Regular readers may have noticed that this is my first blog entry in several days, which is unusual for me. I admit I've been mesmerized by the dramatic Trump/Ukraine/Impeachment saga which has exploded over the past few days.

I'm back in gear today, however, and I'm starting things off with my latest freelance piece over at healthinsurance.org. It's basically a summary explainer of where things stand re. 2020 ACA individual market premiums. As anyone who follows this site knows, the answer this year is basically...FLAT, at least nationally.

The irony of this, of course, is that the 800 pound gorilla in the room is the pending #TexasFoldEm lawsuit decision by the 5th U.S. Court of Appeals, which could potentially tear down the entire Affordable Care Act...and their decision in the case is expected to be released any time over the next five weeks...just ahead of the 2020 Open Enrollment Period.

Long-time readers may have noticed that, while I've obviously ripped on the Trump Administration a lot for the various ways they've screwed around with administration of the ACA over the past 2 1/2 years, there's a handful of actions they've taken which I haven't criticized them for...or at least, which I've been fairly circumstpect about being too critical about.

The biggest, and perhaps most surprising, of the latter is the Centers for Medicare & Medicaid (CMS) decision to shorten the offiical Open Enrollment Period (OEP) roughly in half, from three months (Nov. 1st - Jan. 31st) down to just six weeks (Nov. 1st - Dec. 15th). There's a couple of reasons for this.

First and foremost...the Obama Administration was already planning on shortening the period...it's just that they intended to make the change starting in 2018 instead of 2017. This is from February 2016, long before Trump even secured the GOP nomination:

Back in mid-June, the DC Health Benefit Exchange Authority posted the preliminary, requested average unsubsidized 2020 premium changes for the Individual and Small Group markets:

Overall individual rates increased an average of 9.0 percent and small group rates increased an average of 10.5 percent. In the individual market, CareFirst proposed an average increase of 7.7 percent for HMO plans, and 15.6 percent for PPO plans. Kaiser proposed an average increase of 5.0 percent. For small group plans, CareFirst filed average rate increases of 13.5 percent for HMO plans and 18.5 percent for the PPO plans. Kaiser small group rates proposed an average increase of 3.0 percent. Aetna filed for an average increase of 16.1 percent for HMO plans and 5.0 percent for PPO plans. Finally, United proposed an average increase of 13.0 percent and 7.4 percent for its two HMOs and 11.2 percent for its PPO plans.

This is what it looked like at the time:

via Becker's Hospital Review:

Cigna extended its individual healthcare exchange products for the 2020 plan year, the insurer said Sept. 18.

For 2020, individuals can purchase individual health plans in 19 markets across 10 states. The expansions will take place in counties in Kansas, South Florida, Utah, Tennessee and Virginia. The other states include Arizona, Colorado, Illinois and North Carolina.

The plans will be available for purchase on the individual marketplace during the 2020 open enrollment period, which begins Nov. 1. Plans will take effect Jan. 1.

via Bruce Japsen of Forbes:

I'm a bit late to the game on this due to being backlogged, but for the record (via Abby Goodnough of the NY Times):

Speaker Nancy Pelosi on Thursday released her long-awaited plan to curb soaring prices of prescription drugs, a political chess move that could prod the Senate to move and heat up congressional negotiations with the White House on a popular but elusive goal.

Ms. Pelosi’s plan, which she was to lay out at a morning news conference, would allow the government to negotiate the price of as many as 250 name-brand drugs for Medicare beneficiaries — an idea that many Republicans hate but that President Trump embraced during his 2016 campaign. Drug companies would also have to offer the agreed-on prices to private insurers or face harsh penalties, which could give the package broader appeal with voters.

Back in May, Maryland was the very first state to publicly release their preliminary 2020 individual and small group market rate change requests. For 2019, thanks to several laws passed by the state legislature and signed by Gov. Hogan, including a robust ACA Section 1332 reinsurance waiver program, instead of increasing by another 30%, premiums dropped by 13.4% this year.

For 2020, the preliminary rates looked pretty good: Average rates were expected to drop by around 3% or so.

Well, today the Maryland Insurance Department announced the approved rates for 2020...and it's even better than that:

I haven't written much about South Bend, Indiana Mayor and presidential candidate Pete Buttigieg. The biggest mention I've given him until now was back in March, when he stated that he's an advocate for a robust Medicare-like public option plan.

Today, however, "Mayor Pete," as he's come to be known, rolled out his official healthcare overhaul plan, and sure enough, it centers on...a robust Medicare-like public option. He calls it "Medicare for All Who Want It":

BECAUSE HEALTH CARE IS A HUMAN RIGHT, GUARANTEE UNIVERSAL COVERAGE THROUGH MEDICARE FOR ALL WHO WANT IT.

The Medicare for All Who Want It public alternative will help America reach universal coverage by providing an affordable insurance option to the currently uninsured. The public alternative will provide the same essential health benefits as those currently available on the marketplaces and ensure that everyone has access to high-quality, comprehensive coverage.

(Yes, that's my own selfie with Sen. Warren from Netroots Nation, July 2014)

A few months ago, I noted a rather jarring shift in Sen. Elizabeth Warren's rhetoric when it comes to achieving universal heatlhcare coverage between her CNN Town Hall in March and her first official Presidential Debate appearance in late June.

In March, she gave a detailed, thoughtful, 5-minute answer which mentioned the importance of protecting the Affordable Care Act from Trump & the GOP's sabotage, including specifically calling out the looming #TexasFoldEm lawsuit which threatens to wipe out the entire law.

DISCLAIMER: ACASignups.net has a long-term paid banner ad arrangement with The Robert Wood Johnson Foundation.

I spent most of the past month knee-deep in combing through the Medical Loss Ratio rebate filings of thousands of health insurance carriers. Now, the Robert Wood Johnson Foundation has made it much easier to keep track of which of those carriers are participating in the ACA individual market:

Interactive tracker helps tell the story of insurer participation in the ACA market.

The seventh open enrollment season is almost upon us, and all signs point to growing stability, as measured by moderate premium increases and increased participation by health plans. The tracker shows the change over time in participation at the county level, and allows users to follow individual companies or categories of health insurers. The data reveal a business narrative that has been closely intertwined with the political story of the Affordable Care Act (ACA) marketplace.

Back in July I posted the written Congressional testimony of my friend Rebecca Wood. Rebecca is a staunch "Medicare for All" advocate whose daughter Charlie has complex medical issues.

Today, I'd like to present a Twitter thread by another friend I've met online, Lori, who also has a daughter with complex medical needs named Savannah. While their children both have serious medical issues which need constant care, Lori has a slightly different perspective on the issue of the best route towards achieving universal coverage. This was all in response to my own tweet, which was in response to a comment by Parker Malloy about people who "love" their private insurance:

Who are these people some candidates speak of who just absolutely love their insurance? https://t.co/JD3IEy1Kk9

— Parker Molloy (@ParkerMolloy) September 18, 2019