Health and Human Services Secretary Tom Price on Sunday made a bold and questionable prediction about the Senate GOP bill to repeal and replace Obamacare: He argued that the legislation could actually provide health insurance to more individuals than the Affordable Care Act, a claim undermined by the Congressional Budget Office’s analysis of the bill.
Price made the comment while discussing how the Senate bill closes a gap that existed in certain states that chose not to expand Medicaid under Obamacare. In those states, there is a section of the population that does not qualify for traditional Medicaid, but makes too little to qualify for subsidies on the exchanges since Obamacare intended to cover it through Medicaid expansion. The Senate bill closes this gap, and Price used that provision to argue that more people would be covered under the new legislation.
Right on top of the American Academy of Actuaries' open letter explaining the extreme danger of the GOP passing their BCRAP bill (particularly the Godawful Cruz-Lee amendment) comes this joint letter sent to GOP Senate Majority Leader Mitch McConnell (well...and Chuck Schumer, since he is the Senate Minority Leader) from both America's Health Insurance Plans and the Blue Cross Blue Shield Association (h/t to Sahil Kapur and Topher Spiro...not sure who posted it on Twitter first):
The American Academy of Actuaries has chimed in on the GOP Senate's #BCRAP Obamacare replacement bill, and I have to imagine that they had to bite their tongues clean through while composing this primer explaining the most rudimentary concepts behind "insurance", "risk pools" and "adverse selection" to Paul Ryan, Ted Cruz, Mike Lee and Mitch McConnell:
Risk Pooling: How Health Insurance in the Individual Market Works
Division of Insurance releases preliminary 2018 health insurance information
Final approval expected in late September / early October
DENVER (July 14, 2017) – The Colorado Division of Insurance, part of the Department of Regulatory Agencies (DORA), today released the preliminary information for proposed health plans and premiums for 2018 for individuals and small groups. From this point until August 4, Colorado consumers can comment on these plans.
All counties in Colorado
As the Division of Insurance noted in its June 21 news release, based on the plans filed, there is at least one insurance carrier planning to offer individual, on-exchange plans in every Colorado county. However, the insurance companies have indicated to the Division that they may be forced to reevaluate their participation in the marketplace if the lack of clarity at the federal level continues.
So the latest #BCRAP b-crap being pulled by the Senate GOP is that they supposedly "forgot" to include the Cruz-Lee Amendment with the rest of the revised BCRAP bill that they sent over to the Congressional Budget Office to score next week. Topher Spiro of the Center for American Progress posted a twitter thread this morning which started off like so...
1: Senate Republicans are about to do something unprecedented that will break the Senate.
2: They claim they forgot to send the Cruz amendment to CBO on time. I think it was purposeful.
Now, this raised my eyebrows because I hadn't heard about this tidbit; when I asked for clarification, Spiro responded:
there was some mixup - McConnell staff blaming Cruz staff and vice versa. All staged.
I've been writing for months now about the impact of the Trump/GOP Sabotage Effect on 2018 rate hikes. Generally speaking, premium increases will be due to four things:
Medical Inflation: That is, the actual increases in charges by hospitals, doctors, medical equipment, prescription medication, administrative overhead and so on. In a perfect world, this would be the only reason rates ever go up.
Reinstatement of the Health Insurance Providers Fee: One of the ACA's funding sources is a broad-based fee placed on health insurance companies themselves. Basically, a small portion of all premiums for all enrollees (including the total nongroup (on & off-exchange), small group and large group markets) is paid as a tax to the federal government which in turn uses it to partially fund the ACA's tax credits, CSR payments and Medicaid expansion provisions. The carrier tax was waived for 2016-2017, but is scheduled to be reinstated next year, so premiums wiill go up a bit accordingly. It's supposed to total around $14 billion next year.
Both of these are unfortunate, but make total sense in an ACA world: Healthcare costs do rise year to year (though at a slower pace since the ACA passed), while the carrier tax helps cover a chunk of the subsidies and Medicaid expansion funding.
Still cuts off tax credits at 350% FPL instead of the ACA's 400% FPL. Pass.
Still bases tax credits on a 58% AV Bronze plan instead of the ACA's 70% AV Silver plan. Pass.
Throws another $70 billion onto the "state stabilization fund" pile for a total of $132 billion
Throws another $70 billion on to "offset costs for high-risk patients" (I presume this means reinsurance?)
Yes, it includes the Cruz/Lee "Separate but Unequal" amendment; carriers could indeed go back to offering unregulated plans: No guaranteed issue, no community rating, no essential benefits, as long as they also offer a fully ACA-compliant plan
Tax credits couldn't be used for the unregulated plans, nor would they be attached to the risk adjustment program. In other words: Segregated risk pools
Catastrophic plans would be "counted" the same as other plans (ie, tax credits could be used for them), but they'd amount to the same as Bronze plans now anyway
It includes a #BakedAlaska giveaway to win over Lisa Murkowski...1% of funds have to go to "any state where premiums are 75% higher than average" (i.e., Alaska)
