2018 MIDTERM ELECTION

Time: D H M S

Charles Gaba's blog

 

Yep, that's pretty much a glimpse of the GOP's plans for Medicaid enrollees.

@Neoavatara @xpostfactoid @sangerkatz @larry_levitt We discussed last March. Public Option does no good if you're murdered by secret police.

— ☪️ Charles Gaba ✡️ (@charles_gaba) September 27, 2016

@Neoavatara @xpostfactoid @sangerkatz @larry_levitt Single Payer will be helpful after his Nazi thugs have beaten you up.

— ☪️ Charles Gaba ✡️ (@charles_gaba) September 27, 2016

UPDATE 6/5/17: NO SITE UPDATES UNTIL WEDNESDAY, AS I'LL BE TRAVELLING TO/FROM D.C. FOR THE 2017 NIHCM FOUNDATION HEALTHCARE DIGITAL MEDIA AWARDS DINNER...

OK, this really isn't news (it's been public for several weeks now), but I was recently selected as one of seven finalists in the 3rd Annual NIHCM Foundation Health Care Digital Media Awards:

The National Institute for Health Care Management (NIHCM) Foundation is a nonprofit, nonpartisan organization dedicated to improving the health of Americans by spurring workable and creative solutions to pressing health care problems.

...The NIHCM Foundation Health Care Digital Media Award recognizes excellence in digital media that improves understanding of health care topics through analysis grounded in empirical evidence. The three-year-old award carries a $10,000 prize and is judged by an independent panel of experts:

Last month I wrote up a list of 20 fixes/improvements to the ACA, many of which wouldn't cost taxpayers a dime. One fo them was...

12. LEGALLY TIE MEDICARE ADVANTAGE/MANAGED MEDICAID CONTRACTS TO EXCHANGE PARTICIPATION.

Andrew Sprung, Michael Hiltzik and I have all written about this before. I have no idea whether it's even legally feasible/practical or not, but if so, it makes a lot of sense to me: Remember, many of the same carriers whning about losing hundreds of millions of dollars on the individual market are simultaneously making billions of dollars in profit off of their other divisions...which include fat federal and state contracts to manage Medicare and/or Medicaid plans. If they want to play in the managed care sandbox, make exchange participation a requirement as well. I'm not saying they should have to treat it as a loss leader--they'd still be able to raise their premiums at an actuarially responsible rate as appropriate--but they should have to at least participate.

Another very nice scoop by Sarah Kliff of Vox.com:

News: Tennessee’s empty shelf problem appears to be fixed! Blue Cross of TN will sell coverage in Knoxville area.

— Sarah Kliff (@sarahkliff) May 9, 2017

BCBS of TN says they’ll sell coverage in the 16 Eastern TN counties that had no carrier signed up for 2018. https://t.co/g3dkqU4G1m

— Sarah Kliff (@sarahkliff) May 9, 2017

Here's the full text of the letter; emphasis mine:

May 9, 2017

Dear Commissioner McPeak,

We appreciate getting to meet with you and your team yesterday to update you on BlueCross’s position relative to the individual Marketplace for Tennessee as the first deadline for 2018 approaches.

 

Read this. Read the whole thing, thanks. Then come back here.

Done?

To summarize: For months now I've been predicting/warning that regardless of whatever legitimate risk pool issues the ACA exchanges may still be having in many parts of the country which could lead to significant rate 2018 rate hikes no matter what, there's the additional Fear/Uncertainty/Doubt factor which is being deliberately created by Donald Trump, Tom Price and the Congressional GOP. Insurance carriers hate uncertainty above all else, and I've been expecting them to do one of two things as the 2018 rate filing deadlines approach: Either jack their rates up significantly to cover themeselves for the unholy mess brewing ahead...or to simply get out of Dodge by either dropping out of the exchanges or fleeing the entire individual market altogether, on & off exchange. Most likely, I've been saying, it'll be a combination of both.

UPDATE: As I've been warning for months, several carriers have now openly stated that perhaps 40% of their requested rate hike is due specifically to concerns about the Trump administration & the GOP's ongoing sowing of confusion and outright sabotage of the ACA and the individual market.

Connecticut is the 3rd state to post their initial 2018 rate filings.

Unlike most states, Connecticut did all the legwork for me, making it incredibly easy to plug the numbers into a spreadsheet for weighted average (requested, unsubsidized) rate hikes for both the individual and small group markets:

Over the past few months, my Congressional District Breakdown tables estimating how many people would likely lose healthcare coverage if the ACA were to be "cleanly" repealed (with no replacement) have gotten a lot of attention. This was followed by the Center for American Progress (CAP) running their own estimates of how many would likely lose coverage if, instead of a "clean" repeal of the ACA as a whole, the ACA were to be partially left in place, with the GOP's AHCA (Trumpcare) bill, which dramatically changes the ACA, being signed into law instead.

UPDATE: As I've been warning for months, at least one of Maryland's carriers has openly stated that perhaps 40% of their requested rate hike is due specifically to concerns about the Trump administration & the GOP's ongoing sowing of confusion and outright sabotage of the ACA and the individual market.

