Over at Eclectablog, my friend Amy Lynn Smith has posted an eloquent, politely-worded open letter to newly-reelected Republican Michigan Governor Rick Snyder.
Her point is simple: While progressives may hate much of what he's done in his first term, unlike so many of his ultra-right wing nutbag colleagues, Gov. Snyder has at least shown the occasional moment of decency. Setting up a state-run ACA exchange for Michigan to ward off the fallout from a harmful SCOTUS decision on the King vs. Burwell case would be another such opportunity, which would play directly off of his successful (if belated) push to expand Medicaid for almost half a million Michiganders.
In my latest special entry over at healthinsurance.org, I've written a follow-up to my post from Thursday in which I concluded that the current number of ACA exchange QHP enrollments has probably dropped from the 7.3 million peak it hit in August down to around 6.8 - 7.0 million.
Conservatives from FOX News and Reason immediately pounced on this, of course.
Things have been so crazy this week between the horrific midterm election results and today's unexpected SCOTUS/King/Halbig announcement that once again, my in box is crammed full, so here's some quick takes:
"I definitely feel we need to expand Medicaid in South Dakota, I think it'll help a lot of people who really struggle with their healthcare costs, I think it'll help strengthen individuals in our society, people who are on Medicaid aren't just people who aren't working or don't do something to contribute to society, they're hard working people who had bad things happen to them from health reasons," Matt Barker said.
"I know it's going to be biased, but I think for the most part I think it's good to help families who do need that assistance," Jake Gourley said.
"I think what we're starting to see in some of the states that have already expanded it that there are more benefits than costs to it, it would be foolish for us not to expand it," David Starks said.
Things have been so crazy this week between the horrific midterm election results and today's unexpected SCOTUS/King/Halbig announcement that once again, my in box is crammed full, so here's some quick takes:
First up: PolitiFact debunks one big ol' steaming pile of crap:
...A chain email claimed that more than 214,000 American doctors are "opting-out of Obamacare exchange plans." That is based on a survey of a select group of doctors and even the makers of the survey said it can’t be extrapolated for the entire country. Further, of the doctors responding to the survey, 42 percent said they weren’t participating in marketplace plans because they were never asked to, not because they were "opting out."
The estimate is the result of a flawed methodology and a misreading of survey data. We rate the claim False.
Back in early July, I made a simple proposition which could conceivably mitigate the otherwise severe damage to the Affordable Care Act (as well as to the lives of millions of Americans, the entire healthcare industry and, indirectly, the entire U.S. economy) in the event that the Supreme Court ultimately rules for the plaintiffs in the federal Halbig/King cases.
I called it the "Denny's Grand Slam" solution (alternately the "$360 Solution" or the "GoDaddy Solution"...take your pick), which basically involved states which are currently having enrollments run through the federal exchange set up a bare-bones "exchange" of their own by essentially filing some simple paperwork, registering a domain name for $9.95 with a basic splashpage and then repointing the whole damned thing right back to Healthcare.Gov for the actual enrollment process.
The Healthcare Twittersphere is all abuzz today with the surprising news that the Supreme Court has agreed to take up the King vs. Burwell case regarding Affordable Care Act tax credits for people who enroll thorugh the federal exchange (Healthcare.Gov). (The King case is sort of the kid brother to the Halbig vs. Burwell case, but they're essentially about the same issue).
All sorts of people on both sides of the issue who are much smarter than I about the legal aspects of this case are furiously posting their take on what's likely to happen after the SCOTUS issues their ruling, which I understand wouldn't happen until sometime next summer (they've agreed to take up the case, but I don't think they start hearing arguments for a few months, and then they bop it around for awhile before issuing their final ruling).
Of course, even if the SCOTUS does rule for the plaintiffs in the end, it's very likely that they'll include a note that basically tells Congress "You know, there's an easy way to fix this; just go over section 1401 with a dab of liquid paper and revise the sentence to read "...enrolled in through an Exchange established by the State or the Federal Government" or whatever.
That would be a completely reasonable solution...if there was a snowball's chance in Hell that Congress would do so. Obviously the GOP would never let it go through (assuming that they hold the House and/or take over the Senate), so the clusterf*ck would ensue.
However, depending on what "established by" and "facilitates" are defined as (see section 1311 as referred to in the passage above), it seems to me that there's a different, equally simple (if utterly stupid) possible resolution which would cost no more than $358.20!
Yesterday, in my Big Exclusive Post® about the number of people currently enrolled in exchange QHPs appearing to have dropped down to a bit below 7 million, I noted that based on the 15 states for which I have current enrollment data from September or October (plus 1, Oklahoma, from August), it looks like the national total is right around 7 million on the nose at the moment. However, if you throw Florida into the mix, it drops noticeably, making it look more like 6.8 million.
I also noted that there are two problems with the Florida data: First, that it's had significantly more dropoff (22.5%) from the official April figure than any of the other states listed (with the exception of Nevada, which has had its own technical headaches to the point that it's dropping its exchange entirely).
Even more problematic is that this 22.5% "drop" was supposedly only as of June 30th (it comes from Florida's 2015 policy rate request filing report from the insurance companies operating on the federal exchange).
This makes Florida an incredible outlier; take another look at the chart:
I still stand by this, but an extensive discussion with Jed Graham of Investors Business Daily made me realize that presenting it this way can lead to confusion, because I'm essentially mixing together two different estimated numbers (% paid & attrition rate), each of which may vary widely from state to state, instead of simply comparing the number of people currently enrolled against the 8.02 million who had enrolled (whether paid up yet or not) as of April 19th.
