Just yesterday, the Urban Institute released a detailed analysis of Bernie Sanders's "Medicare for All" plan, which would actually be far more comprehensive than Medicare is, not just in terms of how many Americans it would cover (everyone!) and what percentage of costs it would cover (everything!) but also in terms of what ailments/services it would cover (all of them!).

Their conclusion was that such a policy would cost over twice as much as Senator Sanders claims (around $32 trillion over the next decade on top of what the federal & state governments currently spend, versus the $13.8 trillion that Sanders estimates). Their conclusion was even more expensive than the $24 trillion estimate from a prior analysis by Kenneth Thorpe (the guy who put together Vermont's failed single payer proposal a decade ago).

When UnitedHealthcare announced last month that they were making good on their threat last fall to pull out of the individual market in over two dozen states next year, it caused shockwaves across the health insurance industry. It is an important development, as around 800,000 people will be impacted.

When Humana announced last week that they plan on pulling out of the individual market in at least 5 states next year, it was interesting and a bit of a bummer, but not nearly as earthshattering, because only about 25,000 people will have to shop around and find a new carrier.

Today, it is my duty to announce that Celtic insurance has also decided to pull out of the entire individual insurance market (both on and off-exchange) across at least 6 states, including:

Given that Hillary Clinton has long supported a "public option" being included with the ACA and that she reiterated support for the public option (at the state level, since she recognizes that the odds of getting anything useful through a GOP-controlled Congress at the federal level is likely pretty slim) in late February, this piece by Sahil Kapur of Bloomberg Politics may seem like a nonstory:

At a campaign stop Monday in Northern Virginia, Hillary Clinton reiterated her support for a government-run health plan in the insurance market, possibly by letting let Americans buy into Medicare, to stem the rise of health-care costs.

After the dust settled on the 2014 Open Enrollment Period, I was ready to call it quits; my business had suffered greatly and I even came down with a nasty case of shingles due to working up to 16 hours a day tracking the crazy final weeks. However, many people asked me to keep things going, and thanks to the generosity of many people both here and over at Daily Kos, I was able to commit to covering the 2nd year of ACA open enrollment as well.

After the 2015 enrollment period ended, I was able to make arrangements to keep chugging along for a third Open Enrollment period.

Today, with the 2016 enrollment period several months behind us, I just realized that I completely forgot to mention that yes, I've once again made arrangements to keep at it for a fourth year: I'll continue to track ACA enrollments as well as related ACA/healthcare data developments (Medicaid, BHPs, premium rate hikes, etc etc) for another full year, through at least April 2017.

However, those arrangements only cover a portion of the time and effort it takes to maintain everything here at ACASignups.net...the Spreadsheet, the Graph, and especially the blog.

Some regular visitors have been very generous in the past, so I'm not directing this at them...but for those who haven't yet done so, and who appreciate the data, analysis and discussion here at ACA Signups, I'd greatly appreciate any donation you might be able to spare to help keep it operating.

On the one hand, the open enrollment period itself may seem to be getting almost...boring. Most of the technical issues have been worked out and people are getting more and more used to the process. Dramatic Supreme Court decisions like King vs. Burwell and Hobby Lobby are now behind us.

On the other hand, there's still the drama of the 2017 Rate Hikes, the future of the remaining 11 Co-Ops, the House v. Burwell court case (aka "King v. Burwell Jr."), the mystery of which carriers will pull out (or even jump in) to various states and all sorts of other fun (ok, not so fun) stuff.

Oh yeah, one more thing: This is a Presidential election year, and Donald Trump is almost certain to be the Republican nominee.

Imagine the possibilities.

On January 20, 2016, at exactly 12:23am, I posted my analysis of Bernie Sanders's so-called "Medicare for All" plan.

I'm a long-time single payer advocate (although I'm willing to accept something short of it). I've long admired Bernie Sanders as a Senator. And while I was generally leaning towards supporting Hillary in the primary, I was very open to being persuaded to Feeling the Bern. One of the big things which I was hoping would be the tipping point was Sanders's much-anticipated official Single Payer plan (as opposed to one of the earlier ones he had previously proposed in past years). This was supposed to be the culmination of 30+ years of single payer advocacy from a major presidential candidate who was making that proposal one of the cornerstones of his entire campaign. Expectations were high here, and if I had been impressed by the plan itself (even as a rough "white paper" outline), I was ready to jump on board.

I was not impressed.

I've writte a lot about the so-called "woodworker effect" with Medicaid expansion over the past 2 1/2 years: People who were already eligible for Medicaid before the ACA, but who never signed up for it for a variety of reasons (they didn't know they qualified; didn't know the process for signing up; were too embarrassed to do so; etc etc). I estimated about 3 million "woodworker" enrollees in 2014, although I downshifted that later on and now have the tally estimated at around 3.8 million nationally as of the end of 2015. That's a lot of people being added to the system who would have been eligible for Medicaid even if the ACA had never been passed.

Last week, a major report from the National Bureau of Economic Research confirmed what I've been saying all along (although their estimates are somewhat lower--around 2 million in 2014 plus an unknown number for 2015), which was written about in a feature story by Kimberly Leonard of U.S. News & World Report.

Huh. This is an unexpected but welcome and very specific tweet from the West Virginia Dept. of Health & Human Resources:

173,582 West Virginians are enrolled in Medicaid expansion as of Monday, May 9, 2016.

— WV DHHR (@WV_DHHR) May 9, 2016

I haven't written much about West Virginia, and the last time I addressed their Medicaid expansion data was way back in September 2014, when they hit around 150,000 enrollees...or 100% of the total number thought to be eligible for the program.

Either those estimates were off, or the economic situation has changed over the past year or two. It's also conceivable that the state has deliberately nudged some "traditional" Medicaid enrollees over to "expansion" status in order to save money (remember, the federal government only pays 74% of the cost of "traditional" Medicaid, but 100% of expansion, though this gradually drops to 90% over the next few years).

Last month I noted that, assuming I was reading Connect for Health Colorado's monthly dashboard report correctly, they were down to 115,890 effectuated exchange enrollees as of 3/31/16, or a whopping 23.1% lower than the official APTC report tally of 150,769 QHP selections as of the end of Open Enrollment.

Over the weekend, they released their April dashboard report, and the numbers are actually up slightly...which means that while the net drop compared to the OE3 number is still steep, it's also spread out over a 3 month period instead of 2:

Some of you may recall that a couple of months ago, I was asking for people to vote for a Netroots Nation 2016 panel with myself and 3 other healthcare experts having an all-out “Incremental Progress vs. Single Payer Now!” healthcare debate.

This subject seemed especially ripe for discussion especially given the massive brouhaha from back in January when I reviewed Bernie Sanders’s so-called “Medicare for All” proposal (which actually wouldn’t be Medicare at all, but that’s a different discussion), along with the raging debate which followed both here and across the blogosphere as well as mainstream media websites as well over the next month or so.

As I noted at the time, normally, all 90 panels are chosen by a NN committee, but this year they decided to leave 10 slots open to “public voting”, allowing anyone to create a NN account, log in and vote daily for their favorite panel.

Throughout last September and October, I chronicled the dominos-like downfall of a dozen ACA-created Co-Op insurance carriers. They tumbled, one by one, as a result of a perfect storm of problems, some of which dated back to the final version of the ACA which was signed into law; others which cropped up along the way:

Conrad's plan called for $10 billion of government grants distributed among nonprofit, member-owned health insurance startups. The money came with few restrictions. Competing against big for-profit insurers is difficult, Conrad said. The co-ops needed as much freedom as possible to ensure their survival.