OE6

2018 MIDTERM ELECTION

Time: D H M S

A few days ago I warned Congressional Democrats that while I agree that appropriating CSR reimbursement payments at this point would be a net negative move thanks to the clever Silver Load/Silver Switcharoo workaround developed last year, there's one possible cloud surrounding that silver lining, so to speak: What if the Trump Administration were to attempt to put the kibosh on Silver Loading altogether?

I don't know the legality of such a move, mind you, but It has been thrown around the rumor mill of late, so I figured I should remind them to keep that possibility in mind.

Well, today I received some reassurance...

Azar Says He Is Not Aware Of Discussions On Blocking ‘Silver-Loading’ in 2019

Two pieces of welcome news out of the Green Mountain state via Louise Norris at healthinsurance.org:

New legislation will allow Vermont insurers to load cost of CSR only onto on-exchange silver plans for 2019

For 2018 coverage, Vermont, North Dakota and the District of Columbia were the only states that didn’t allow insurers to add the cost of cost-sharing reductions (CSR) to premiums after the Trump Administration cut off federal funding for CSR. In most states, insurers were allowed to either add the cost of CSR to all silver plan premiums, to all on-exchange silver plan premiums, or, in a few cases, to all metal-level plan premiums. But in Vermont, North Dakota and DC, insurers simply had to absorb the cost of CSR, estimated at $12 million a year in Vermont.

As a reminder, for 2018:

OK, this is just kind of...odd.

As regular readers will recall, after three years of full 3 month Open Enrollment Periods across every state, last year the Trump Administration slashed the official Open Enrollment Period in half, down to just 6 weeks, from November 1 - January 31 down to November 1 - December 15th.

In response, most of the state-based exchanges announced that they were sticking with a longer period anyway, ranging anywhere from a 7th week all the way out to the full 3 month period, in the case of California, New York and the District of Columbia...each of which kept things going all the way through January 31st as had become the norm.

California even went one step further, passing a state law specifically mandating a 3-month Open Enrollment Period for 2018 and beyond.

Until today, I've been operating on the assumption that they'd be sticking with the November/December/January schedule which had become the default.

Apparently not, however. According to Louise Norris:

As long as I'm snarking on Washington's exchange for getting so excited over what appear to be pretty minor tweaks (to the average Joe, anyway), I might as well also give a shout-out to Connect for Health Colorado as well, which just posted this tidbit:

To Our Valued Stakeholders,

We took an important step forward this week with our board’s decision to move ahead on building a new eligibility system. With our own system, we will be able to provide customers a better application and enrollment experience and at the same gain more control and predictability for IT expenses.

A simplified path for enrolling with financial help can be expected to help us grow enrollment while getting more Coloradans the Advance Premium Tax Credit and Cost Share Reduction benefits that they are eligible to receive. We will continue to support Health First Colorado (Medicaid) enrollments and ensure that customers are routed to the right program, whether they begin at our site or with the PEAK application.

...assuming racist Governor Paul LePage actually stops being a jackass long enough to actually implement it.

According to the CMS/ASPE 2016 Final Enrollment Report, during the 2016 Open Enrollment Period, Louisiana enrolled 214,148 people in exchange-based Qualified Health Plans.

However, during the 2017 OEP, Louisiana only enrolled 143,577 people...exactly 33% fewer.

Most states dropped a bit year over year in 2017 in large part due to the Trump administration cutting off outreach/marketing during the critical final week, but Louisiana saw the worst year over year drop. Why? Well, the most obvious reason was pretty simple: The state expanded Medicaid halfway through the year.

This won't have too much effect until November (aside from more mentions of Special Enrollment Periods, I presume), but this is EXTREMELY welcome news for ACA supporters; 

EXECUTIVE ORDER NO. 4

WHEREAS, a primary goal of my administration is to ensure that every New Jerseyan has access to affordable health insurance and none of our residents are unable to see a doctor when they are sick; and

WHEREAS, the Affordable Care Act represented a huge step forward in ensuring that all Americans have access to affordable health insurance; and

WHEREAS, New Jersey turned down a substantial amount of federal funding when it declined to create a state-based exchange that would have been customized to the needs of New Jersey residents, and given the State greater flexibility in its enrollment period; and

WHEREAS, over 275,000 New Jerseyans currently receive health insurance coverage on the federal marketplace created under the Affordable Care Act; and

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