Tennessee

OK, I made those last two up.

But yes, Clay County, TN Director of Schools Jerry Strong is indeed blaming the Affordable Care Act for his county's decision to pull the plug on the entire district in the middle of the school year:

The economy is so bad in Clay County, Tennessee that school is canceled indefinitely.

The decision to ebb budget concerns by shutting academic doors came down on Thursday when Clay County Director of Schools Jerry Strong quite literally decided to lock the doors of the county’s schools. He was particularly concerned with partially unfunded government mandates and what he believed to be the effects of Obamacare making it impossible to keep funds in the green.

(sigh) I noted, at the end of my "Transitional Plan" rant a few days ago, that in addition to the Kentucky Health CO-OP going belly up, there would likely be additional casualties announced over the next couple of weeks:

By contrast, the damage from the Risk Corridor program being crippled is specific, quantifiable and obvious: Company X lost $22 million in 2014; they were supposed to receive $20 million (or whatever) back in risk corridor reimbursements; the CMS dept. only has $2.5 million to pay them back with, period, so they have to eat the remaining $17.5 million loss until next year or the year after...if they're able to stick it out that long.

The Kentucky Health CO-OP couldn't stick it out that long...and it's possible that similar press releases may be forthcoming for a few other CO-OPs (and/or other smaller insurers) over the next week or so.

Sure enough, the Tennessee CO-OP, Community Health Alliance, has pulled the plug as well:

As we head into the final batch of states, it looks like the national weighted average rate increases, which had been hovering in the 11-12% range up until a week or so ago, are unfortunately starting to inch upwards, slammed by 20%+ averages out of South Dakota, Montana, West Virginia, Oklahoma and Utah. Lower average rate hikes out of Connecticut and Wyoming have also been announced, but the other 5 states more than cancelled those two out.

And now you can add Tennessee to the mix. Starting with Louise Norris' exchange-only data (which comes in at a 33% average hike), I've also plugged in additional off-exchange individual market numbers to come up with what looks like an overall average rate hike of around 28.3%:

Well, score one for the Koch brothers:

In December, Tennessee Gov. Bill Haslam, a Republican, got the deal he wanted from the Obama administration: Tennessee would accept more than $1 billion in federal funding to expand Medicaid, as allowed for in the Affordable Care Act, but Obama aides would allow Haslam to essentially write staunchly conservative ideas into the program's rules for the state. He dubbed the reformed Medicaid program "Insure Tennessee."

But the state's chapter of Americans for Prosperity, the national conservative group whose foundation is chaired by controversial billionaire David Koch, argued Haslam was just trying to trick conservatives into implementing Obamacare in their state by giving it a new name. AFP campaigned aggressively Haslam's plans for the next six weeks, even running radio ads blasting GOP state legislators who said they might vote for it.

On Wednesday, Haslam's bill died in a committee of the Tennessee state senate. The vote was one of the clearest illustrations of the increasing power of AFP and other conservative groups funded in part by the Koch brothers.

Presented without comment, because this story is so awesome there's not much I could say to make it any better:

Community Health pulls plans after meeting ACA goals

Community Health Alliance has pulled its health insurance plans off the federal marketplace because it hit its enrollment goals.

Knoxville-based Community Health Alliance, a nonprofit consumer operated and oriented insurance provider, or co-op, hit its enrollment goals in the first two months of open enrollment. It stopped offering plans on the exchange Jan. 15.

It'll still have to get through the GOP-controlled state legislature, of course, but it looks like you can scratch Tennessee off the "Expansion Refusenik" list. I presume this'll be a "Private Option" program similar to the one in Arkansas:

In a major policy move, Gov. Bill Haslam has announced the new Insure Tennessee plan, a two-year pilot program to provide health care coverage to tens of thousands of Tennesseans who currently don't have access to health insurance or have limited options.

The plan would be leveraged with federal dollars, said Haslam, who has been working on a Medicaid expansion plan that could gain approval from both federal officials and the Republican-dominated General Assembly.

Excellent news!! I've posted exactly one (1) Tennessee-specific blog entry since I started this site a year ago, having to do with TN's possible caving on Medicaid expansion. Aside from that, I've had bupkus outside of the official monthly HHS reports during the First Open Enrollment period (OE1)...until today.

Today I learned that the number of Tennesseans currently enrolled in QHPs (as in currently in-force policies) via the federal ACA exchange stands at 125,704.

This is significant because the official 4/19/14 total for Tennessee was 151,352 people.

Assuming 88% of the original number paid their premiums, that would be about 133,200 as of last spring, which means Tennessee has only had about a 5.7% net attrition rate over the past 6 months.

A few days ago, news broke that Pennsylvania's Governor Tom Corbett, whose re-election numbers are in the toilet and who is desperate to get Pennsylvanians to like him, has finally agreed to the Medicaid expansion provision in the Affordable Care Act.

While "doing a single decent, human thing after a couple of years of being a jerk about it" shouldn't really count as being praiseworthy, I suppose he deserves at least a small golf clap, just as Michigan Gov. Rick Snyder and Ohio Gov. John Kasich did.

Anyway, next up to bat would appear to be Tennessee Gov. Bill Haslam:

In a move that could mean health coverage for thousands of Tennesseans, Gov. Bill Haslam said Thursday that the state may soon submit a proposal to Washington to expand Tennessee's Medicaid program but did not release any new details on how it might work.

UPDATE: On the down side, I was off by 4% this time around.

On the up side, I UNDERESTIMATED:

Actual Feb. enrollments: 942,833, for a total of 4,242,325 thru 3/01/14.

Sarah Kliff at Vox just announced that the February HHS report is expected to be released today at around 4:00pm. A few items in anticipation of that:

  • As I've noted several times, I'm projecting the report to total around 902,000 exchange-based private QHP enrollments for the month of February (technically 2/02 - 3/01)
  • If accurate, this would bring the cumulative total of exchange-based private QHP enrollments to 4.202 million (from 10/1/13 - 3/01/14)
  • From the data I have, the average daily enrollment rate in February was almost identical to that of January, which had about 1.146 million QHP enrollments. HOWEVER, the January report included five weeks of data (12/28 - 2/01), while the February report will only include four weeks (2/02 - 3/01). Therefore, even at the same daily average, it'll be about 20% lower no matter what.
  • Don't be surprised if Peter Lee of CoveredCA decides to steal some thunder by announcing that California has enrolled 1,000,000 QHPs all by itself either today or tomorrow. However, that would include the past 10 days, while the HHS number will only run thru 3/01.
  • If you want to get REALLY specific, call it 902,800 and 4,202,292.
  • I've been dead-on target 6 times in a row without hyping up my projections beforehand. This time I am hyping myself up beforehand, so I'll probably be way off...but as long as I've UNDERestimated the tally, I'll be perfectly fine with that...
  • The report will be released in about 5 minutes, but my kid gets home from school in about 10, so it'll be a good 20 minutes before I can really post anything. Feel free to follow Sarah Kliff of Vox in the meantime!

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