Lawmakers and the governor reached a deal to pass a health care package that, as one senator put it, will “keep the lights on” for health care reform.

The package contains $3.2 million in new state health care spending, which is eligible for roughly another $3 million in federal match. The money will be used to level-fund exchange subsidies for out-of-pocket costs, target increases to Medicaid rates and invest in initiatives to strengthen the primary care system.

UPDATE 5/19/15: SEE IMPORTANT UPDATE TO THE LUIS LANG SAGA!!

I know I said I was done writing about Luis Lang, the guy in South Carolina who's going blind and is uninsured due to a combination of his own decisions and the SC administration. However, my colleague Harold Pollack over at healthinsurance.org just posted a lengthy interview with the guy to get his take on things. Since I'm one of those who tore him to shreds, it behooves me to let him say his piece.

Read Pollack's piece for the full interview, but here's my main thoughts in response:

NOTE: READ THIS IMPORTANT UPDATE.

My friend was killed in the @Amtrak crash. Her family received this note. I think we should all give Chad a call... pic.twitter.com/CH59KJw2QK

— Rachel Lutz (@racheldaytwa) May 15, 2015

The note in question:

*(OK, that's snark)

Hey, remember this Nontroversy from 2012?

For a few hours yesterday, the top link on the Drudge Report led to a YouTube video in which an Ohio woman said she's going to vote for President Obama because he gave her a phone. The woman is inarticulate and she speaks loudly, and on top of those things she's black. Basically, she is exactly the kind of person many on the right envision—wrongly, it should be said—when they think of who is guzzling from the government teat these days. That she was bragging about Obama giving "every minority in Cleveland" luxuries like cell phones was just the icing on the cake.

Of course, it turns out that the "Obamaphone" brouhaha was, to put it mildly, a wee bit exaggerated (and the program was actually started by Ronald Reagan):

A couple of weeks ago I posted an entry about the latest quarterly Gallup poll results, which show that the uninsured rate among U.S. adults has continued to drop, and stood at just 11.9% as of the end of March.

However, I also noted that the graph included by Gallup makes the drop look more dramatic than it really is, by not including the entire picture. I whipped up my own version which starts at 0% to give a more accurate representation; here they are again:

This International Business Times article raises a fair point: Having affordable policies doesn't necessarily equal having affordable care:

 Nearly 12 million people signed up for health coverage plans on exchanges created under Obamacare, according to the website ACAsignups.net. [ed: hey, that's me!!]

But more than half of the adults who bought such plans had deductibles of $1,500 or more, Families USA, a Washington nonprofit organization focused on health care, found. Adeductible is the cumulative amount a person has to spend on health care before his or her insurance company starts to pay. Despite receiving tax credits to help offset the cost of coverage, these deductibles were prohibitively expensive.

This article is mainly about New Jersey ACA navigators strategizing for the 2016 open enrollment period, but it also includes one handy data nugget:

In addition, NJ FamilyCare – the state’s primary Medicaid coverage program -- has added 463,463 residents to its rolls since December 2013, including 42,947 in April.

The fact that 9% of the net increase happend 16 months after the Medicaid expansion provision started is surprising to me, consideirng that according to the Kaiser Family Foundation, only around 390,000 uninsured NJ residents were even eligible for the program as of last fall to begin with. In other states, like Michigan, things have pretty much plateaued as every eligible resident has pretty much been enrolled already.

I don't post about the state of Maine very often, and given that their Governor is an utter nutbag that's usually a good thing. Tonight, however, I'm happy to report that at least 2 of the 34 states at risk of losing their federal tax credits in the event of a King v. Burwell plaintiff win next month are seriously prepping to "establish" a state-based exchange if need be (Pennsylvania is the other one):

In a unanimous vote, the Legislature’s Insurance and Financial Services Committee endorsed the effort to maintain the health insurance premium subsidies that are offered as tax credits through the Affordable Care Act. Those credits are being challenged in a federal lawsuit known as King v. Burwell, which the U.S. Supreme Court is expected to decide next month.

Right off the bat, I want to clarify that I might have misread some of the numbers here; while some states provide the per-company average rate change requests in a nice, simple table format, I had to wade through a mountain of forms at the SERFF Filing Access Database to hunt all of these down, and there seems to be little consistency from company to company about the formatting of the documentation, etc etc. It's possible that I've confused a Small Group filing for an Individual one, for instance, and I may have misunderstood the current enrollment number for one or two companies. Finally, in one case (Physicians Health Plan), their 2016 rate request seems to have been redacted for some reason. Fortunately, they only appear to have around 600 enrollees anyway, which means any change in their rates would barely move the state-wide needle at all anyway.

With those caveats out of the way, assuming I have these numbers straight, here's what it looks like...and remember, these are requested changes only; they still have to be approved:

The California ACA exchange, CoveredCA, released their 2016 budget today, and the outlook is...well, kind of underwhelming, frankly:

After using most of $1 billion in federal start-up money, California's Obamacare exchange is preparing to go on a diet.

That financial reality is reflected in Covered California's proposed budget, released Wednesday, as well as a reduced forecast calling for 2016 enrollment of fewer than 1.5 million people.

The recalibration comes after tepid enrollment growth for California during the second year of the Affordable Care Act. The state ended open enrollment in February with 1.4 million people signed up, far short of its goal of 1.7 million.

A number of factors contributed to the shortfall, but health policy experts said that some uninsured folks still find health insurance unaffordable despite the health law's premium subsidies.

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