2018 MIDTERM ELECTION

Time: D H M S

A bunch of people have sent me links to this story out of Virginia:

RICHMOND — Republicans appear to have outmaneuvered Gov. Terry McAuliffe in a state budget standoff by persuading a Democratic senator to resign his seat, at least temporarily giving the GOP control of the chamber and possibly dooming the governor’s push to expand Medicaid under the Affordable Care Act.

Sen. Phillip P. Puckett (D-Russell) will announce his resignation Monday, effective immediately, paving the way to appoint his daughter to a judgeship and Puckett to the job of deputy director of the state tobacco commission, three people familiar with the plan said Sunday. They spoke on the condition of anonymity because they were not authorized to discuss the matter.

The short version is this:

This is incredibly face-slappingly depressing news:

Insurance experts say it's hard to know how many people opted to forego insurance and take a tax penalty and now have decided they want insurance, and also how many simply failed to sign up in time and now regret the decision.

But confusion over the new health law, also known as Obamacare, kept some from enrolling, health insurance experts say.

Some people thought they didn't have to meet the new health law's deadline because they didn't qualify for a premium subsidy from the federal government, said Carrie McLean, director of customer care at eHealthInsurance.com, a private Web-based insurance broker. Others thought that only people who wanted to purchase insurance through Covered California, the state's health benefit exchange, had to do so by March 31, she said.

And, according to a Kaiser Family Foundation survey in March, more than 60% of those without health coverage were unaware of the enrollment deadline for most people to sign up for individual health coverage.

According to the Kaiser Family Foundation, about 143,000 residents are eligible for expanded Medicaid under the ACA, so this means that the state has already signed up over 86% of the total eligible since October:

Under the health care reform law, West Virginia expanded its Medicaid program to cover those who earn up to 138 percent of the federal poverty line, or about $16,000 a year for an individual. As of May 27, 123,403 West Virginia residents had signed up for Medicaid under the expanded program.

Thanks to contributor Brian W. for both of the following pieces out of Forbes, published just two days apart; the contrast in headlines couldn't be more stark. First up is Bruce Japsen, who writes:

Obamacare Sticker Shock? Unlikely For Most In 2015

Though some analysts and even health plan executives believe there could be many double-digit percentage increases in premiums where some health plans underpriced for this year’s first year of enrollment to get customers, there have been examples where insurers are considering introducing even lower premiums than what they offered this year or new product with lower rates. A Bloomberg News report last week, for example, cited Molina Healthcare (MOH) in Washington State as offering a 2015 rate that is an average “6.8 percent reduction” from this year’s rate.

Every little bit...

Connector Updates for May 31, 2014

32,208 Applications completed in the Individual Marketplace
9,432 Individuals and families enrolled in the Individual Marketplace
629 Employers applied to SHOP Marketplace
851 Employees and dependents enrolled via SHOP Marketplace
 

It's rather ironic that Oregon, which had a disastrous exchange website which it's abandoning in order to join the federal exchange, still continues to post their enrollment data on a regular basis (pretty impressive numbers at that, by the way--another 10,204 added to Medicaid in the past week or so), while the federal exchange, which has been running smoothly for months now, has decided to stop posting their own updates. In any event...

Medical enrollments through Cover Oregon: 297,712
Total private medical insurance enrollments through Cover Oregon 1: 85,782                

Oregon Health Plan enrollments through Cover Oregon: 211,930

Dental enrollments 
Total private dental insurance enrollments through CoverOregon 1: 17,578          

Net enrollments 
Net private medical: 78,970
Net private dental: 15,476

Don't let the snarky headline fool you; I'm still very much a single-payer guy. However, anyone who still claims that the ACA exchanges are "socialized medicine" doesn't have the slightest clue what they're talking about. In case you needed even more proof that the ACA is very much private-market friendly:

Illinois:

After sitting out the first year, UnitedHealth Group Inc. intends to offer individual policies on the Illinois health insurance exchange next year, according to sources familiar with the company's plans.

