Charles Gaba's blog

On the one hand, I always thought that reducing healthcare spending was supposed to be a good thing. On the other hand, apparently to most economists, increasing spending overall is supposed to be a good thing. So...um...ok, then:

WASHINGTON (Reuters) - The U.S. economy likely grew at a much faster pace in the second quarter than previously estimated, according to data on Thursday that showed a big jump in healthcare spending.

The Commerce Department's quarterly services survey, or QSS, showed healthcare outlays increased at a much brisker clip than the government had assumed in its last estimate of gross domestic product in late August.

As a result, economists said healthcare spending could add as much as three-tenths of a percentage point to second-quarter GDP growth, taking it to as high as a 4.7 percent annual rate.

It's been awhile since I've beaten up on Mitch McConnell (R-Yertle) for his cognitive dissonance when it comes to somehow keeping "Kynect" (ie, the Affordable Care Act) while simultaneously repealing "Obamacare" (ie, the Affordable Care Act).

As I noted back on May 29th, "McConnell is utterly full of crap. He knows it, Grimes knows it, the Kentucky media knows it; he's just hoping that the voters of Kentucky are too stupid to know it."

At the time, the Kynect ACA exchange had enrolled around 413,000 people. Since then, the number of Kentuckians enrolled via "Obamacare" has risen to over 521,000 (and even that was over a month ago; it's likely past the 550K mark by now).

Back in May, California was contending with a whopping 2.2 million new Medi-Cal (Medicaid) enrollees being added to the system. The logjam resulted in a backlog of 900,000 people.

By July 23rd, the backlog had been reduced by 1/3 to 600K. By August 20th, it was down to 490K. And today, Health Access CA reports that...

Pending backlog now down to 350,000 Medi-Cal applicants (from 900,000)--from the DHCS Medi-Cal Stakeholders Advisory Committee. #ACA #HCR

— Health Access CA (@healthaccess) September 11, 2014

Still a long way to go, but they're getting there...

An Open Letter to Democratic U.S. Congressional Candidates:

As I've noted before (and as others, such as Greg Sargent of the Washington Post have confirmed), when it comes to the Affordable Care Act, the Republican Party has been reduced, at this point, to literally running against the word "Obamacare" instead of the actual law itself.

By this point in the 2014 campaign cycle, those of you with any sense have moved from running away from the Affordable Care Act to going on offense by not only defending the law but actively pointing out the benefits that it's bringing to your constituents (or at the very least actively countering bald-faced lies about it from your opponent).

Of course it would've been even more "win, win, win all around" if they'd just done this 9 months ago, but I'll take it...

The Obama administration has agreed in concept to Utah’s novel alternative to expanding Medicaid, including the notion that able-bodied people who get insurance subsidies should accept the state’s help with finding work, Gov. Gary Herbert said late Tuesday.

The governor said after a meeting with Sylvia Burwell, secretary of the Department of Health and Human Services, that a final agreement is two or three weeks away.

HHS did not agree that insurance subsidies would be contingent on recipients holding a job or looking for work, but the agency did agree that employment can be a goal of Utah’s program, Healthy Utah.

"It’s a win, win, win all the way around," the governor said, describing the negotiations as resulting in federal approval of 95 percent of his Healthy Utah plan.

The estimate of how many Utahns would be eligible ranges from 54K - 75K; I have it down as 61K, right in the middle.

Michigan's ACA expansion program has understandably slowed down, adding only 2,573 more people over the past 2 weeks, but it still deserves kudos for breaking 75% of the total Michiganders eligible (500K) in only a bit over 4 months.

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 375,744
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of September 8, 2014 
*Updated every Monday at 3 p.m.

This is very good news all around. Not only is a 3% increase pretty small, it's a dramatic reversal of typical increase prior to the ACA kicking in in 2010:

Menlo Park, Calif. – Average annual premiums for employer-sponsored family health coverage reached $16,834 this year, up 3 percent from last year, continuing a recent trend of modest increases, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2014 Employer Health Benefits Survey released today. Workers on average pay $4,823 annually toward the cost of family coverage this year.

This year’s increase continues a recent trend of moderate premium growth. Premiums increased more slowly over the past five years than the preceding five years (26 percent vs. 34 percent) and well below the annual double-digit increases recorded in the late 1990s and early 2000s.  This year’s increase also is similar to the year-to-year rise in worker’s wages (2.3 percent) and general inflation (2 percent).

There's a whole section which goes into the impact of the ACA on this trend:

Alien Autopsy

Contributor ArcticStones forwarded this to me. I'm not in a position to either confirm or debunk many points in this article, but a quick search of this site for "Massachusetts Limbo" will bring up a number of references made in it. The author is a quite open Republican activist. However, if his claims are correct--and the bulk of them certainly seem to be--then those in charge of the first version of Massachusetts' ACA exchange should be held accountable for some rather appallingly bad decisions before, during and after the 2014 open enrollment period.

I generally support the Affordable Care Act, and states like Kentucky, Connecticut and (for the most part) Washington State, New York, Rhode Island and Colorado have proven that when the technology, budget, personnel and other project aspects are handled properly, it can be extremely successful. However, that also means not turning a blind eye or blaming the wrong source when things go wrong...and in the case of states like Oregon and Massachusetts, things did indeed go very, very wrong.

I've been shouting from the rooftops that auto-renewing your ACA policy is a bad idea, for a variety of reasons, since at least June.

Now it turns out there's another good reason to read the fine print before just blindly renewing (and this is a Good Thing®):

The benefit packages of lower-cost bronze and silver-level health plans — sold through the state's health insurance exchange — aren't as expensive as they might seem at first, they say.

Carolina Coleman, the project's research director, and John Connolly, the nonprofit's deputy director, say that many consumers who focus only on their high deductibles may be missing some gems hidden in their existing policies.

...With out-of-pocket costs rising, Weinberg of the Bay Area Council says, patients need to take a more active role in navigating their benefits.

In The Hill yesterday, Elise Viebeck posed 5 reasonable questions about the upcoming 2nd Open Enrollment period, set to run from 11/15/14 - 2/15/15:

  • Is HealthCare.gov ready?
  • Are three months enough?
  • What are consumers hearing?
  • What about cancelled plans?
  • Who will take the fall for problems?

Fair enough. I have my own questions to add to these, however:

Will the House GOP Commerce & Energy Committee finally admit that yes, around 90% of all QHP enrollees are actually paying for their first month's premium?

Will Avik Roy finally admit that yes, the majority of QHP enrollees are newly enrolled?

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