OK, I wasn't expecting this at 10:40pm on a Friday night, but here you go...via Stephanie Armour and Anna Wilde Mathews of the Wall St. Journal:

Trump Administration Expected to Suspend ACA Program Related to Insurer Payments

The Trump administration is expected to suspend an Affordable Care Act program that plays a key role in the health law’s insurance markets, a move that could deal a financial blow to many insurers that expect payments.

The suspension of some payouts under the program, known as risk adjustment, could come in the wake of a recent decision by a federal judge in New Mexico, who ruled that part of its implementation was flawed and hadn’t been adequately justified by federal regulators, people familiar with the plans said.

A few days ago, the Centers for Medicare & Medicaid released three important new reports on the 2018 Open Enrollment Period and trends in the individual market. There's a lot of data to go over, so I'm breaking my analysis into several smaller posts for easier readability.

OverviewPart OnePart TwoPart ThreePart Four

Now we move onto the second report released by CMS this week: The "Subsidized/Unsubsidized Enrollment Trend Report". If you set aside the anti-ACA digs from the Trump Administration, there's some fascinating data to be found, including what they claim to be one of the Holy Grails of the ACA individual market: Supposedly accurate data on the number of off-exchange ACA-compliant enrollees across the first four years of the ACA exchanges! Yes, I know, it's exciting, heady stuff.

A few days ago, the Centers for Medicare & Medicaid released three important new reports on the 2018 Open Enrollment Period and trends in the individual market. There's a lot of data to go over, so I'm breaking my analysis into several smaller posts for easier readability.

OverviewPart OnePart TwoPart ThreePart Four

Next, let's take a look at the average unsubsidized monthly premiums and APTC subsidies in each year. I've already crunched all of these data before, but that was based on the QHP selctions from the 2017 and 2018 Open Enrollment Periods. The table below is more accurate since it reflects the actual average premiums and subsidy amounts for all of 2017 and for 2018 after subtracting out nearly all of those who never actually paid for their first month of coverage. The numbers for each state and nationally should be close but slightly different:

A few days ago, the Centers for Medicare & Medicaid released three important new reports on the 2018 Open Enrollment Period and trends in the individual market. There's a lot of data to go over, so I'm breaking my analysis into several smaller posts for easier readability.

OverviewPart OnePart TwoPart ThreePart Four

OK, next up: HOW MANY HAVE PAID???

Whew! Georgia only has 4 carriers participating in the individual market, but tracking down some of the data was a royal pain in the butt, especially Ambetter/Centene, which not only buried the numbers I needed inside a whopping 1,900-page PDF file, but the actual average requested rate increase wasn't even included; for that I had to check a different file. Yeesh.

The good news is that carriers in Georgia are only requesting around a 6.1% average rate increase for ACA-compliant individual market policies next year.

The bad news is that if it weren't for the ACA's individual mandate being repealed and the Trump Administration's expansion of #ShortAssPlans, 2019 premiums would likely be dropping by around 5.8% instead.

NOTE: My broadband connection has been experiencing a lot of problems lately; I have a service guy on his way out today for the fourth time in the past two weeks, but this means I'll likely be offline for a few hours, so this post will be incomplete for awhile.

Yesterday, the Centers for Medicare & Medicaid released three important new reports. I did an initial write-up about their overall findings yesterday; today I'm taking a deeper look at the actual reports themselves.

First up, the February 2018 Effectuation snapshot report:

This Just In...

Centers for Medicare and Medicaid Services Releases Reports on the Performance of the Exchanges and Individual Health Insurance Market
Reports show individual market erosion and increasing taxpayer liability

Um...yeah, deliberately sabotaging the ACA a dozen different ways and cutting off CSR reimbursement payments, thus forcing the carriers to load CSR costs directly onto premiums, which in turn jacks up APTC subsidies accordingly, will have the effect of "increasing taxpayer liability"). Go on...

Last summer, as part of his blatant and openly-declared attempt to undermine and sabotage the Affordable Care Act, Donald Trump's HHS Dept. slashed the marketing budget for HealthCare.Gov, the federal ACA exchange, by a whopping 90% (from $100 million to just $10 million), while also cutting the navigator/outreach budget by 41% (from $59 million down to $36 million). On top of this, they also proceeded to confuse the hell out of the grantees of those remaining funds by not providing any information or details before sending out the funds...and then changing their minds at the last minute in many cases and pulling the checks literally moments before they were supposed to be put in the mail. They also slashed the Open Enrollment Period itself in half while they were at it, from 3 months down to just 6 weeks.

On November 8, 2010--right after the "Red Wave" midterm election in which Republicans picked up a jaw-dropping 63 seats in the U.S. House of Representatives, 6 Senate seats and 680 state legislative seats--Paul Waldman wrote, in The American Prospect:

In charting the last two years, from the euphoria of election night 2008 to the despair of election night 2010, I keep returning to Mario Cuomo's famous dictum that you campaign in poetry but govern in prose. The poetry of campaigning is lofty, gauzy, full of possibility, a world where problems are solved just because we want them to be and opposition melts away before us. The prose of governing is messy and maddening, full of compromises and half-victories that leave a sour taste in one's mouth.

...All else being equal, this means Republicans have an easier time getting elected and a harder time legislating the things they really want to do (other than tax cuts, which are never a hard sell), while Democrats have a harder time getting elected but ought to have an easier time legislating.

For nearly a year, healthcare wonks like myself, David Anderson, Andrew Sprung and Louise Norris have been heavily getting the word out to promote not just the "Silver Loading" CSR-load workaround, but an even more clever variant which I've coined "the Silver Switcharoo" which takes the concept of Silver Loading and goes one step further.

It gets a bit complicated, but here's my explainer of how the Silver Switcharoo works for ACA individual market policies.

The bottom line is that in theory/on paper, just about everyone either comes out ahead or at least is no worse off if they use silver switching:

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