via the Washington Informer:

D.C. residents are among tens of thousands of Americans left uninsured by a health insurance scam that collected more than $100 million in premiums for junk plans.

A special enrollment period from now through Aug. 30, via the DC Health Benefits Exchange Authority, has been earmarked for residents who bought the junk plans from a Florida-based operation that was recently shut down by a federal court.

This Just In from the Indiana Insurance Dept...

INDIANA 2020 ACA FILINGS

The overall average rate increase for 2020 Indiana individual marketplace plans is 9.0%. CareSource and Celtic (MHS/Ambetter) have filed to participate in the 2020 Indiana Individual Marketplace. The Department of Insurance anticipates that all 92 counties in Indiana will be covered by both CareSource and Celtic (MHS/Ambetter).

Anthem has filed to offer a 2020 Off-Marketplace plan in Indiana. This plan is a catastrophic plan and is offered only in Benton, Jasper, Newton, Warren and White Counties.

Filing a rate does not guarantee it will be approved for use on the Marketplace, nor does the filed rate guarantee to be the final rate. Therefore, the Department of Insurance is not able to ascertain the amount of any final rates at this time. The state has until September 24, 2019 to review and submit dispositions to U.S. Department of Health and Human Services.

This Just In from the Montana Insurance Commissioner's office:

2020 Rate Filings and Rate Review

Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Montana State Auditor’s Department of Insurance for review and before plans can be sold to consumers.

What is rate review?

The rate review process, established by the Montana Legislature in 2013, does not give the Commissioner the authority to disapprove rates or prevent them from taking affect. It does give the commissioner the chance to review the factors insurance companies use in setting rates.

If the commissioner finds a rate increase to be excessive or unjustified, the insurer can voluntarily lower the rate increase. If the insurer decides to use the rate anyway, the commissioner will issue a public finding announcing that the rate is unjustified.

What does the department consider?

This Just In from the Kentucky Insurance Commissioner's office:

Proposed Insurance Rates Submitted to DOI for Review

Rates Subject to Review

Frankfort, Ky. (June 25, 2019) – Insurance Carriers have submitted proposed rates to the Department of Insurance (DOI) for Kentucky’s 2020 individual and small group markets. Anthem Health Plans of Kentucky, Inc. (Anthem) filed requests for 13 different plans to be offered on the Exchange with a proposed average rate increase of 12%. CareSource Kentucky Co. requested an average rate decrease of 4.5% for 12 different plans to be offered on the Exchange. This decrease follows the 19.4% rate increase approved last year for the 12 plans it offered. The submitted rates are subject to review by the Department.

After some last-minute drama in one state and a surprising lack of drama in another, both New Jersey and Pennsylvania have officially passed bills allowing them to each establish their own ACA exchanges and enrollment platforms, splitting off from the federal exchange and HealthCare.Gov:

New Jersey:

New Jersey Gov. Phil Murphy signed into law a bill establishing a state-based health care marketplace.

Murphy signed the legislation on Friday in a private ceremony.

Under current law, New Jersey uses a federal exchange, or marketplace, letting people shop for and enroll in coverage under the Affordable Care Act.

Not much of an entry, but still: A month ago, the Oregon Division of Financial Regulation posted the requested 2020 rate changes for the Individual and Small Group health insurance markets: 3.3% on average for the Indy market, 8.7% for the sm. group market.

Today, after reviewing the requests from the insurance carriers, the department has posted their "semi-final" rates. These may still see some additional tweaking before the final, approved rates are locked in, but the odds are that these will be the final rates:

Salem — Oregonians can now see the state’s preliminary rate decisions for 2020 individual and small employer health insurance plans. The Division of Financial Regulation must review and approve any rates before they can be charged to policyholders.

Preliminary rate decisions are for individuals who buy their own coverage rather than getting it through an employer and for small businesses.

Here's the transcript of the entire healthcare segment of Night One of the Democratic Candidate Presidential Debate:

HOLT: Senator Warren, you signed on to Bernie Sanders’ Medicare-for-all plan. It would put essentially everybody on Medicare and then eliminate private plans that offer similar coverage. Is that the plan or path that you would pursue as president?

WARREN: So, yes. I'm with Bernie on Medicare for all. And let me tell you why.

I spent a big chunk of my life studying why families go broke. And one of the number-one reasons is the cost of health care, medical bills. And that's not just for people who don't have insurance. It's for people who have insurance.

Here's the transcript of Sen. Elizabeth Warren's response to a question about Universal Healthcare Coverage from a March CNN Town Hall:

Senator Warren, thank you so much for being here this evening and your tireless advocacy for universal health care. As a supporter of universal health care and an advocate for organized labor, I do worry about the current bill...that would eliminate the private health employer-based plans that so many unions have advocated for. Can you explain how Medicare for all would be better for workers than simply improving the Affordable Care Act?