The decision by UnitedHealth, the nation's largest and the state's No. 2 insurer, has the potential to shake up the Illinois market, which was dominated in 2014 by Blue Cross and Blue Shield of Illinois, the state's dominant insurer.

...United's participation also could help lower rates for consumers, a key concern among the law's supporters.

While United would neither confirm nor deny its plans to offer policies in Illinois next year, a spokesman said the Minnesota-based insurer intends to increase its participation over time in exchanges nationwide.

As of 1 month ago (May 4th), my calculations of NEWLY ADDED Medicaid/CHIP determinations stood at:

  • 4.89 million "strict expansion" enrollees
  • 1.19 million bulk transfers from existing programs
  • 2.26 million "woodworker" enrollees
  • Total: 8.34 million new determinations

Between various state-level Medicaid enrollee updates as well as today's April CMS report (referred to earlier today), these numbers have changed as follows:

Check out what just showed up in my in box this afternoon:

HHS Blog: Medicaid Enrollment Shows Continued Growth in April

Medicaid Enrollment Shows Continued Growth in April

By Cindy Mann, Deputy Administrator of the Centers for Medicare & Medicaid Services and Director of the Centers for Medicaid and CHIP Services

Medicaid enrollment continues to increase all across the country, especially in those states that have expanded their Medicaid programs under the Affordable Care Act.

As of the end of April, 6 million more individuals were enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) as compared to the period before the initial open enrollment under the Affordable Care Act started. That includes 1.1 million additional people enrolled in April as compared to March in the 48 states that reported data for both April and March.

Finally, we have Nevada; while their QHP enrollment was pretty lame, their Medicaid expansion has done quite well. They have an estimated 304,000 people eligible for expansion, of which the state has already enrolled about 27%:

There were 467,000 Medicaid enrollees as of the end of April — 50,000 more than anticipated, said Mike Willden, director of the state Department of Health and Human Services. Of those 83,000 people are newly eligible childless adults who did not previously qualify.

Willden projected Nevada's Medicaid numbers will reach 600,000 by the end of the year.

"That is substantial," he said.

Another Medicaid update out of New Mexico:

An estimated 220,000 New Mexicans are eligible for expanded Medicaid benefits, and 121,000 of them signed up for the newly available coverage. Many of them found their way to Medicaid by visiting the insurance exchanges online, by talking with guides, or at enrollment events designed to encourage use of the exchange.

Lots of Medicaid expansion updates today; here's Illinois...

Statewide, about 330,000 have enrolled in the expanded Medicaid program through the end of May, blowing away initial state estimates of about 200,000 for all of 2014, Koetting said.

The total eligible for ACA expansion in Illinois is around 801,000, so they've hit around 41% of that already.

OK, looks like expansion Medicaid enrollments are starting to slow down here in Michigan; only about 8,000 more people signed up over the past week. Still, that's 55% of the half a million total Michiganders estimated to be eligible for the expanded program:

Healthy Michigan Plan Enrollment Statistics

Beneficiaries with Healthy Michigan Plan Coverage: 276,662
(Includes beneficiaries enrolled in health plans and beneficiaries not required to enroll in a health plan.)

*Statistics as of June 2, 2014 
*Updated every Monday at 3 p.m.

Rand Paul has a habit of being just as much of a weasel as his senior counterpart Mitch McConnell on most issues, but occasionally being "refreshingly" honest. Case in point:

FRANKFORT — Saying he favors a full repeal of "Obamacare" but citing a "technical question," U.S. Sen. Rand Paul on Friday gave cover to U.S. Senate Minority Leader Mitch McConnell a week after McConnell said Kynect and the federal law are not connected.

..."There's a lot of questions that are big questions that are beyond just the exchange and the Kynect and things like that," Paul said.

"It's ... how we're going to fund these things."

...When asked a second time if he would want to dismantle Kynect, Paul said: "I would repeal all of Obamacare."

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