I've written many times before about how polling on the issue of "Medicare for All" has consistently proven that many Americans are confused about what the phrase actually means.

While a majority of the country keeps saying they want "Medicare for All", poll after poll has shown that a huge chunk of those who say so think it means "Medicare for All Who Want It"...that is, they think it refers to a Public Option, where it's up to them whether their major medical coverage would be public or private. This is true even among Democrats, who obviously support the concept in higher numbers than Republicans or Independents.

Yesterday a new poll came out from Monmouth University which mostly just confirms this point...

*OK, technically he didn't, but...well, read on.

About five weeks ago, around the 3rd week of July, regular readers may have noticed that my output both here as well as on Twitter dropped off considerably for a week or so (much to the relief of some, I'm sure).

I made a vague reference or two to "dealing with a personal crisis" while also reassuring folks that it wasn't anything tragic (no one died, got terribly sick, divorced, etc), but didn't get into any details.

For reasons which will soon become clear, my wife was not thrilled about the idea of my sharing our little saga with the world...at least not until we were 100% certain it had been resolved.

More specifically, while she agreed that there was a legitimate healthcare angle to justify posting something about it on my site, she wanted me to wait at least five weeks before going public...namely, yesterday.

As it happens, yesterday also just happened to be the exact date that the Twitterverse exploded with two major stories related to...bed bugs.

Back in June I noted that Maine's Bureau of Professional & Financial Regulation released their preliminary 2020 rate filings for the Individual and Small Group markets. At the time, the three carriers on their Indy market were requesting average rate increases of around 4.7% next year.

In July I reported that the carriers themselves sliced their unsubsidized 2020 rates down of their own volition, to a 1.6% decrease on average.

Last week, after a public comment meeting, it looks like the Maine Insurance Dept. went ahead and approved the lower, revised rates for all three individual market carriers.

Last month I posted the average requested unsubsidized premium rate changes for the 2020 Individual Market in Ohio. At the time, the state was looking at a weighted average reduction of 7.0% from 2019 rates.

Since then, the Ohio Dept. of Insurance has reviewed and approved the rates for 2020, and while they don't provide much detail on individual carriers, overall it looks like they reduced rates slightly more (average reduction of 7.7%). The wording below is almost identical to what it was last month, except for the highlighted text:

Last month I reported on Tennessee's preliminary 2020 premium rate filings. At the time, the weighted average rate change for ACA Individual Market policies was a 1.1% reduction over this year.

Today, the Tennessee Insurance Dept. officially approved the rate changes exactly as is, without making any changes one way or the other:

TDCI Approves Carriers’ 2020 Rates on the Federally Facilitated Marketplace
More Choices, Rate Decrease Highlight Rating Filing Season

The Tennessee Department of Commerce and Insurance (TDCI) announces the approval of insurance rates requested by the five carriers offering coverage on the Federally Facilitated Marketplace (FFM) in 2020.

Last week, a blog post over at the Georgetown Center on Health Insurance Reforms called my attention to a seemingly bizarre change of stance by the Trump Justice Department as to what the final ruling should be in the idiotic #TexasFoldEm anti-ACA lawsuit being brought by 20 (now 18) Republican state attorneys general:

Now, DOJ is changing its position again. In supplemental briefings to the Fifth Circuit Court of Appeals, DOJ states that any invalidation of the ACA should “not extend beyond the plaintiff states….” As a remedy, DOJ argues that the court should invalidate the ACA only in the states that brought suit. In effect, if the court were to follow DOJ’s scheme it would mean striking down the ACA in the eighteen plaintiff states, but allowing it to remain intact in the thirty-two other states.

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 the Montana Insurance Commissioner's office:

REINSURANCE LOWERS HEALTH INSURANCE RATES FOR 2020

  • New Program Championed by Rosendale Leads to Double-Digit Rate Decreases in the Individual Market

HELENA, Mont. – State Auditor Matt Rosendale announced today that every health insurance plan sold on the individual market in Montana will have lower rates next year, largely due a new program that he’s championed for the past two years.

