*(OK, not really; I'm not the only one who was suggesting this, but it some people really do seem to think that I have dictatorial control over CMS...)

Some Guy, 11/22/15:

I guess the question here is just how much verification the HHS Dept. and/or the assorted state-based exchanges are doing of these claims. In cases like getting married/divorced, giving birth, becoming a citizen or getting out of jail, I would imagine the verification should be pretty easy. However, the "Tax Penalty Ignorance" exception was pretty much based on an honors system, and I don't know how easy/difficult it is for the feds to "verify" that your income has increased/decreased substantially...at least, not until you file your taxes the following year, which could be up to a year after the claim is made.

...So, what's the solution to this, assuming the problem is widespread? Well, I can think of some obvious tweaks to the rules, almost all of which involve simply reducing grace periods:

As far as I can tell, there are basically only 8 potential paths forward when it comes to the Affordable Care Act:

  • 1. It can be repealed and replaced with something worse, which is what many Republicans are proposing.
  • 2. It can be repealed and replaced with nothing at all, which is what other Republicans are proposing.
  • 3. It can be left exactly as is, which no one, to my knowledge, is proposing.
  • 4. It can be kept and mildly improved, which is what I was afraid Hillary Clinton was proposing until recently.
  • 5. It can be kept and substantially improved, which is what Hillary Clinton is now proposing.
  • 6. It can be kept and substantially improved, while also laying the groundwork for a series of gradual, longer term steps towards universal, comprehensive single payer (or similar) plan, which is what I'm proposing ("longer term" defined as 10-20 years, possibly longer).
  • 7. It can be kept in place for now (along with Medicare, Medicaid, employer-sponsored insurance, the VA/TriCare, etc.) but replaced in the short term ("short term" defined as "within the next 5 years"), which is what Bernie Sanders is proposing.
  • 8. It (along with Medicare, Medicaid, employer-sponsored insurance, the VA/TriCare, etc.) can be immediately replaced on January 20, 2017, which is what some Hillary supporters are trying to claim that Bernie Sanders is proposing, but which he isn't.

Again, Rhode Island is the only state to continue with regular, weekly exchange enrollment reports during the off season. I would love it if every exchange did this:

INDIVIDUAL AND FAMILY ENROLLMENT • As of February 20, 2016:

  • 36,004 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.
  • The majority of these individuals are 2015 HSRI enrollees that were auto-renewed into a 2016 plan.
  • 8,657 of the 36,004 individuals have selected a plan for 2016 coverage, and are new to HSRI this year or returning after being enrolled with HSRI at some point during a prior year.
  • 33,920* of the 36,004 individuals are enrolled in 2016 coverage through HSRI, and have paid their first month’s premium.

*The number of paid enrollments is expected to increase as payments for March coverage are made by today’s deadline and processed over the next several days.

At long last, the New York State of Health exchange has released their final 2016 Open Enrollment Period data! (thanks to Dan Goldberg for the heads up)

Actually, two of the data points (private QHPs and BHP enrollment) aren't very different from what I already knew. However, there's some interesting news on the Medicaid & Child Health Plus side:

Rate of Uninsured Drops to Lowest Level in Decades

ALBANY, N.Y. (February 23, 2016) - NY State of Health, the state’s official health plan Marketplace, today announced more than 2.8 million people have signed up for health insurance as of  January 31, 2016, the end of the 2016 open enrollment period.  Since the Marketplace opened in 2013, the number of uninsured New Yorkers has declined by nearly 850,000. According to recently released data by the Centers for Disease Control and Prevention, the rate of uninsured declined from 10 percent to 5 percent between 2013 and September 2015 and is at its lowest level in decades.

As I've noted before, one of the biggest hurdles to overcome when considering moving to Single Payer healthcare is that at least a half a million people currently work directly for health insurance carriers, plus (I'm guessing) another couple million in directly related services. While I do support moving to SP eventually, any plan which replaces the current private insurance industry would have to also take into account what would happen to those people.

A huge shout-out to Dan Diamond and Rachana Pradhan of Politico for breaking this story:

Clinton revives support for health care 'public option'

Hillary Clinton wants to bring back the public option, offering a competing vision to Bernie Sanders’ support for a more progressive health care system.

Clinton's campaign has updated its website to note her continued support for the government-run health plan that was dropped from Obamacare during the law's drafting. The idea was popular among progressives who prefer a single-payer plan -- like the one Bernie Sanders is touting.

...A new version of Clinton’s campaign website suggests she won't try to push the public option through Congress, but instead will work with governors using existing flexibility under Obamacare "to empower states to establish a public option choice." That may be a reference to a waiver program taking effect in 2017 that lets states assert greater control over their health care systems.

If she's serious about this, this could be very interesting indeed.

Thanks to Richard Mayhew for bringing this to my attention (and Arielle Levin Becker for the story):

About 8,000 CT exchange customers didn’t pay first bill

About 8,000 people who signed up for coverage through the Connecticut’s health insurance exchange missed the deadline for their first payment and lost coverage, exchange CEO Jim Wadleigh said Monday.

“This number is bigger than we were anticipating,” Wadleigh said. Just over 116,000 people signed up for private insurance through Access Health CT, the state’s exchange, during the open enrollment period that ended Jan. 31. “The fact that all these customers have not made their first payment was kind of a shock to even us.”

As I noted last week, Your Health Idaho has released their final official OE3 number. I had previously noted that there were only 8 states in which the exchanges appeared to have performed worse on private policy enrollment in 2016 than they did in 2015, and that most of those had special circumstances:

So, last year, after getting a chuckle out someone snapping up TedCruz.com and posting a pro-immigration reform message on it, I snapped up a few other variables which Senator Maple Leaf missed, such as TedCrooz.com, TedCruise.com and so forth. I figured I'd get a handful of visits from people misspelling his name, but I also kind of assumed that those people would instantly realize their error, seeing how the moment the site loads, it's pretty obvious that not only is this not Ted Cruz's campaign website, the whole site is the complete opposite of everything Cruz-ish...especially in regards to the Affordable Care Act.

Apparently I was wrong. It never fails to amaze me how utterly oblivious some people supporters are to the websites they're visiting. Check out the most recent missive I received over the weekend:

Sunday, February 21, 2016 - 3:56pm

Every year, at least since the ACA exchanges went into effect, insurers have been required to submit their plans and premium rates for the upcoming year to state or federal regulators months ahead of time, in order to allow time to review, modify and approve rates. Once Open Enrollment begins, it was my understanding that the specifics of the plans offered are supposed to be locked in for the full calendar year. In other words, no bait & switching allowed: If a certain plan was set to cost someone $300/month with a $2,000 deductible, 70% actuarial value, such-and-such co-pays and so forth, they aren't allowed to change those plan specs once the Open Enrollment Period begins, and they're required to stick to those prices and coverage specifics for the full upcoming year.

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