In 2014, the overall average premium payment rate for those who selected a Qualified Health Plan (QHP) from the various ACA exchanges ended up being around 88% nationally. This varied from state to state and company to company, but in the end it was roughly 88%.
In 2014, the overall average net monthly attrition rate ended up being roughly 3% per month (by net, I mean after taking into account both new people enrolling during the off-season and existing enrollees dropping their coverage). Based on this, here's what the 2014 exchange enrollment looked like (click image for full-size version):
The whole fuss and bother at the heart of the King v. Burwell case centers around this subsection of the Patient Protection and Affordable Care Act:
(2) (a) the monthly premiums for such month for 1 or more qualified health plans offered in the individual market within a State which cover the taxpayer, the taxpayer's spouse, or any dependent (as defined in section 152) of the taxpayer and which were enrolled in through an Exchange established by the State under 1311 [1] of the Patient Protection and Affordable Care Act
The short version of the plaintiff's argument, of course, is that supposedly this means that federal tax credits are kosher for individual states which "established" their ownexchanges (16 states plus the District of Columbia) but not for the remaining 34 states, since they're being run by the federally-"established" exchange.
The government's defense, of course, is that there's like a half-dozen other places throughout the law which make it pretty damned clear that tax credits should be kosher for states run through the federal exchange as well:
Every once in awhile I'm accused of being a little too blunt. As a blogger, I'm presumably not under the same "professional standards" of language and protocol as, say, the New York Times, the Associated Press or the U.S. Congress.
That's why it came as quite a relief to me to read this quote from an AP story in the New York Times this morning, which sums up the Republican Party's quandary pretty succinctly:
"If you win the case you actually have people who lost their insurance. You now share the responsibility for fixing it," said former Rep. Tom Davis, R-Va., who once led the House GOP campaign committee. "And you've got a lot of pissed off people. That hurts you."
Actually, the main angle of the AP story is that the King v. Burwell case has supposedly now turned into the old Life Cereal TV commercial. You know the one:
Whenever I post about King v. Burwell, I have a tendency to lump all 34 states together into collective numbers (around 6.5 million losing their tax credits, plus another couple million being priced out of the market due to the resulting premium spikes, plus another 4-5 million having to pay through the nose to keep theirs).
Next, I assume my standard 88% payment rate. Ironically, the higher this percentage is, the more people who could actually get royally shafted by a King plaintiff win.
NOTE I posted a partial version of this entry last night, then yanked it overnight in order to think about whether it was a valid concern or simply the same sort of click-bait headline hysteria that I've criticized other sites for posting.
After thinking it through, I"ve decided to go ahead and post a modified version with a bit of additional context and a less panicky headline. Think of it as more of a legal thinking exercise than anything else...but at this point, anything is conceivable.
For months now, I and many others have been sounding the warning bells re. the absurd King v. Burwell ACA case, currently awaiting a decision by the Supreme Court.
MNsure survived the legislative sessionwithout major changes. Some Republicans wanted to scrap the state's health insurance exchange altogether and some Democrats wanted to make it a state agency.
By some accounts, MNsure's performance has greatly improved since it's rocky 2013 roll out.
MNsure CEO Scott Leitz is leaving his position to work for a health care think tank. He took over the program after its first executive director resigned under fire.
The state Senate overwhelmingly adopted major health care changes Thursday in a bipartisan vote that reins in some facility fees, looks to development of a health information exchange to guarantee the sharing of patient data and aims to keep private physician practices in business.
But a new study casts doubt on that theory and suggests Obamacare’s bet may indeed pay off. The study, published in Health Affairs by John Romley, Dana Goldman and Neeraj Sood, found that hospitals’ productivity has grown more rapidly in recent years than in prior ones. Hospitals are providing better care at a faster rate than growth in the payments they receive from Medicare, according to the study.
A new healthcare reform debate may be on the horizon. Democrats refer to the issue at hand as the nation's "underinsured" population, reported the Associated Press.
Of course, when you throw in the missing tax season SEP / off-season enrollments, the actual total should be closer to 12.4 million or higher, and should finally reach my personal Open Enrollment Period target of 12.5 million by the end of May.
Well, it's a week later, and I'm feeling confident enough (especially with the support of new data out of California) to state that the actual total number should indeed have passed the 12.5 million mark nationally sometime over Memorial Day weekend (or today at the latest, since most exchanges were closed for the holiday).
One of the Big ACA Stories today is Robert Pear's piece in the New York Times about the origin/history of the infamous "...established by the state" wording in the Affordable Care Act which is at the heart of the impending King v. Burwell Supreme Court decision (now just 1 month away from the expected announcement):
...The answer, from interviews with more than two dozen Democrats and Republicans involved in writing the law, is that the words were a product of shifting politics and a sloppy merging of different versions. Some described the words as “inadvertent,” “inartful” or “a drafting error.” But none supported the contention of the plaintiffs, who are from Virginia.
Pear goes on to interview and quote various former/current members of Congress and their staff--both Democrats and Republicans alike--all of whom give the same response:
