough debunking of Sharyll Attkisson's ludicrous claim that only 3.4 million people out of the "38 million" who are "eligible for coverage under Obamacare" have actually received healthcare coverage since the law went into effect.

As I noted, these numbers were just a wee bit off. The "3.4 million" is actually more like "11.8 million", and while the "38 million" is actually reasonably close if you're only including those who were a) uninsured last year and b) who qualify for either Medicaid or tax credits via the ACA exchanges (more like 36.4 million), even this is stupid because no one in the Obama administration, HHS, CMS or the CBO ever claimed that all 36.4 million would be insured in the first year of the exchanges.

Some interesting ACA-related news items which aren't really state-specific...

Non-Profits want their status known on exchanges

Research has shown that consumers "do think there is a difference," between for-profit and not-for-profit health plans, says the head of an industry group. But in the final rule on health insurance exchanges, CMS has declined to require that tax-status be disclosed.

Nonprofit health insurance plans continue to dominate customer satisfaction and quality lists, and they want consumers to know about it.

Bruce McPherson, president and CEO of the Alliance for Advancing Nonprofit Health Care, says federal and state health insurance exchanges should do more to make the tax status of health plans readily available to consumers.

And this is kind of important, because at the same time...

Publicly traded insurers take bigger role in Obamacare's second year

COLORADO: Exchange COO joins exodus, new system late

Colorado’s 2.0 “Kentucky-style” system that is supposed to simplify the way people get health insurance won’t be ready until days before the Nov. 15 open enrollment starts.

And as Colorado’s health exchange enters its busy season, a third “chief” has announced she’s leaving Connect for Health Colorado. Chief Executive Patty Fontneau departed in August. Chief Financial Officer Cammie Blais left two weeks ago. And Chief Operating Officer Lindy Hinman announced her resignation and plans to leave next month after open enrollment begins.

VIRGINIA: Funds to help Va. health care coverage signups

Virginia is getting $9.3 million in federal funding to help residents sign up for health insurance.

Gov. Terry McAuliffe said the money will help hire more than 100 people to help with enrollment that runs from Nov. 15 through Feb. 15.

VERMONT: Federal Law Raises Questions About Who Can Bid For IT Projects That Support The Exchange

A provision of the Affordable Care Act precluding health insurers or companies in the “same controlled group of corporations” as a health insurer from holding exchange contracts raises questions about Optum working on Vermont Health Connect.

Concerns regarding Optum were raised at the federal level by Sens. Orrin Hatch, R-Utah, and Chuck Grassley, R-Iowa, the ranking members of the Finance and Judiciary committees respectively.

IDAHO: Your Health Idaho to launch sign-up system

Basically just an overview of the new Idaho ACA exchange; ID is the only state moving from HC.gov to their own website for the 2nd year, giving them a unique perspective. Most interesting to me is that they're spinning the "autonomy/states-rights" angle, which was the whole reason for pushing states to set up their own exchanges in the first place:

WASHINGTON: Health Exchange leaders are trying to solve the problems from the first sign-up period

CLARKSTON, WA – Leaders with Washington’s Health Care Exchange are preparing for the second open enrollment period, but at the same time they are still working on resolving billing and computer problems for 1,300 accounts from the first sign-up period.

IOWA: Three health insurers get OK to increase rates

This is very confusingly worded, because it makes it sound like all 3 companies have been operating on the HC.gov exchange when it turns out that only 2 of them have. Wellmark did not participate in the ACA exchange; the 19,000 customers referred to here have off-exchange policies which are still ACA-compliant:

Commissioner Nick Gerhart said today that he has approved premium increases from Wellmark Blue Cross and Blue Shield, CoOportunity Health and Coventry Health.

Some fun with numbers.

As I predicted in early September, Part Two of the "OMG!! GAZILLIONS OF POLICIES CANCELLED!!" freakout has commenced with 3 weeks to go before the election. Case in point: Colorado, where the state Insurance Commissioner sent a letter to "state Senate Republicans" yesterday (I'm going to assume that this was in response to their request, as opposed to the Commissioner voluntarily choosing to only inform the Republicans specifically) stating that a total of 22,000 policies are scheduled for cancellation due to non-compliance with ACA provisions:

Over 22,000 Coloradoans have had their health insurance canceled by Obamacare in the past month — and 200,000 are slated to be shut down in 2015, the state insurance department announced Friday.

The Colorado Division of Insurance wrote to state Senate Republicans Friday, notifying them that five more insurance carriers have ended plans for 18,783 more Coloradoans in just the last month. By far, the most canceled plans will come from Humana Insurance Company and Humana Health Plan.

When I last checked in on New Jersey back in June, their Obamacare Medicaid expansion tally was at around 229,000 people. This number has jumped to 343,000, out of around 466,000 NJ residents eligible for the program, or roughly 74%:

The 343,000-person expansion in Medicaid enrollment this year is nearly three quarters of the 466,000-person expansion-eligible population estimate by the Kaiser Family Foundation. But the 161,775 residents who enrolled through the marketplace are equal to just over one quarter of the estimated 628,000 eligible.

The other noteworthy thing here is that according to my own breakdown of the KFF estimates, New Jersey only has around 562,000 uninsured eligible for tax credits via the ACA, not 628K. However, this is mostly moot since those with insurance can also purchase QHPs via the exchange as well if they wish, so it's not really that big of a deal.

As for the 161,775 QHP figure, that dates back to last spring, so no update there.

A couple of days ago, in response to my debunking of Mitch McConnell's litany of lies about the Affordable Care Act, I posted a letter from a Kentucky resident who gave his view of the situation.

In response to thatanother Kentucky resident responded with a different perspective. Again, aside from cleaning up some typos and breaking it into more paragraphs for easier readability, I'm presenting it verbatim:

Mr. Gaba, I am also from Kentucky. I appeciate your fact checking of McConnell on the ACA and in most instances I would say that you are correct and he is not.

That said, I work in health care and we have also seen a boon in our bottom line due to decreased uncompensated care and bad debts. We are also in a poor county and almost 80% of the people were Medicaid recipients including some of my family members, so the ACA, at least in the short term has benefited us.

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