I wrote a lot about Matt Bevin during the Kentucky gubernatorial campaign last fall, as well as after he won the election, was sworn in as governor, and started doing his best to screw up stuff which wasn't broken. As you'll recall, when it came to the Affordable Care Act and the state ACA exchange (kynect), Bevin originally promised that he was going to kill the kynect exchange completely (even though there's no reason to do so, it's been operating smoothly for years and has excellent branding in the state) as well as killing the ACA Medicaid expansion (even though, again, it's been a huge success in the state at no cost to them so far and only pennies on the dollar going forward).

Well, as Jeffrey Young notes over at the Huffington Post, it turns out that Bevin can't even screw over hundreds of thousands of people properly:

Kentucky has turned into the place where Obamacare repeal rhetoric meets Obamacare repeal reality. Reality is winning.

Snarky headline aside, I a shout-out to contributor "dee" for this heads up:

H&R Block says health care law fines have more than doubled

Many people who went without health insurance last year are now seeing fines more than double under President Barack Obama’s health care law, H&R Block said Tuesday.

The Kansas City-based tax preparation company said that among its customers who owe a penalty for the 2015 tax year, the average fine is $383. That compares with $172 for 2014, the company said in a report that marked the halfway point in the current tax season.

The Kaiser Family Foundation actually issued this report a few days ago, but I'm a little swamped lately:

Assessing ACA Marketplace Enrollment

As of the end of the third open enrollment under the Affordable Care Act (ACA), 12.7 million people had signed up for coverage in the health insurance marketplaces, up from 11.7 million last year and 8.0 million in 2014.

Actual enrollment will end up somewhat lower than this because some people will not pay their premiums or will have their coverage terminated due to inconsistencies on their applications, and there is typically additional attrition as the year progresses (e.g., as some enrollees get jobs with health benefits). For example, in 2015 paid enrollees totaled 10.2 million as of end of March and 9.3 million as of the end of September. If a similar pattern holds, actual enrollment should end 2016 over 10 million, which was the target established by the Department of Health and Human Services (HHS). (There are reasons to believe that attrition may be lower this year, including the fact that terminations occurring during open enrollment have already been subtracted from official signup figures, which was not the case previously.)

While enrollment is in line with the HHS target announced in advance of this year’s open enrollment, it is short of earlier projections by the Congressional Budget Office (CBO), which became an implicit yardstick for judging the law. In March 2015, CBO projected average monthly marketplace enrollment of 21 million in calendar year 2016, though recently lowered that forecast to 13 million.

In this analysis, we look at why enrollment may be lower than projected by CBO and discuss the potential for future enrollment growth.

Dylan Matthews, Vox, 1/28/16, regarding the cost savings BERNIE SANDERS claims are possible:

In a phone call, [Sen. Sanders's policy director Warren] Gunnels explained the $1.1 trillion gap. It comes down to five factors:

  • ...Sanders assumes $324 billion more per year in prescription drug savings than Thorpe does. Thorpe argues that this is wildly implausible. "In 2014 private health plans paid a TOTAL of $132 billion on prescription drugs and nationally we spent $305 billion," he writes in an email. "With their savings drug spending nationally would be negative." (Emphasis mine.) The Sanders camp revised the number down to $241 billion when I pointed this out.

...When I pointed out that the yearly savings numbers they were presenting on prescription drugs were literally impossible, the Sanders camp revised the number to $241 billion — huge and arguably implausible but not larger than total annual spending on prescription drugs.

6/10/16: REPOSTED FROM THE ARCHIVES AS A REMINDER.

Yes, this is off topic. No, I don't care tonight.

Yes, the entire Republican debate was a revolting, disgusting, putrid embarrassment from start to finish (with the odd exception of the moderators from FOX News, who actually did a great job).

However, forget about the discussion of Donald Trump's penis size which opened the evening (no, I'm not making that up, and no, it's not a metaphor).