Maryland is the 2nd state to post their initial 2018 rate filings.

Last year they had 6 carriers participating in the individual market; this year it looks like all 6 are still planning to participate:

  • CareFirst Blue Choice, Inc​
  • CareFirst of Maryland Inc.
  • Group Hospitalization and Medical Services Inc. (GHMSI)
  • Cigna Health and Life Insurance Co.​​
  • Evergreen Health, Inc.​​
  • Kaiser Foundation Health Plan of the Mid-Atlantic States​​

The initial 2018 filings for four of the six carriers are pretty straightforward. Two of them are a bit tricky, though: Kaiser Permanente and Evergreen Health.

UPDATE: As I've been warning for months, at least one of VA's carriers has openly stated that perhaps 40% of their requested rate hike is due specifically to concerns about the Trump administration & the GOP's ongoing sowing of confusion and outright sabotage of the ACA and the individual market.

A couple of weeks ago I noted that Virginia is one of the first states to post their initial premium rate hike filings. At the time, they hadn't posted the actual filings but at least listed the insurance carriers which were planning on participating in the individual and small group markets next year, both on and off the ACA exchange:

There are so many stories I could be writing right now about the fallout, potential fallout, next steps and so forth of yesterday's House vote on the AHCA. But this one in particular really says it all.

Here's an article in the Buffalo News regarding New York Republican Congressman Chris Collins (NY-27), who voted for the bill:

Watch: Chris Collins admits he didn't read health care bill

WASHINGTON – Rep. Chris Collins told CNN that he didn't read the entire Republican health care bill that the House passed Thursday.

And then he told The Buffalo News that he was unaware of a key provision in the bill that decimates a health plan that serves 635,000 New Yorkers.

Asked by CNN's Wolf Blitzer if he had read the entire health bill, Collins, R-Clarence, said: "I will fully admit, Wolf, that I did not. But I can also assure you my staff did. We have to rely on our staff. ... I'm very comfortable that we have a solution to the disaster called Obamacare."

Welp. I've done everything I can to help stop them, but it looks like the House Republicans have decided to go ahead and vote on their big ol' dumpster fire of a bill after all.

No CBO score. No review. No debate. No transparency. No time for anyone to read the bill. Everything they falsely accused the Democrats of 7-8 years ago (yes, I gave a range of 7-8 years, because there was a solid year of debate, discussion, meetings, arguments and so forth before the final votes were cast).

Maybe they'll pull it off. Maybe they won't. If it passes the House, what'll happen to it in the Senate? Who the hell knows, but the fact remains that anyone who votes for this piece of crap doesn't deserve to hold office any more than the racist, misogynistic, xenophobic con-artist moronic pussy-grabbing asshole who leads their party.

So be it.

Remember this mess in November 2018.

Linda Qui is a NY Times Fact Checker, formerly of PolitiFact. She cited me as a fact-check source twice for PolitiFact: Once in October 2015 and again just before the election last fall (I can't find the link for that one). The first time around it was about Donald Trump's claim that premiums were skyrocketing (again, this was back in 2015, referring to 2016 rates increases). After a phone discussion, here's what I wrote her:

Yes, some people in some plans through some carriers in some states are, indeed, looking at rate hikes of “35 - 50%” if they stick with those plans in 2016. Alaska, Minnesota and Hawaii, for instance, are all looking at 30-40% average hikes, and individual plans (or individual carriers) in a few states are indeed jacking up rates by that much.

However, by my current estimates, here’s the state-by-state breakdown:

Back in January, I wrote a long rant about High Risk Pools. The general thrust was that in theory HRPs aren't necessarily a horrible idea; on paper they can be made to work...assuming the math adds up and they're properly funded on a permanent basis.

However, I also pointed out that due to the very nature of HRPs (i.e., segregating out a small, highly vulnerable group of people from the rest of society), it's incredibly easy for legislators not to properly fund or maintain them, especially after the initial funding comes up for renewal.

Wow. Thanks to Bob Herman of Axios for the heads up:

Molina Healthcare Announces Leadership Changes

CAO Joseph W. White Named Interim CEO and Appointed CFO
Board Initiates Permanent CEO Search

Dale B. Wolf Named Chairman of the Board

Pre-Releases First Quarter 2017 GAAP Net Income Per Share

 

No real analysis here, just some choice tweets from this morning on the latest insanity. I'll likely tack on a few more as the day progresses.

.@SteveScalise says the repeal bill has "layers of protection" for peeps w/pre-existing conditions. That's the new GOP talking point, guys

— Rachael Bade (@rachaelmbade) May 2, 2017

"Layers of protection." As Jeffery Young of the Huffington Post noted...

You always test out new talking points when you're winning. It's a sign of great confidence in the policy and politics of your situation. https://t.co/CTgnppDP01

— Jeffrey Young (@JeffYoung) May 2, 2017

Speaking of having tremendous confidence...

Ryan tells fellow Republicans behind closed doors to pray for the health vote they may be about to take this week.

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