A few weeks ago I posted the preliminary 2020 ACA-compliant premium changes for Florida's Individual and Small Group markets. At the time, the requested rate hikes were only available for about 4 of the 10 carriers participating in the Individual Market, and just 10 of the 14 carriers on FL's Small Group market. However, the Florida Office of Insurance Regulation did provide the weighted average request: A 1.2% increase for the Indy Market and 6.4% for Small Group plans.

Today, FLOIR has released the approved rates for each, including the actual average changes for each carrier...and once again, they've whittled the rate changes down further yet on Indy plans (although they actually bumped them up a point on the Small Group market). From the press release:

OIR Announces 2020 PPACA Individual Market Health Insurance Plan Rates

Last summer, there was a hell of a bombshell dropped on the judicial system when the U.S. Dept. of Justice, under then-Attorney General Jeff Sessions, announced that instead of defending the Affordable Care Act against the Texas vs. U.S. lawsuit (which is their job, after all), they were effectively throwing the case by not only refusing to defend the law in court, but actively agreeing with the plaintiffs that the absurd premise of their lawsuit was correct:

Last night, the Washington Post posted a story with a headline which made top campaign representatives for both Bernie Sanders and Kamala Harris go nuts on Twitter:

Sen. Bernie Sanders changes how Medicare-for-all plan treats union contracts in face of opposition by organized labor

Sen. Bernie Sanders announced a key change to his Medicare-for-all insurance plan Wednesday, a move meant to assuage fears on the part of organized labor, whose support is being heatedly sought by all of the candidates for the Democratic presidential nomination.

Back in June, the New Mexico Insurance Dept. posted the preliminary 2020 rate change filings for the ACA individual and small group markets. At the time, the vcarriers were requesting the highest average premium increase in the country for next year: An increase of 13.0%.

The main source of this double-digit hike was New Mexico Health Connections, one of just a handful of original ACA Co-Op carriers to survive. They were requesting a whopping 30% average rate hike for 2020, and with over 1/3 of the market share, this was more than enough to drag the statewide average up. A second carrier, Presbyterian, only sells off-exchange but was requesting a 16.3% increase which also pushed the average up.

Well, today the approved rate filings have been released, and there's several eyebrow-raising developments.

First of all, there's this (first noted by Sabrina Corlette):

CHRISTUS HEALTH PLAN LOSES QUALIFIED HEALTH PLAN STATUS

If you've been following me on Twitter lately, you know that I've grown increasingly frustrated with two aspects of the Democratic Presidential primary process in recent months:

  • First, Sen. Elizabeth Warren's seeming 180-degree turnaround from her March stance on achieving universal healthcare coverage ("a lot of different pathways") to her more recent rhetoric (a simple, point-blank "I'm with Bernie on Medicare for All.") at the first debate in late June. At the time, I assumed this was simply due to the absurdly short time constraints and the terrible framing of the question by the moderators, but it's mid-August now and so far she seems to be sticking to her guns re. being 100% onboard with BernieCare.

 

I wrote last month that Highmark BCBS, the sole individual market carrier operating in Delaware, has requested a 5.8% average premium reduction for 2020. In the press release from the state insurance department they noted:

It is important to note, that the proposed rate decrease is unrelated to Delaware’s intended submission of a 1332 Waiver to establish a reinsurance program. If the application process is successful, the actuarial consultant’s projections are correct, and the State of Delaware secures adequate funding, the waiver program may decrease rates by an additional 20%.

Well, today CMS indeed approved that ACA Section 1332 Reinsurance program waiver:

(OK, no, this does not appear to be a "Yelp!"-like system where enrollees can directly influence the star ratings...I just posted the logo for the hell of it)

I didn't catch this when the press release went out a few days ago, but this could be significant...or it could be a big batch of nothing:

CMS is Bringing Health Plan Quality Ratings to All Exchanges for the First Time
Consumers will have improved access to health plan quality information for the 2020 Open Enrollment Period

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