In an election where people like me are practically begging Democratic candidates in blue states to campaign on the Affordable Care Act, this is a jaw-dropping development.
South Dakota's Senate race normally would be considered a yawner. While the state does have a history of electing the moderate Democrats from time to time, it's pretty red for the most part, and no one was expecting Democrat Rick Weiland to have much of a chance against former Republican Governor Mike Rounds.
However, in an interesting development, independent candidate Larry Pressler has jumped into 2nd place in a recent poll. The thing is, Pressler isn't some no-name small timer; he's already a former U.S. Senator, serving for 3 terms before losing to Democrat Tim Johnson in 1996.
With Johnson retiring, his seat is open, and Pressler wants it back, so he's jumped back into the game. Here's the thing, though: Pressler used to be a Republican. In South Dakota.
Gallup has just released their latest nationwide, fully-detailed quarterly insurance survey, and the results are...pretty much exactly what everyone in the real world (as opposed to FOX News, etc.) has been reporting for months now.
The uninsured rate for adults (Gallup doesn't survey kids under 18, of course), which hit a high of 18% last fall (just prior to the ACA exchanges launching) is holding steady at 13.4%, the same number it was at in the 2nd quarter of 2014:
The total U.S. population currently sits at roughly 316 million. Of that, around 76.7% are over 18, or about 242 million people.
18% of that is 43.6 million. 13.4% is 32.4 million...a net reduction of around 11.2 million uninsured, or about a 26% drop in the uninsured rate nationally.
There's nothing wrong with this AP article noting that getting an exemption from the $95 (or 1% of your taxable income) fine for not having ACA-compliant healthcare coverage could prove to be pretty complicated. Overall it's a fair assessment of some of the potential headaches involved in the hoops you have to jump through to get a waiver...
WASHINGTON (AP) — Millions of Americans may qualify for waivers from the most unpopular part of President Barack Obama's health care overhaul. But getting that exemption could be an ordeal.
Community groups are concerned about a convoluted process for waivers from the law's tax penalty on people who remain uninsured. Not everyone is complaining, however: Tax preparation companies are flagging it as a business opportunity.
The law's requirement that Americans carry health insurance remains contentious. Waivers were designed to ease the impact.
However, one line in the aticle made me chuckle:
But while some exemptions seem simple, others will require math calculations.
Wal-Mart told The Associated Press that starting Jan. 1, it will no longer offer health insurance to employees who work less than an average of 30 hours a week. The move affects 30,000 employees, or about 5 percent of Wal-Mart's total part-time workforce, but comes after the company already had scaled back the number of part-time workers who were eligible for health insurance coverage since 2011.
By an amazing coincidence, January 1st just happens to be the same day that new ACA-compliant policies purchased during the 2nd open enrollment period kick into effect.
...metal level/plan design, age, and geography, on health insurance plan premiums. At present, certain states are only reporting partial information about next year’s rates, and others are only reporting percentages that rates will change without sharing actual premium data. Unless otherwise noted, only individual health insurance filings containing rate information have been included in this analysis.
The most-recent CMS report, which only runs through June 30th, gave the net gain in Medicaid/CHIP enrollment as around 7.2 million, plus an additional 950,000 people who were added to Medicaid due to ACA provisions prior to October 2013. That's 8.15 million total over pre-ACA numbers.
There's two important points to keep in mind, however: First, again, that only ran through 6/30/14; there's been 3 solid months of additional Medicaid/CHIP enrollments since that time; and second, as of September there was a backlog of over a million people still waiting to be processed and added to the Medicaid/CHIP roles (1/3 of this in California alone).
I have no idea how much of this backlog has since been cleared up, but if CA's improvement rate is anything to go by, my guess is that most of it should be out of the way by the time the 2nd open enrollment period kicks in on November 15th.
Minnesota continues to quietly crank along as we enter the 2nd year of MNsure:
latest enrollment numbers
October 5, 2014
Health Coverage Type Cumulative Enrollments
Medical Assistance 217,535
MinnesotaCare 75,870
Qualified Health Plan (QHP) 55,243
TOTAL 348,648
Note that I'm not really even bothering to keep the Off-Season Projection Chart updated anymore; we're close enough to the 2nd Open Enrollment period that it seems a bit silly to bother (heck, I've already projected the graphs out through 11/15 anyway).
A couple of weeks ago there was a rather absurd-sounding report from a right-wing outlet called "The Pioneer Institute" which claimed that the Massachusetts Health Connector (their ACA exchange site) was going to cost over $1.1 billion over a 2-year period. I didn't really address it at the time, mainly because regardless of the disastrous experience of the MA exchange, that number just didn't seem grounded in reality. Sure enough, it turns out that estimate was about four times too high:
BOSTON - With the next open enrollment period set for Nov. 15, Gov. Deval Patrick on Monday said the state's troubled health care exchange website is fixed, at a cost of an additional $26 million to the state, bringing the federal and state total to $254 million in information technology costs.
...Consumers who log onto the Health Care Connector website will have a "full end-to-end shopping experience" for health plans on Nov. 15, Patrick said.
Louise Norris of HealthInsurance.org is quickly becoming one of my favorite ACA enrollment colleagues (and competitors, after a fashion). The other day she wrote a far better-detailed writeup listing all of the improvements that the various exchanges have made for the 2015 open enrollment period than I did; and now she's also done the grunt work of tracking down the "grandfathered policy" status in all 50 states...although she refers to these plans as being "grandmothered" instead of grandfathered, with the following distinction:
A simple cost comparison using data from the Medical Expenditure Panel Survey illustrates why Medicaid expansions can substantially affect premium prices for private insurance plans. Under national health reform, community rating regulations apply to purchases made on state exchanges by both individual consumers and small employers. In 2011, the health care costs of individuals getting insurance in these ways averaged $4,300 (with lower costs for the healthiest among them). By contrast, health care costs for nonelderly adults on Medicaid averaged $8,300 (even though Medicaid pays low rates to hospitals and physicians). If all Medicaid beneficiaries were shifted to the exchanges, prices for each purchaser would go up by more than $1000.
I haven't read the MEPS referred to, but I think the gist of it is this:
