NOTE: I've asked Nicholas Bagley, law professor at the University of Michigan, to chime in to make sure I have everything below correct. I'll post an update if I have any of the details wrong.
UPDATE: OK, I've heard back from Bagley; he confirms that yes, I have it right:
"Yes [you have it correct]. Because of the Byrd rule, the big risk isn't legislative repeal...There are two real risks. First, that the individual mandate is repealed, destabilizing the DC exchange....Second, that Trump changes the OPM rule enabling the feds to cover the costs of congressional insurance."
This is section 1312(d)(3)(D) of the Affordable Care Act. The so-called “Grassley Amendment” says that members of Congress and their staff may only get their health insurance through the exchange or on the individual market. No Federal Employees Health Benefit Plan for them!
Republicans will first have to overcome a revolt from Senator Rand Paul on unrelated budget issues, with the Kentucky Republican saying Tuesday in an interview he would oppose the budget resolution because it adds significantly to the deficit.
"It never gets to balance. Not in 10 years, not in 100 years, not in 1,000," Paul said.
Justin Kloski learned that he qualified for Medicaid under the worst of circumstances. The student and part-time lawn-company worker had lost 20 pounds, could not shake a nagging cough and was sleeping 14 hours a day when he decided to visit a clinic in Muncie, Ind., that provides free care for the poor and uninsured. A clinic employee invited Mr. Kloski, now 28, to apply for Medicaid.
A few days later, he took his new coverage to the emergency room at IU Health Ball Memorial Hospital in Muncie. A CT scan found a 15-centimeter tumor in his chest, so big it was pressing on his windpipe. In May 2015, he learned he had Hodgkin’s lymphoma, a form of cancer that is curable if caught early.
The Affordable Care Act, and Governor Pence’s decision to go against many other Republican governors and expand Medicaid under the law, may well have saved Mr. Kloski’s life.
A definitely-NOT-comprehensive selection of opinions regarding the Republican Party's imminent "Repeal & Delay" strategy for the Affordable Care Act:
What outside experts are saying about repeal and delay:
American Academy of Actuaries: “Repealing major provisions of the ACA would raise immediate concerns that individual market enrollment would decline, causing the risk pools to deteriorate and premiums to become less affordable. Even if the effective date of a repeal is delayed, the threat of a deterioration of the risk pool could lead additional insurers to reconsider their participation in the individual market.” [Letter to Congress, 12/7/16]
Nick Gerhart (Iowa Republican Insurance Commissioner): “If you're going to repeal this, I hope that there's a replacement stapled to that bill.” [NPR, 11/21/16]
It's New Year's Day, so I figured I should indulge in a little year-end navel-gazing by looking back and seeing which posts generated the most traffic throughout the year. There's a good chance that this site won't survive the new year anyway, so what the heck.
Below is a daily traffic graph showing the days with the biggest traffic spikes, along with the specific stories driving those spikes. I hope you don't mind, but I'd rather not post the actual numbers involved publicly.
As you can see, in 2016, there were 5 stories in particular which captured tons of traffic:
Every month I post an entry about the official CMS Medicaid enrollment report, documenting the increase in Medicaid enrollment since ACA expansion went into effect. The numbers were increasing dramatically every month for nearly two years, but started slowing down last fall as most of the expansion states started maxing out on their eligible enrollees. I wrote about the August 2016 report back on 11/20, and normally would be writing about the September report today. Instead, however, I'm skipping right past September, because the preliminary report for October was just released today:
UPDATE: Denis Byron, in the comments below, claims that Ryan Cooper's story (and therefore, mine) is "incredibly deceptive" and that I should be "ashamed" of myself for basing this entry on it. I've contacted Cooper about Byron's claims and will update the article if Cooper responds. Byron is correct that I am by no means a Medicare expert, so I'll leave it at that for the moment.
UPDATE 12/31: A few folks in the comments have noted that a) pre-existing condition denials aren't an issue for most group policies even without the ACA and b) some of the professions listed below don't appear to belong on the list since those groups should be guaranteed coverage anyway (ie, the VA/TriCare for those in the military; members of police/firefighter unions and so on). Both KFF and I have already addressed the first point (yes, they're covered now but if they lose their job for any reason they'd likely be screwed; thus, the "...if they were to lose their current coverage" caveat). As for the second one, I've asked Larry Levitt & Cynthia Cox of the KFF to clarify.
Update 12/31: I've received clarification from Larry Levitt re. the 2nd criticism: "I suspect insurers were mostly being overly cautious just in case. Active duty military would be covered otherwise. Police and fire generally would, but possibly not in small towns or volunteer firefighters."
Remember, the ACA's Medical Loss Ratio rule (80% of all premiums have to go towards actual healthcare, leaving only a 20% maximum margin for administrative/operational costs) already does a pretty good job of keeping carriers from outright gouging enrollees...although that only comes into play when the carriers would otherwise be spending less than 80% on healthcare claims. In cases where they're already spending more than 80%, it's kind of moot...and for the past couple of years, many carriers are at 100% or higher, which is the main reason some of them are pulling out of the market next year in the first place.
In other words, unlike other "retail" markets where more competition is generally considered to automatically help keep prices down, there's only so much that more players can do in the individual health insurance market. If everyone is already losing money, adding one more to the mix isn't gonna make anyone else drop their rates further.
