Samaritan Ministries is an organization of devout Christians who eschew traditional health insurance to pool their money and cover each other’s catastrophic medical bills. It’s one of the very last mutual aid societies in the U.S., in which a community of individuals with shared beliefs band together to form a voluntary social-safety net. A century ago, an estimated one-third of American men belonged to mutual aid societies, but most faded away with the expansion of the welfare state.
Three years ago, I travelled to Samaritan’s headquarters in Peoria, Illinois to learn more about this remarkable organization.
In the story that came out of that trip, I predicted that Obamacare would lead to the demise of Samaritan and two similar organizations in the U.S. This model, I thought, wouldn’t be able to compete with the heavily subsidized plans soon to become available on the new health-care exchanges.
Thanks to Richard Simpkins for bringing this to my attention.
A week or so ago, Akash Chougule, Director of Policy at Americans for Prosperity (you know, the Tea Party political outfit funded by the Koch Brothers), posted an Op-Ed piece at Forbes tearing apart Ohio Governor John Kasich's decision to expand Medicaid via the Affordable Care Act. From a Republican POV, of course, Kasich agreeing to accept ACA Medicaid expansion is blasphemous. The piece was posted just ahead of the Ohio Republican Presidential primary, so naturally it was intended to hurt his chances of winning his home state (it didn't work, of course; Kasich did indeed win Ohio, keeping his campaign alive awhile longer, if just barely).
Anyway, here's the part which made both Simpkins and myself scratch our heads:
Ohio Governor John Kasich has spent no small amount of time on the presidential campaign trail discussing his decision to expand Medicaid to 650,000 able-bodied adults under Obamacare. But policymakers in non-expansion states should take a closer look at what’s actually unfolded in Ohio before considering going down the same path.
SORRY ABOUT THE DELAY!! I posted Part One on March 11th and planned on posting Part Two last weekend, but the week kind of got away from me...
In Part One of my analysis of the final, official OE3 ASPE report, I looked at the grand total nationally, the final state-based exchange numbers, revisited the BHP/pre-purged QHP factor, and also took a quick peek at some other odds & ends. Here's my long-overdue look at the rest of the report:
Re-Enrollments:
In 2015, appx. 6.1 million people ended up renewing their policies nationally (4.5 million via HC.gov, 1.6 million via the SBMs) out of 6.3 million still enrolled through the end of the year. That's a 97% renewal/re-enrollment rate, which is pretty good.
In 2016, appx. 7.8 million people renewed their policies nationally (5.6 million via HC.gov, 2.2 million via the SBMs) out of 8.8 million still enrolled through the end of the year. That's down to an 89% renewal/re-enrollment rate...still not terrible, but concerning.
Bear in mind that I was expecting assumed 9.0 million to renew...but I was also expecting about 9.7 million to still be enrolled (ie, I expected a 93% renewal rate out of a higher total). HHS, meanwhile, had a mid-range of 8.1 million renewing out of an expected 9.1 million (89%). The actual numbers were lower on both sides, which isn't a good sign.
I've noted before that every once in awhile, someone trying to load Ted Cruz's official campaign website will inadvertently bring up this site instead, thanks to my whimsical decision a year ago to snap up a half-dozen copycat domains (TedCrooz.com, TedCruise.net, etc.) just for fun.
I further noted that a few of these folks still can't seem to figure out that the website clearly has nothing whatsoever to do with Ted Cruz's presidential bid, beyond occasionally poking fun at how full of crap he is when it comes to the Affordable Care Act, in spite of the overwhelming evidence. I know this because I've received at least 3-4 contact form submissions from these folks...and in every case before today, they still couldn't figure it out.
As you'll recall, the woman worded her question as follows:
O'DONNELL: Hello, I voted for Obama, but then my health insurance skyrocketed, from $490 a month to $1,081 a month, for a family of 4. I know Obama told us that we'd be paying a little more, but doubling...more than doubling our health insurance costs has not been a "little" more. It has been difficult to come up with that kind of payment every month. I would like to vote Democratic, but it's cost me a lot of money, and I'm just wondering if Democrats really realize how difficult it's been on working-class Americans to finance Obamacare.
I originally intended this to be an update to yesterday's post about the woman at the Ohio Democratic Town Hall in which a woman asked Hillary Clinton why her family's insurance rates have gone up from $490/month to $1,081/month since the Affordable Care Act was passed. However, that post had already gotten absurdly long and unwieldy, so I've split it off into a new entry.
In the comments yesterday, a man named Danny Robins posted the following. I've broken it up a bit for readability, and have included my responses; both his points and my responses lend some additional insight into both Ms. O'Donnell's dilemma as well as my own point about Clinton's response:
My Columbus Ohio based health insurance practice for the past 7 years has been focused on helping small employers offer more affordable health benefits outside of the employer sponsored health insurance market. It has been widely reported that up to 70% of small employers no longer sponsor a health plan because they can not afford it. As such, I have assisted with over 2,000 people obtain individual or family health coverage.
UPDATE: I made two major errors in my original calculations below: First, I thought that Ms. O'Donnell lived in Howell, Ohio; it turns out she lives in Powell, Ohio. Secondly, I didn't realize that her children likely qualify for the CHIP program, which is essentially the kid's version of Medicaid. I've updated all calculations to reflect both of these factors...and they actually make the point of the diary even more valid).
I didn't tune in to this evening's CNN Democratic Town Hall until right after a key question to/response from Hillary Clinton specifically about the premiums for individual policies on the Affordable Care Act exchanges. Fortunately, several people were uploading the entire things in chunks (of varying audio/video quality) even as it was being broadcast, so I was able to watch the clip in question:
A couple of weeks ago, I noted that the final, official ASPE report for the 2016 Open Enrollment Period was running quite a bit later than it did the first two years: In 2014 it was released either 12 or 16 days after open enrollment ended (OE1 ended on 4/15 but the report covered an additional 4 days), while last year it was also released 16 days after the end of the 2015 season.
For whatever reason, it took a full 40 days for the ASPE report to be released this year, but whatever; let's dig in!
First, it's worth remembering that the HHS Dept. included 1 extra day this year (Feb. 1st) for HC.gov as well as 4 of the state exchanges to account for some "in line by midnight" enrollees:
The Massachusetts ACA exchange reported exactly 196,554 QHP selections (including the still-qualifying "ConnectorCare" plans) as of January 31st, the final day of the 2016 Open Enrollment Period.
They just held their March board meeting, which always include highly detailed powerpoint charts & graphs running through the end of the prior month...so here's where things stand after the first month of the off season. The main number: The official effectuated enrollment number is up to 208,374 (remember, Massachusetts doesn't even report QHP enrollees until they've actually paid their premium. It'd be awesome if every other exchange was able to do so as well, as that would finally kill off the "But how many have PAID??" talking point once and for all.
