Three ACA-related stories which are all interesting but which I don't have a whole lot to add to:

The trouble with trying to sign people up for health insurance when care is already free

It’s hard work trying to get people to sign up for health insurance when their care is mostly free to them. Andrea Thomas is working to get Alaska Natives in Sitka, Alaska, to do just that. She’s the outreach and enrollment manager at SouthEast Alaska Regional Health Consortium (SEARHC), and it’s her job to sign people up for health insurance coverage through exchanges created as a result of the Affordable Care Act.

To get a sense of just how uphill Thomas’s battle is, consider this: Of the more than 100,000 people who live in Alaska and self-identify as Alaska Native or American Indian, only 115 had signed up for health insurance through an Affordable Care Act exchange as of March 31.  Alaska Natives and American Indians are exempt from tax penalties for not signing up for health insurance.

This Just In (busy day today)...

Commissioner Approves Premium Rates for 2015 Individual Market

(Baltimore) – Maryland Insurance Commissioner Therese M. Goldsmith today announced approved premium rates for individual health insurance plans to be offered in the State for coverage beginning January 1, 2015.

Premium rates for three of the six carriers currently participating in Maryland’s individual insurance market – All Savers Insurance Company, Evergreen Health Cooperative, and Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. − will drop by an average of 6.7 percent, 10.3 percent, and 14.1 percent, respectively. The other three carriers currently in the market, all CareFirst companies, received approval to increase premium rates by 9.8 percent (CareFirst BlueChoice, Inc.) or 16.2 percent (CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc.), on average − substantial reductions from the 22.8 percent and 30.2 percent increases those companies requested for 2015.

Thanks to contributor Britt M. for sending me both of the above links.

Between the recent campaign ad by AR Senator Mark Pryor defending his ACA vote (if not actually uttering the "O" word), the good-to-excellent 2015 premium news out of states like Arkansas, CaliforniaConnecticut and Mississippi, as well as the recent polling out of CA which finds a spike in approval of the law, it's no wonder that even hard-right Tea Party politicos like Wisconsin Governor Scott Walker may be considering setting up their own ACA exchanges after all if they have to:

Watching the tide turn quickly on ‘Obamacare’

About a year ago, Georgia Insurance Commissioner Ralph Hudgens bragged to a crowd of fellow Republicans: “Let me tell you what we’re doing [about ObamaCare]: Everything in our power to be an obstructionist.”
It was a striking quote that quickly took on national significance. As a rule, policymakers at least pretend to care about working constructively, but here was a state official boasting about his deliberate embrace of obstructionism.
And yet, this week, Hudgens said he didn’t really mean it.

“I spoke to a Republican group in Rome, Ga., and I said I was going to be an obstructionist, but I can’t be. I mean, I was talking to a Republican group and I was throwing them some red meat.”


OK, a couple of caveats here: First, yes, it's California; obviously this isn't exactly representative of states like, say, Oklahoma or Alabama. Second, CoveredCA had a much smoother rollout last fall than did (and some of the other state exchanges are still struggling with serious technical issues).

Having said all that, California does still have over 12% of the total U.S. population, and they do tend to be early adopters historically. With that in mind...

The nation’s new health care law is surging in popularity in the Golden State, according to the Field Poll, which finds more Californians today — of all political stripes — support the Affordable Care Act than at any time since it was signed into law four years ago.

And by a two-to-one margin, they praise the successful way it’s been rolled out in the state, compared to the federal government’s glitch-ridden system.

Still more now say they’re satisfied with the way the health care system is working in the state, compared to a year ago.

Wow. The logic here is

Low-income consumers struggling to pay their Obamacare premiums may soon be able to get help from their local hospital or United Way.

Some hospitals in New York, Florida and Wisconsin are exploring ways to provide such aid, which would at least partly guarantee the hospitals get paid when the consumers seek care.

But the hospitals' efforts have set up a conflict with insurers, which worry such programs will add too many sick people to their rolls. The premium assistance could drive up costs for everyone and discourage healthier people from buying coverage, insurers wrote recently to the Obama administration.

Think about that one for a moment.

The hospitals (you know, the ones who are supposed to help heal the sick) are offering to help pay the insurance companies for patients who can't afford it otherwise...and the insurance companies are actually opposed to this...because it might add "too many sick people" to their customer base.

