Michigan

Since today's just filled with wonderful news for 418,000 Kentucky residents who are very likely to lose Medicaid coverage, I figured I might as well toss this on the fire as well:

It appears that East Lansing-based Consumers Mutual Insurance of Michigan could wind down operations this year as it is not participating in the state health insurance exchange for 2016.

But officials of Consumers Mutual today are discussing several options that could determine its future status with the state Department of Insurance and Financial Services, said David Eich, marketing and public relations officer with Consumers Mutual.

Consumers Mutual CEO Dennis Litos said: "We are reviewing our situation (financial condition) with DIFS and should conclude on a future direction this week.”

Well I'll be damned. Given all the tea leaf/entrail-reading that I've had to do in some states to try and piece together the weighted average rate increases for 2016 (usually due to missing enrollment/market share data for the companies participating), it's a pleasant surprise to see that my own state of Michigan has posted the approved rate hikes without any gobbledygook:

Individual market to increase on average 6.5%, small group 1.0%

FOR IMMEDIATE RELEASE - August 18, 2015

LANSING - Michigan consumers and small businesses will experience lower increases in the cost of their 2016 health insurance plan than those in many other states, according to the Michigan Department of Insurance and Financial Services (DIFS). DIFS reports that the average approved rate changes on a premium weighted basis increased by 6.5 percent for the individual market and 1 percent for the small group market.

Nice job by Amy Lynn Smith over at Eclectablog today:

Once again, the Affordable Care Act (ACA) is proving its critics wrong. Opponents of the ACA, or Obamacare, have been falling all over themselves proclaiming that an influx of new patients will overburden the healthcare system, creating a dire doctor shortage.

At least in Michigan, that’s proven to be absolutely false.

A new University of Michigan study shows that the availability of primary care appointments actually improved for people with Medicaid in the first months after the state launched the Healthy Michigan Plan, the state’s Medicaid expansion under the ACA. What’s more, it remained mostly unchanged for those with private insurance.

This AP article provides snippets about a handful of states; it'd be nice if they just released the actual report so we could see the hard expansion numbers (as opposed to the total increase numbers, which are still obviously useful but don't distinguish between traditional Medicaid and ACA expansion enrollees):

In Kentucky, for example, enrollments during the 2014 fiscal year were more than double the number projected, with almost 311,000 newly eligible residents signing up. That's greater than what was initially predicted through 2021. 

...At least 14 states have seen new enrollments exceed their original projections, causing at least seven to increase their cost estimates for 2017, according to an Associated Press analysis of state budget projections, Medicaid enrollments and cost details in the expansion states. A few states said they could not provide original projections.

As I noted at the end of April, after climbing at a furious pace every week for months on end, Michigan's implementation of the Affordable Care Act's Medicaid expansion provision (aka "Healthy Michigan") plateaued at around 600,000 enrollees back in February, and then bobbled around the 600K level for several weeks straight. As I noted at the time, I'm still checking this figure weekly, but it has never deviated far from that number--sometimes a bit higher, sometimes lower.

As of June 30th, it stood at 606,779. 600K seems to be the level that ACA Medicaid expansion can be expected to stay at for the forseeable future.

So, with all the fuss & bother over the imminent King v. Burwell decision, what's the deal here in the Wolverine state?

Well, first of all, here's what's at risk if the Supreme Court rules for the plaintiffs, Congress fails to pass a simple tweaking of the law to resolve the issue and the state administration fails to "establish" an exchange which passes muster with regard to the minimum legal definition required:

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:

...it could actually be several hundred dollars lower.

A week ago I posted a story in which I busted Michigan State Senator Patrick Colbeck for blatantly spewing nonsense numbers about the ACA in an Op-Ed in the Detroit News.

Yesterday, my follow-up story, about the Detroit News allowing Colbeck to go back in and correct some (but not all) of his insanely false factual garbage a solid 10 days later (while failing to give any indication about just how absurdly wrong he had been in the first place) went viral, generating more visitors than any other story I've posted in months.

After an all-day saga, the end result was that the Detroit News finally posted a "correction" notice...except they did so in such a disingenous way (and so long after the original editorial was publshed) as to be nearly meaningless.

After months of never-ending growth, "Healthy Michigan", aka MI's implementation of the Affordable Care Act's Medicaid expansion provision, has officially stabilized at around 600,000 enrollees:

The reason it's bobbling around the 600K mark, of course, is because of normal "churn" as people move onto/off of the program as they gain/lose jobs, move into/out of the state, give birth/lose family members and so forth.

A few weeks ago, the Detroit News posted a story gushing praise all over Michigan's implementation of the Affordable Care Act's Medicaid expansion provision, known locally as "Healthy Michigan", and somehow managed to not mention the ACA once until the 9th paragraph...and even then, failed to explain the connection between the two (as in, HM only exists because of ACA).

A couple of days ago, the editiorial board of the News posted an editorial which correctly calls for the renewal of Healthy Michigan, which requires a federal waiver once a year (I think) in order to continue because it includes modifications from simply increasing the eligibility threshold to 138% of the Federal Poverty Level.

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