Yup, there's no denying that all of this sounds like a whole big bag of hurt. Installation, configuration, maintenance and improvement of technical infrastructure costs money, time and know-how.
The funny thing is, if the King v. Burwell plaintiffs are shot down and if Healthcare.Gov ends up in the free and clear to continue operations including providing the federal tax credits, I, for one, would have no problem with some or all of the state-based exchanges making the move to HC.gov.
It's certainly more fiscally efficient (HC.gov has cost somewhere around $250-$300 per enrollee to date, as opposed to the several thousand dollars per enrollee that most of the state exchanges are costing....or, to use an extreme case, the $57,000 per person that Marco Rubio's Republican "Anti-Obamacare" Brainchild, "Florida Health Choices" has cost to date).
6/27/16:In light of the 1-year anniversary of the Supreme Court's King v. Burwell decision...along with the celebration of the Obergefell vs. Hodges decision and today's Whole Woman's Health v. Hellerstedt decision, I've dusted off this post from a year ago...
(THIS IS BEING UPDATED MOMENT TO MOMENT, SO CHECK BACK FREQUENTLY FOR UPDATES)
However, if the courts decide to look at the case on the "micro" level--parsing exact definitions of the word "State" (which seems to be the concensus as to how they're proceeding from the people I've talked to about it), then they'll also have to (or at least certainly should) also look equally closely at two other words: "Establish" and "Facilitate."
So, as I said, depending on how the court defines the terms "establish" (ie, to "establish" an insurance marketplace) and "facilitate" (as in, "facilitating" the purchase of insurance policies through the marketplace), it's conceivable that all it would take for any of the individual states to "establish" their own exchange would be to register a domain name at GoDaddy or wherever and set up a simple welcome/information portal site...which would then lead them to HC.gov for the actual purchase of the policy.
As petty and stupid as this may sound, it's no more petty and stupid than the plaintiff's case in the first place.
But LePage has also tried to take advantage of a wording error with the 2013 law funding energy efficiency programs. While lawmakers wanted $60 million spent to help homemakers use less energy heating their homes, the snafu would have reduced that to $22 million—less than half.
The text error in Maine involved just one word left out—"and." However, it wasn’t just the wording that mattered but also a decision from a body controlled by his appointees, the Maine Public Utility Commission, that ruled 2-1 that there would be far less money for efficiency projects than legislators wanted.
The error came down to this, according to the Portland Press Herald:
Trying (once again) to get these off the books ahead of tomorrow's Supreme Court Opinion Announcements (although most people seem to think that King v. Burwell will be announced on either Friday (most likely) or Monday)...
Cathy Barney remembers well the days her family budget was overwhelmed with a nearly $1,200 monthly bill for health insurance.
...The Milford family of four finally got the break they’d been pleading for two years ago. Under key provisions of the Patient Protection and Affordable Care Act, the Barneys now pay just $400 a month for their health insurance thanks to cost-saving tax credits ushered in by President Barack Obama’s long debated health reform law, also dubbed Obamacare.
“We finally got some relief,” said Barney. “It’s been nice to not have been so squeezed these last two years.”
So, for the past few weeks I've been shouting from the rooftops about the other fallout of the King plaintiffs winning: Massive rate hikes next year, which would likely cause a roughly 50% rate hike across 34 states for millions of people.
I based that on the assumption that 2016 rates would already be going up 10-12% on average anyway, plusan additional 35-47%, for a total increase of around 50%. I based this on:
100 x 1.10 x 1.35 = 148.5 (48.5% increase)
100 x 1.12 x 1.47 = 164.64 (64.6% increase)
I decided to be err on the low side of this range, figuring that even a 50% rate hike would be more than enough to make the point.
However, according to a new article by the Urban Institute (the source of the earlier 35% increase estimate...the RAND Corporation was the source of the 47% estimate), it looks like it could be even higher:
Yes, with the All King v. Burwell, All The Time® mindset this month, it's easy to forget that the core purpose of this website is supposed to be to track the enrollment numbers...and between KvB and this being the middle of the off-season, it's no wonder that there hasn't been much of that lately.
With that in mind, thanks to Andrew Sprung for this tidbit...Indiana is one of the states which initially refused to expand Medicaid under the Affordable Care Act, but which came around earlier this year, starting enrollment in their (heavily modified) Medicaid expansion program at the end of January.
"The Healthy Indiana Plan ... is aspirational," said Brian Neale, the governor's health policy director. "We believe that individuals, if offered the opportunity, will make the right choices."
The Kaiser Family Foundation has posted their latest Analysis of 2016 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces.
The main paragraph which leaps out, of course, is this one:
Across the 11 cities we examined, the premium for the second-lowest-cost silver plan in the Marketplace – before accounting for any tax credit – is increasing by an average of 4.4%. By contrast, in these cities, the average change in the benchmark silver plan was -0.6% from 2014 to 2015. (The nationwide average increase in this plan was 2% from 2014 to 2015).
