About a month ago I wrote a flow chart, of sorts, explaining the different potential permutations of the absurd Texas vs. Azar (aka Texas vs. U.S., aka #TexasFoldEm) lawsuit which threatens the entire Affordable Care Act. Since then there's been a few more developments (actually, a few more non-developments), the timing of which change the potential landscape a bit.

Sometime this morning the Supreme Court is expected to announce whether they'll intervene in the case:

Hey everyone! The Supreme Court may announce at at 9:30am today its decision about whether to take the big Affordable Care Act case.
If it says yes, it'll hear argument in the fall (around the election!). If it says no, it'll take another three years or so to get a final answer.

— Nicholas Bagley (@nicholas_bagley) March 2, 2020

Here's the catch, though:

If yes, they'll HEAR the case in the fall...but when would they announce their *decision*?

NOTE: Michigan's Democratic Presidential primary isn't until March 10th, a week after Super Tuesday. With that in mind, I was planning on waiting until after it passed before announcing my own decision. After Joe Biden blew the doors off everyone in the South Carolina primary, however, I've decided to move up my announcement, because it looks pretty clear that there's only three possible ways things can go now: A Bernie victory, a Biden victory or a bonkers contested convention where anything goes.

When I supported Elizabeth Warren for the first half of 2019 (mostly...I never formally endorsed her but was 90% of the way there), I did so with the understanding that, if elected, her actual administration would be more restrained in governing than her official policy positions would indicate (it would have to be due to the nature of Congress)...and I was fine with that.

I knew that Warren knows enough about how the sausage is made to understand that you can only move the Overton Window so far before you end up achieving nothing at all. She gave what I felt was a pitch-perfect response to the question of achieving Universal Healthcare at a CNN Town Hall in March 2019:

Last March I wrote an analysis of H.R.1868, the House Democrats bill that comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or make improvements in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

Last March I wrote an analysis of H.R.1868, the House Democrats bill that comprises the core of the larger H.R.1884 "ACA 2.0" bill. H.R.1884 includes a suite of about a dozen provisions to protect, repair and strengthen the ACA, but the House Dems also broke the larger piece of legislation down into a dozen smaller bills as well.

Some of these "mini-ACA 2.0" bills only make minor improvements to the law, or make improvements in ways which are important but would take a few years to see obvious results. Others, however, make huge improvements and would be immediately obvious, and of those, the single most dramatic and important one is H.R.1868.

The official title is the "Health Care Affordability Act of 2019", but I just call both it and H.R.1884 (the "Protecting Pre-Existing Conditions and Making Health Care More Affordable Act of 2019") by the much simpler and more accurate moniker "ACA 2.0".

SHOT (if you can afford one):

!! Azar refuses to promise a coronavirus vaccine will be affordable for anyone:

"We would want to ensure that we work to make it affordable, but we can't control that price, because we need the private sector to invest.. Price controls won't get us there."

— Michael McAuliff (@mmcauliff) February 26, 2020

CHASER:

If the U.S. Preventive Services Task Force recommended a coronavirus vaccine, the ACA would require that all insurance plans cover it with no patient cost-sharing. (That wouldn't apply to short-term plans expanded by the Trump administration, which do not comply with ACA rules). https://t.co/OK7SOm22Wh

— Larry Levitt (@larry_levitt) February 26, 2020

Last October I noted that the state of Colorado had released a report on the latest evolution of their impending State-based Public Option addition to their ACA exchange. At the time, the key specs included:

• The "State Option" plans are supposed to be available via Connect for Health Colorado starting in 2022 (i.e., they'd enroll starting in November 2021)
• They expected average premiums are expected to be around 9 - 18% lower than similar policies offered by other carriers
• Hospitals would be reimbursed at rates ranging from 175 - 225% of Medicare rates

Here's where it got more interesting:

For years now, I (along with many others) have criticized Bernie Sanders for the big blank section of his "pure" Medicare for All single payer healthcare proposal. He's kind of, sort of given some ideas about how he proposes paying for it in the past, but yesterday he finally released an updated, revised list of additional taxes, loophole cuts and so forth which he claims would cover the total cost.

Since I've given him so much grief before, and since I did a detailed write-up about Elizabeth Warren's proposal last fall, I owe him some coverage of his new pay-for proposal as well. Let's take a look:

According to a February 15, 2020 study by epidemiologists at Yale University, the Medicare for All bill that Bernie wrote would save over $450 billion in health care costs and prevent 68,000 unnecessary deaths – each and every year.

Back in early January I noted that the DC Health Link had reported having 18,611 people enrolled in ACA individual market policies as of January 5th. DC's official deadline wasn't until January 31st, however, and even then they bumped it out by an additional five days (thru January 5th).

Unfortunately, they haven't issued an official final enrollment report yet, but I've been able to get the top-line numbers from an audio recording of their monthly executive board meeting on February 12th:

If you read through the transcript carefully, it boils down to this:

“The economy, stupid” is a phrase coined by James Carville in 1992. It is usually mistakenly rendered as “It’s the economy, stupid.” Carville was a strategist in Bill Clinton’s successful 1992 presidential campaign against incumbent George H. W. Bush. His phrase was directed at the campaign’s workers and intended as one of three messages for them to focus on. -- Wikipedia

The latest Kaiser Family Foundation tracking poll (considered the gold standards when it comes to national polling on healthcare policy issues) is out, and it's findings aren't terribly surprising to anyone who's been paying attention:

This Just In from the NY State of Health ACA exchange:

Press Release: NY State of Health Announces Record High Enrollment More than 4.9 Million New Yorkers Enrolled

• One in four New Yorkers enrolled through NY State of Health
• Enrollment through the Marketplace increased by over 150,000 from last year

ALBANY, N.Y. (February 20, 2020) - NY State of Health, the state’s official health plan Marketplace, today announced that over 4.9 million people, more than one in four New Yorkers, signed up for health coverage through NY State of Health during this year’s Open Enrollment Period. With an increase of 150,000 people over 2019, enrollment is at a record level, including more than 1 million people enrolled in Qualified Health Plans and the Essential Plan. Marketplace enrollment growth is consistent with New York’s declining uninsured rate, which reached a historic low of 4.7 percent. Open Enrollment ran from November 1, 2019, through February 7, 2020.