I haven't written much about the recent announcement by Vermont's governor that after years of pushing a single payer plan for the state, he's basically pulled the plug on it (at least for the time being). I noted the announcement but didn't have much to add myself.
Part of this is because I'm swamped with the actual ACA open enrollment itself, of course. Part of it is because it's too depressing a development for me to really think about right now. Part of it is because others far more knowledgeable than I am have much more to say about it.
One such person is Vox's Sarah Kliff, and she's written a fairly definitive explanation of what went wrong. The short version: Vermont's tax base is too small to support the initial costs, even if it would save gobs of money in the longer term.
In Vermont, this is massive: the state only raises $2.7 billion in taxes a year for every program it funds. Early estimates said that Vermont's single-payer plan might need $1.6 billion in additional funds — a huge lift. But $2.5 billion was impossible.
Way back in July, when the Halbig v. Burwell case was on the media radar, I wrote about the potential backlash against Republican governors/legislators who failed to take any action towards establishing a state-based exchange to salvage the tax credits for tens or hundreds of thousands of their own residents. At the time, I speculated that doing so could be as simple as slapping up a simple splashpage & redirect to HC.gov, which I termed the "Grand Slam Solution" (ie, "for less than the cost of a Denny's Grand Slam breakfast...")
...the "domain solution" I describe above would still have one more hurdle, of course: You'd still have to get the individual states to agree to pony up $9.95 per year and set up a simple domain redirect. Illinois has already done so; presumably other blue-leaning states would follow. That would leave about 30 states, give or take, including Texas, Florida and so forth.
One persistent Obamacare fear, for years now, has been that the new law would decimate the employer-sponsored insurance system. Why would companies waste money on buying coverage for their workers, the argument goes, when they could hand these people off to Obamacare's new exchanges?
And some high profile companies like Walmart went through and did this, leading to much speculation about whether Obamacare would kill employer-sponsored coverage.
New research from the Urban Institute suggests that, at least in year one, companies like Walmart were the exception rather than the norm: employer-sponsored coverage held steady through the Affordable Care Act's launch.
Huh. OK, this one is unexpected, mainly because they waited until 4 days after the original 12/15 deadline to make the announcement:
The Hawaii Health Connector has extended the deadline for residents to enroll in health insurance that takes effect on Jan. 1.
The extension will be until noon on Dec. 31. The original deadline was this past Monday.
The state's health insurance exchange created by the Affordable Care Act, also known as Obamacare, signed up 3,500 residents in the first month of open enrollment , which started on Nov. 15. To enroll, call 1-877-628-5076 or go to www.hawaiihealthconnector.com.
So, that makes 3 states now which have bumped their deadline for January 1st coverage out until 12/31: Hawaii, Vermont and Minnesota.
A week ago, I reported an update regarding the "Florida Health Choices" website, spearheaded by Florida GOP Senator Marco Rubio, which is a taxpayer-funded healthcare exchange to sell private insurance policies to Florida residents:
TALLAHASSEE — Last year, legislators allocated $900,000 to help Floridians find affordable health care through a new state-backed website.
At the same time, they refused to expand Medicaid or work with the federal government to offer subsidized insurance plans.
You know...Obamacare, without the "Obama" part.
It also doesn't offer any tax credits to make healthcare policies, you know, affordable.
Then again, that's kind of a moot point, since it doesn't actually even offer healthcare policies anyway--just "discount cards" for dental visits, prescriptions and prescription eyeglasses.
So...you know, it's basically a coupon store.
Oh, yeah...and even some of those coupons are kind of a scam:
A few days ago, I reported that Oregon had only enrolled 40,581 people in private 2015 policies via Healthcare.Gov as of December 14th. I further speculated that even if you include the big Deadline Spike on the 15th, the grand total for OR was likely around 48,000 total in time for January coverage...and of those, the odds are that around 8K of them are new enrollees, leaving around 40K manual renewals from this year.
At my last count, there were around 77K people still enrolled in 2014 plans as of late October, so that leaves potentially 37K people who will miss the boat for January coverage (at least with tax credits...they can still enroll off-exchange without credits, and almost 27K have done so in the state so far).
Many of those 37K may have dropped off of the exchange voluntarily, due to switching to employer-sponsored coverage, aging into Medicare and so on, while others who don't qualify for tax credits anyway may have gone off-exchange instead this year.
However, politically/image-wise, there are still thousands of people who qualify for tax credits who probably missed the deadline.
I'm not sure what to make of this. "Over a million people enrolled" it says. The embedded image specifically refers to 2015 coverage (and of course that's what they're pushing hard right now). Yet the most recent HHS Dept. weekly "snapshot" report has the number of plan selections as 2,446,562.
So, what does "over a million" refer to? Well, it could be a couple of things. It's most likely referring to the 48% of those who are new enrollees (around 1.17 million)...but if that was the case, it would make more sense to me to include the confirmed renewals for 2015 as well and say "more than 2.4 million enrolled."
At least 1.1 million people have signed up for healthcare through ObamaCare outside of the federal marketplace, according to a review of state data by The Hill.
That tally is on top of the 2.5 million people who signed up for coverage in the 37 states using the federal exchange, putting ObamaCare on track to outpace its goal for 2015.
I have a confirmed total of just over 3.5 million private policy enrollments via the various exchanges (federal + state) to date, so when I read the first sentences, it made me think "Ah ha! They've been reading ACASignups.net and also managed to find at least another 100K policy enrollments that I've missed! I was intrigued. But then...
Out of the 13 states that don’t use the federal exchange, 11 have reported data since Dec. 17 — a total of 1,142,124 sign-ups. Rhode Island and Idaho have not yet reported numbers.