WARREN: OK, so it's a good question. Let's start with our statement that we should make every time we start to talk about changes in our health care, and that is health care is a basic human right and we fight for basic human rights. And then let's put these in order, because I appreciate that your question starts with the Affordable Care Act. Let's all remember when we're talking about what's possible, let's start where we are and the difference between Democrats and Republicans.

via Susan Livio of NJ.com (thanks to Andrew Sprung for the heads' up):

New Jersey’s most powerful state lawmaker said he will delay a vote to create the state’s own online shopping portal for health insurance, one of Gov. Phil Murphy’s priorities intended to guard against the possible repeal of the Affordable Care Act.

The delay means the state won’t meet an Aug. 1 deadline to submit an application to the federal government to create the exchange. The anticipated launch of a Fall 2020 open enrollment period would have to be postponed until 2021, a group of health policy experts warned.

State Senate President Stephen Sweeney, D-Gloucester issued a statement Tuesday affirming his support for creating New Jersey’s own health exchange. Sweeney said he just disagrees with the way fellow lawmakers want to go about it because it doesn’t include a means to automatically enroll low-income people into the Medicaid program.

Jibbers Crabst on a stick. Any time University of Michigan Law Professor Nicholas Bagley begins his Twitter threads with a screenshot of legalese, it's bad news.

First, here's his full thread:

The panel in the Fifth Circuit that's about to hear Texas v. United States has just asked for further briefing on standing -- and in particular on whether the intervenor states and the House of Representatives can properly appeal the case.

— Nicholas Bagley (@nicholas_bagley) June 26, 2019

I know I rip on Republicans a lot here at ACASignups.net, and I stand by pretty much all of it. Once in a while, however, a GOP member of Congress does do (or tries to do) something useful when it comes to healthcare policy...and the name most often attached to that is Senator Lamar Alexander of Tennessee. Alexander happens to be retiring, I should note. These two facts may or may not be connected, but I digress.

In any event, Sen. Alexander and Democratic Senator Patty Murray of Washington State have been working together for quite some time now on several healthcare bills to help stabilize the ACA, reduce drug prices and so forth, to varying degrees of success. I may not have agreed with most of Alexander's ideas, but he seems to be genuinely interested in improving the situation...and of course I can't say enough good things about Sen. Murray.

*(OK, probably not, but...well, read on...)

Regular readers may have noticed that I didn't post a single blog entry on Tuesday even though there's been a ton of healthcare policy stuff going on. No, I didn't take the day off; I started poring over a spreadsheet at around 10am and was working on it almost nonstop all day.

On Monday, along with posting their decisions on several important federal cases, the U.S. Supreme Court announced that, much to the surprise of many healthcare wonks, they will take up the long-gestating (and presumed dead) Risk Corridor Massacre lawsuit:

Big news: SCOTUS is taking up the ACA risk corridors case. GOP's decision to stymie that program arguably did the most damage to the ACA marketplaces. https://t.co/VeMRcd5MYn

— Bob Herman (@bobjherman) June 24, 2019

 

Long-time readers of this site may recall the infamous Risk Corridor Massacre of 2014-2015. Here's a very simplified backstory:

  • When the ACA was first developed and voted on, lawmakers knew that the disruption to the individual health insurance market was going to be pretty rocky for the first few years, so they put three types of market stabilization programs into place. They were known as the "Three 'R's"...Risk Adjustment, Reinsurance and Risk Corridors:

...Risk adjustment interrupts these cycles by doing exactly what its name implies. It adjusts for differences in the health of plans’ enrollees by redistributing funds from companies with healthier-than-average customers to plans with sicker-than-average customers. Such transfers could occur within or across health plan tiers in the exchanges (bronze, silver, gold, platinum). All the redistributed monies come from insurance companies in the marketplaces. No taxpayer bailout here.

I'm neither an attorney nor a Constitutional expert, so this may not have any legal significance beyond confirming what everyone already knew about the Trump Administration. Then again, perhaps it will.

Just a little over two weeks from now, the United States Court of Appeals for the Fifth Circuit will be hearing oral arguments in the Texas vs. Azar case, otherwise known as #TexasFoldEm. As a reminder:

If the entire ACA were to be repealed:

  • 16 million people would lose Medicaid
  • 9 million people would lose subsidized private ACA exchange coverage
  • 850,000 would lose BHP coverage in Minnesota & New York
  • Medicare Part D donut hole? Reopened.
  • Children being allowed to stay on their parents plans until age 26? Gone.
  • Discrimination against those with preexisting conditions? Back.
  • Annual & lifetime limits on coverage? Back.
  • Caps on out of pocket expenses? Gone.

...and much, much more.

Various healthcare wonks, including myself, have been warning for years that imposing work requirements on Medicaid enrollees would be pointless, ineffective, wasteful, expensive and cruel.

Several studies, including this one from just the other day, have driven home this point clearly: Adding work requirements to Medicaid expansion enrollees serves no useful purpose other than to kick tens of thousands of people off of their healthcare coverage (which, of course, is the whole point from the POV of those who add the requirements).

As for the one positive-sounding goal (increasing employment) which supporters always use to try and justify them, that's a complete joke:

The first major study on the nation’s first Medicaid work requirements finds that people fell off of the Medicaid rolls but didn’t seem to find more work.

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