There are only two parts of the travesty which deserves any attention whatsoever. First, this exchange:

In Michigan, 15,000 children and pregnant women poisoned by lead and other toxic chemicals in their water supply from penny-pinching austerity measures by Republican Governor Rick Snyder and his GOP colleagues in the state legislature are finally being enrolled in Medicaid. So, you know, yay.

In Oklahoma, meanwhile, 111,000 dirt-poor adults (mostly women) are being kicked to the curb thanks to...penny-pinching austerity measures by Republican Governor Mary Fallin and her GOP colleagues in the state legislature:

Just how grim the state’s budget situation has become was apparent Wednesday morning as the state House of Representatives discussed and ultimately agreed to a bill that would cut 111,000 Oklahomans, most of them women, from Medicaid.

While giving his big ACA speech in Milwaukee, Wisconsin a little while ago, President Obama mentioned a few key data points: 129 million people with pre-existing conditions being protected, 140 million people who were already insured having free preventative care added, etc etc.

He also dropped one really big new number: 20 million.

That's the net increase in the number of Americans who the HHS Dept. of the United States says have gained coverage (either via ACA exchange policies, Medicaid expansion or the ACA's provision requiring policies to allow young adults between 19 - 26 years old to say on their parents plans).

The official ASPE report breaks it out as follows:

Even as I type this, President Obama is giving a big speech in Milwaukee, Wisconsin to congratulate them on winning the White House 20 City ACA Signup Challenge.

He was introduced by a man named Brent Brown, who had sent a letter to the President last June (I've expanded the letter itself to include the full text):

In June, I wrote this in a letter to the President:

To My President,

I sincerely hope that this reaches you, as far too often praise is hard to come by. Apologies to people who deserve it perhaps even less so.

I did not vote for you. Either time. I have voted Republican for the entirety of my life.

I proudly wore pins and planted banners displaying my Republican loyalty. I was very vocal in my opposition to you–particularly the ACA.

Andy Slavitt, acting administrator for the Centers for Medicare & Medicaid, just announced that CMS has authorized expanding Medicaid to 15,000 children and pregnant women in Flint, Michigan, as well as expanding the services provided to 30,000 current Medicaid enrollees. Here's the full press release (emphasis mine): 

HHS Approves Major Medicaid Expansion for Flint

FLINT, Mich. – Today, the U.S. Department of Health and Human Services announced that the Centers for Medicare & Medicaid Services (CMS) has approved the State of Michigan’s 1115 demonstration to extend Medicaid coverage and services to Flint residents impacted by the lead exposure. In recognition of the public health crisis in Flint, it is a top priority for the Administration and for the Department to ensure that all children and pregnant women exposed to lead in their water in Flint have access to the services they need.  Approximately 15,000 additional children and pregnant women will be eligible for Medicaid coverage and 30,000 current Medicaid beneficiaries in the area will be eligible for expanded services under this new waiver agreement.

“Expanding Medicaid coverage to tens of thousands of expectant mothers and youth means the most vulnerable citizens served by the Flint water supply can now be connected to a wide range of needed health and developmental services, including lead-blood level monitoring and behavioral health services,” said HHS Secretary Sylvia M. Burwell.

Michigan will expand Medicaid coverage to children up to age 21 and pregnant women who were served by the Flint water system from April 2014 up to a date specified by the Governor, and who have incomes up to 400 percent of the federal poverty level (FPL).  Michigan will also set up a state program allowing pregnant women and children up to age 21 who were served by the Flint water system and individuals with incomes above 400 percent of FPL to purchase unsubsidized coverage.  This comprehensive health and developmental coverage includes lead-blood level monitoring and behavioral health services, among other services.

So, yesterday evening, Donald Trump finally released his "terrific" healthcare plan to replace the ACA. I started to write up a full deconstruction of it, point by point...

Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare.

Translation: Since March of 2010, nearly 18 million additional Americans have gained healthcare coverage, while nearly 14 million jobs have been added to the workforce.

This legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan President in American history...

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