Add Utah to the list of GOP-run states changing their tune on Obamacare:

Gov. Gary Herbert announced Thursday that after months of negotiations, he has reached a final agreement with the Obama administration on his novel alternative to expanding Medicaid.

"They are giving us more flexibility than has been given to any other state in America. We are breaking some new ground," Herbert announced in his monthly press conference on KUED.

Herbert said he soon will send to the Obama administration a letter outlining the agreement they’ve reached on Utah’s alternative, his Healthy Utah plan.

The deal would help low-income Utahns earning up to 138 percent of the federal poverty level who are not covered by Medicaid buy private health insurance plans.

From the sounds of it, it looks like this will be set up along the lines of the Arkansas "private option" program, which basically amounts to using Medicaid funding to cover practically 100% of the cost of private QHPs.

As we head into the final few weeks before the 2nd Open Enrollment period, it looks like MNsure is the only state which is left posting regular off-season enrollment updates. Things are definitely tapering off (only 113 new QHPs over the past 6 days & 3,294 added to Medicaid/MinnesotaCare), but that's still over 3,400 more people with coverage.

latest enrollment numbers 

October 22, 2014

Health Coverage Type Cumulative Enrollments
Medical Assistance 227,476
MinnesotaCare 78,321
Qualified Health Plan (QHP) 55,564
TOTAL 361,361

I wouldn't normally give much thought to the Daily Signal, seeing how a) it's an offshoot of the right-wing Heritage Foundation and b) the last time I analyzed one of their pieces it was this idiotic piece by Sharyl Attkisson. However, supporter Adam Goldstein asked me to check out their latest, so I did...and while it's heavily biased against the Affordable Care Act, I find it noteworthy that even these wingnuts are willing to concede that a) their own colleague, Ms. Attkisson, was pathetically wrong and b) the net reduction in the uninsured rate nationally thanks to Obamacare is actually off to a pretty good start:

Our analysis of the data is reported in more detail in our latest paper, but our key findings are that in the first half of 2014:

Well isn't this a breath of fresh air!!

WASHINGTON -- Democratic Sen. Jeanne Shaheen refused to shy away from Obamacare on Tuesday in the first televised debate of the New Hampshire Senate race.

Shaheen, one of several vulnerable Democrats up for re-election in November, forcefully defended the health care law moments after Scott Brown, her Republican opponent, said he would fight to repeal it. When specifically asked if Obamacare was a proud achievement, Shaheen responded, "Absolutely."

"I think making sure that almost 100,000 people in New Hampshire have access to health care is real progress for people in this state," Shaheen said.

Good for her!

Many Republicans are caught in a quandary when it comes to the Affordable Care Act. They hate the fact that a black Democrat implemented their own law nationally, they hate poor people getting healthcare coverage at little cost to them and they hate middle-class people getting healthcare coverage at a price they can afford. However, they love getting elected/re-elected. So, what's a good Republican candidate to do?

Well, for Mitch McConnell, many GOP Governors and other Republican candidates, the answer seems obvious: Repeal the Affordable Care Act nationally while at the same time changing the laws at the state level to increase eligibility to the same 138% FPL (Federal Poverty Level) threshold included in the ACA.

Ohio Republican Governor John Kasich, folks:

Gov. John Kasich of Ohio said his comments about a Republican-led Congress being unlikely to repeal the Affordable Care Act — which commentators on the right and left pounced upon Monday — were taken out of context.

...Mr. Kasich, referring to repealing the Affordable Care Act, was quoted as saying “that’s not gonna happen.”

...“I’ve always thought if we got a majority we would repeal Obamacare,’’ he said. “My only point was they’d probably make an accommodation for Medicaid expansion.’’

...It is an open question how expanding Medicaid benefits as generously as the Affordable Care Act allows, to adults earning up to 138 percent of the poverty level, could be paid for without increased taxes and Medicare cost reductions also created by the health care law.

...“I’m in favor of repealing Obamacare,” he repeated. “That’s all I can tell you.’’

Well, let's see here.

Last week the "Healthy Michigan" program (our name for Obamacare Medicaid expansion) had reached around 415,000 enrollees. Today it was announced that this number is around 10,000 higher:

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 424,852
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of October 20, 2014 
*Updated every Monday at 3 p.m.

Obviously this is fantastic news; the state is up to 88% of the 477,000 Michiganders estimated to be eligible for the program.

However, when you add in the 213,000 residents of Michigan who are receiving tax credits via private healthcare policies through the Affordable Care Act...aka "Obamacare"...that's around 638,000 people who would lose their coverage if the Republican Party were to successfully repeal the law, which they've been dead-set on doing for 4 years now.

Last week I announced that I've started writing occasional pieces for HealthInsurance.org. Today they've published my 2nd entry, which is all about Kentucky, Mitch McConnell and the real-world impact on hundreds of thousands of people that repealing the ACA would have.

UPDATE: In my story, I noted that the Federal Government is picking up 100% of the tab for the expanded Medicaid enrollees for the first 3 years, and then thought that it dropped down to 90% for another 6 years, and then to the normal fed/state split after that (70/30 in the case of Kentucky).

Thanks to David M. for bringing to my attention this correction: The expansion program is an even better deal for the states than I thought, because apparently the Federal share only drops to 90% permanently (well, unless a future Congress messes around with that provision of the ACA, of course).

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