And then there are the portions of the law which have gone, well, not so great, to put it mildly...in particular the non-profit, public/private hybrid Co-Ops, which are the only remaining remnant of the originally much-hoped-for "Public Option". For a variety of reasons, not the least of which was an utterly unnecessary and ultimately pointless stunt pulled by Marco Rubio and other Congressional Republicans (aka the Risk Corridor Massacre), over half of the two dozen Co-Ops nationwide melted down in spectacular fashion last fall, leaving only 11 of them surviving into 2016 after the dust settled.
In light of this, I figured it would be worth posting some positive Co-Op news for a change. First up, Ohio.
On September 26, 2013, just 5 days before the disastrous initial launch of HealthCare.Gov (as well as ugly rollouts of many of the state-based exchanges), President Obama gave a speech pumping up the impending start of the first Open Enrollment Period at Prince Geroge's Community College.
At one point in the speech, he touted how easy and handy the website would be to use:
Starting on Tuesday, every American can visit HealthCare.gov to find out what’s called the insurance marketplace for your state. Here in Maryland, I actually think it's called MarylandHealthConnection.gov. (Applause.) MarylandHealthConnection.gov. But if you go to HealthCare.gov, you can look and they'll tell you where to go. They'll link to your state.
Now, this is real simple. It’s a website where you can compare and purchase affordable health insurance plans, side-by-side, the same way you shop for a plane ticket on Kayak -- (laughter) -- same way you shop for a TV on Amazon. You just go on and you start looking, and here are all the options.
Well, there's two more rather interesting developments to the Risk Corridor mess.
...This fall, more than a dozen health insurers representing 800,000 people have dropped out of the ObamaCare exchanges, many out of fear that the administration no longer has the cash to cushion their losses in the costly early years of the marketplace.
In 2014, Open Enrollment officially ended on March 31st, but they allowed a 2-week "overtime" period for people who had started the process before the end of March but weren't able to complete it. The true deadline ended up being April 15th, although the official, final ASPE report ended up tacking on 4 more days (thru April 19th) for whatever reason. The final report was released 12 days later, on May 1st, 2014.
Last year, Open Enrollment officially ended on February 15th, but they tacked on a one-week "overtime" period, so the true deadline ended up being February 22nd. The official, final ASPE report was released 16 days later, on March 10th, 2015.
This year, Open Enrollment officially ended on January 31st, although the final Weekly Snapshot Report for the federal exchange tacked on 1 extra day (February 1st), so I assume that will be included. That means it's been 24 days so far, and the ASPE report hasn't been released as of yet...
To the best of my knowledge, the entire U.S. individual health insurance market should be roughly 19 million people this year. Of that, around 12 million are, of course, ACA exchange-based (I'm lopping off 700K to account for those who didn't pay their first premium, dropped out after the first month or otherwise aren't actually enrolled at the moment).
The other 7-8 million or so are off-exchange...people who enrolled directly through their insurance carrier, bypassing the ACA exchanges. Since off-exchange enrollees don't qualify for federal tax credits, the vast majority of these folks (a good 95% or more, I'd imagine) earn too much to receive them (officially over 400% of the Federal Poverty Line; realistically, some are in the 300-400% FPL range). The rest of them are presumably either undocumented immigrants, people who still don't know about the tax credits via the exchanges, or weren't able to find an exchange-based policy which they were satisfied with, even with the tax credits.
However, even then there are 4 different types of off-exchange policies:
*(OK, not really; I'm not the only one who was suggesting this, but it some people really do seem to think that I have dictatorial control over CMS...)
I guess the question here is just how much verification the HHS Dept. and/or the assorted state-based exchanges are doing of these claims. In cases like getting married/divorced, giving birth, becoming a citizen or getting out of jail, I would imagine the verification should be pretty easy. However, the "Tax Penalty Ignorance" exception was pretty much based on an honors system, and I don't know how easy/difficult it is for the feds to "verify" that your income has increased/decreased substantially...at least, not until you file your taxes the following year, which could be up to a year after the claim is made.
...So, what's the solution to this, assuming the problem is widespread? Well, I can think of some obvious tweaks to the rules, almost all of which involve simply reducing grace periods:
5. It can be kept and substantially improved, which is what Hillary Clinton is now proposing.
6. It can be kept and substantially improved, while also laying the groundwork for a series of gradual, longer term steps towards universal, comprehensive single payer (or similar) plan, which is what I'm proposing ("longer term" defined as 10-20 years, possibly longer).
7. It can be kept in place for now (along with Medicare, Medicaid, employer-sponsored insurance, the VA/TriCare, etc.) but replaced in the short term ("short term" defined as "within the next 5 years"), which is what Bernie Sanders is proposing.
8. It (along with Medicare, Medicaid, employer-sponsored insurance, the VA/TriCare, etc.) can be immediately replaced on January 20, 2017, which is what some Hillary supporters are trying to claim that Bernie Sanders is proposing, but which he isn't.
INDIVIDUAL AND FAMILY ENROLLMENT • As of February 20, 2016:
36,004 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.
The majority of these individuals are 2015 HSRI enrollees that were auto-renewed into a 2016 plan.
8,657 of the 36,004 individuals have selected a plan for 2016 coverage, and are new to HSRI this year or returning after being enrolled with HSRI at some point during a prior year.
33,920* of the 36,004 individuals are enrolled in 2016 coverage through HSRI, and have paid their first month’s premium.
*The number of paid enrollments is expected to increase as payments for March coverage are made by today’s deadline and processed over the next several days.
Actually, two of the data points (private QHPs and BHP enrollment) aren't very different from what I already knew. However, there's some interesting news on the Medicaid & Child Health Plus side:
Rate of Uninsured Drops to Lowest Level in Decades
ALBANY, N.Y. (February 23, 2016) - NY State of Health, the state’s official health plan Marketplace, today announced more than 2.8 million people have signed up for health insurance as of January 31, 2016, the end of the 2016 open enrollment period. Since the Marketplace opened in 2013, the number of uninsured New Yorkers has declined by nearly 850,000. According to recently released data by the Centers for Disease Control and Prevention, the rate of uninsured declined from 10 percent to 5 percent between 2013 and September 2015 and is at its lowest level in decades.
