OK, I'm finally able to get back to digging into the meat of the FINALLY just-released 2018 Open Enrollment Report from the Centers for Medicare & Medicaid.
In Part 2, I'm looking at the actual 2018 Open Enrollment Period Public Use Files, which break out a ton of demographic info by state, county and even zip code depending on the state (some of it is available for all 50 states + DC, while other data is only available for the 39 states hosted by HealthCare.Gov).
First up: As I noted earlier today, there's around a 10,000 enrollee discrepancy between the national total I came up with back in early February and CMS's official total. I compared my state-by-state totals against CMS's report and found differences in 5 of the state-based exchanges:
NOTE: THIS IS A LIVE BLOG, SO CHECK BACK FREQUENTLY FOR UPDATES.
Yes, at long last (3 weeks later than last year, which itself was 4 days later than in 2016), the Centers for Medicare and Medicaid has finally released the official, final 2018 Open Enrollment Report.Let's dig in!
This report summarizes enrollment activity in the individual Exchanges during the Open Enrollment Period for the 2018 plan year (2018 OEP) for all 50 states and the District of Columbia. Approximately 11.8 million consumers selected or were automatically re-enrolled in Exchange plans during the 2018 OEP. An accompanying public use file (PUF) includes detailed state-level data on plan selections and demographic characteristics of consumers. The methodology for this report and detailed metric definitions are included with the public use file.
The Kaiser Family Foundation runs a widely-respected monthly natonal tracking poll about healthcare issues. The questions they ask sometimes change from month to month, and this month they asked a whole bunch of questions about...the Individual Market and the ACA exchanges. In other words, pretty much a bonanza of data-nuggety goodness for this site:
As part of the Republican tax reform plan signed into law at the end of 2017, lawmakers eliminated the ACA’s individual mandate penalty starting in 2019. About one-fifth of non-group enrollees (19 percent) are aware the mandate penalty has been repealed but is still in effect for this year. Regardless of the lack of awareness, nine in ten non-group enrollees say they intend to continue to buy their own insurance even with the repeal of the individual mandate. About one-third (34 percent) say the mandate was a “major reason” why they chose to buy insurance.
Republicans also want to use the funding bill to go after Obamacare. They would prohibit funding for administering or enforcing the health care law, prohibit the administration from collecting a fee from insurance companies to run the insurance exchanges and eliminate more than half a billion dollars in funding for managing the program at the Centers for Medicare and Medicaid Services.
(sigh) I'm not quite sure how "prohibiting funding for administration" differs from "eliminating funding for managing the program", but it amounts to the same thing: They're trying to shut down CMS's ability to actually run the ACA.
The good news is that none of that ended up making it into the omnibus bill.
Regular readers know that I've developed a tradition over the past three years of tracking the average unsubsidized premium rate increases for the ACA-compliant individual market, painstakingly poring over the rate filings for every carrier in every state and running a weighted average by their market share.
Every year there are numerous challenges and headaches which get in the way, including things as obvious as "not every carrier publishes the number of enrollees they have covered" to complex situations like "carrier X is dropping out of the on-exchange market in half the counties of the state but is sticking around in the off-exchange market". In addition, many carriers submit an initial rate request...followed a few months later by a revised one...neither of which might end up matching the final premium changes approved by state regulators. Sometimes there may be 2-3 more revised filings along the way which muddy the waters even further.
Over the past few weeks, in the midst of the failed Republican-sponsored "ACA stabilization bill" known as Alexander-Collins (which laughably included "Bipartisan" in the title evne though it had changed dramatically from the actual bipartisan bills which Senators Patty Murray and Bill Nelson had worked with Lamar Alexander and Susan Collins on last fall), Democrats in both the House and Senate introduced real ACA stabilization/improvement bills of their own.
Whenever the discussion of what the next Big Move for healthcare policy should be comes up in Democratic/progressive circles, the incredibly difficult path which had to be paved to get the Affordable Care Act passed in 2009-2010 is often brought up as an example of how difficult it is to make even minor changes, much less major ones.
That gets a bit repetitive after awhile, however, so here's another excellent case study from 20 years earlier: The Medicare Catastrophic Coverage Act of 1988.
Retreat in Congress; The Catastrophic-Care Debacle - A special report.; How the New Medicare Law Fell on Hard Times in a Hurry
With the benefit of hindsight, legislators and policy makers in both parties now agree that the seeds of disaster for the Medicare Catastrophic Coverage Act were sown well before it became law barely a year ago.
Louisiana officials will have to notify around 60,000 people who are elderly or disabled in early May that they are slated to lose their Medicaid benefits in July as a result of the Legislature's stalemate over the state budget and taxes.
Gov. John Bel Edwards has proposed eliminating some Medicaid programs that provide long-term care in order to cope with a $994 million budget deficit. The governor said he doesn't want to put forward such cuts, but he doesn't have much of a choice given the state's financial restrictions starting July 1, when the new budget year begins.
The Louisiana Department of Health is legally obligated to warn people about what might cuts be coming in July two months ahead of time, even if the programs are ultimately spared.
Here is our call to action for employers: Guide employees of any eligibility status to health coverage, whether employer-sponsored or government-supported, because it will benefit both employees and your company.
The main thrust of the article is that while most employers offer some sort of healthcare coverage option to their employees (in fact, most did so before the ACA mandated it), most of them don't appear to make a whole lot of effort to actually get the employees to enroll in that coverage...and even fewer make any sort of effort to encourage their staff to enroll in other types of healthcare coverage outside of the employer plan.
They include several charts and graphs, but this is the key one to me:
Gov. Gary Herbert signed a measure Tuesday to give more than 70,000 needy Utahns access to government health coverage, ending years of failed attempts on Capitol Hill to expand Medicaid in the state.
But whether House Bill 472 ever takes effect still remains uncertain. Under President Obama’s signature Affordable Care Act (ACA), the Utah law needs approval by the federal Centers for Medicare and Medicaid Services (CMS), which has sent mixed signals on whether it will fully sign off.
Even if CMS does approve HB472, it will likely be about a year — even on an aggressive schedule — before the state can begin enrolling people for coverage. Meanwhile, a competing Utah citizens initiative that would expand Medicaid coverage more widely than HB472 also continues to gather signatures for a spot on November’s ballot.
While many want Democrats in Congress to focus on improving the way the ACA is working rather than trying to pass a national health care plan, there is support for such a proposal. This month’s Kaiser Health Tracking Poll finds six in ten (59 percent) favor a national health plan, or Medicare-for-all, in which all Americans would get their insurance from a single government plan.