Thanks to contributor Mark N. for bringing my attention to this piece by Avik Roy (with whom regular readers know I've butted heads with on a number of occasions). Interestingly, he seems to have written this piece specifically for Politico, not for Forbes where his stuff can usually be found...although he did post a follow-up piece addressing (right-wing) criticisms of his plan at Forbes. Not sure of the significance of that.

Anyway, Mark gives a nice summary of the original article:

...the "keep Obamacare" and ditch Medicare. In other words, run the elderly through the Obamacare exchanges using premium support etc. but making the rich elderly pay their way. The average cost per month of a Medicare beneficiary is about $1000, I learned recently, which is not horrendous. I can't stand Avik. But this is the first thing he ever wrote that I can relate to. My 23 year old waitress daughter is paying taxes to support a bunch of elderly people who have 1000 times as much money as she does. You see my point.

The Invisible Hand of the Free Market slaps "ACA = Socialism!" claims upside the head, Part 8

Carriers have submitted proposed 2015 rates for the Arkansas Health Insurance Marketplace — the health care exchange created via the Affordable Care Act — to AID for review. According to information previously available online via the Arkansas Insurance Department, the news is good: if the proposed rates are approved, they will lead to an overall decrease in insurance rates on the Marketplace. 

...Blue Cross Blue Shield, which currently has the largest market share on the marketplace, proposed a rate increase of zero...Celtic, selling in Arkansas as Ambetter, which currently has the second largest market share, proposed a rate decrease of 12 percent. Finally, QualChoice, which has the smallest market share, proposed a rate increase of 5 percent.

On the one hand, aside from a brief panic attack I had the week after Independence Day, I've consistently been confident that my 8,000 - 10,000/day estimate for off-season QHP enrollments is solid. With 7 months from 4/15 - 11/15, that's anywhere from 1.7 - 2.1 million people enrolling in exchange-based QHPs in addition to the 8.02 million who had done so as of mid-April.

On the other hand, even the minimal off-season data that I've been able to cobble together has nearly dried up in the past few weeks; only 4 states have been posting regular updates since April, and 2 of them (Hawaii and Oregon) haven't done so in several weeks as they overhaul/retool their websites. This leaves just Minnesota (with nearly daily updates, hooray!) and Maryland (which only released reports monthly, but has been reliable about doing so); pretty slim pickings of late, so it's reassuring to see that my claims are more than reasonable:

Almost 7 million people can sign up for health plans under ObamaCare even before the new enrollment period begins in November, according to an advocacy group.

Shades of John "OMG!! Papa Johns will be forced to raise prices by 14¢ a pizza!!" Schnatter in Chicago this week...

The Chicago Cubs denied an assertion by the Chicago Sun-Times on Friday that the tarp debacle earlier in the week against the San Francisco Giants happened because the club short-staffs the grounds crew at Wrigley Field in order to avoid paying health insurance.

The short version: The nasty storm last week ended up making Wrigley Field unusable because the grounds crew was shorthanded. According to the Sun-Times, the reason they were shorthanded is because the team management slashed their hours in order to avoid having to pay for (gasp! the horror!) healthcare coverage for the staff.

As writer David Brown notes, if true, this is pretty slimy behavior for two reasons:

If a grounds crew person needs to work at least 130 hours a month to meet the requirements for health care, that's the cost of doing business. But the Cubs have gone on the cheapsince being sold by Sam Zell, and it's not just in the free-agent market. 

OK, technically this is only the 2nd separate entry under the "Invisible Hand Slaps!" moniker, but I've posted 5 updates to the original one and it started to get unwieldy, so I'm calling this "Part 7" instead:

UnitedHealth Group Inc. will apply to sell Obamacare plans in 24 states next year, vastly broadening the footprint of the nation’s largest insurer, which had stood largely on the sidelines during the law’s first year.

UnitedHealth  UNH  is expanding its reach sixfold, from just four states where it is participating in plans offered under theAffordable Care Act.  The Minnetonka, Minn.-based insurer plans to offer coverage in such states as Florida, Louisiana, Michigan, North Carolina, Ohio, Pennsylvania and Texas.