Blog Archives

Across the Country in ACA World - Oct No. 3

10/29/2019

What’s getting funded: The Rhode Island Healthcare Cost Trends Project was just awarded a second grant ($1,300,000 in addition to the $550,000 in the first round) from the Peterson Center on Healthcare to expand work on data-driven healthcare transparency to limit healthcare cost growth. The project is a collaboration between Rhode Island state agencies and Brown University. See Peterson Center on Healthcare Expands Partnership with Rhode Island and Brown University on Data-Driven Healthcare Transparency.

The Washington Health Benefit Exchange is jointly leading the implementation of that state’s public option program. The exchange is taking comments on the draft gold, silver and bronze plans that will serve as the foundation for the state’s new Cascade Care public option, to be available for coverage year 2021. The exchange hosts the stakeholder workgroup that proposed the public option plans, and its website provides links to the full public option report, the draft plans, an explanatory powerpoint, background info and links to submit public comment. Colorado, the other state working on a public option, has taken a different approach.

Mass Health Connector aims to boost the state’s coverage rate from 97.2% to 100%, focusing on the last holdouts. According to the latest census information, just 2.8% of Massachusetts residents lack health coverage, the lowest rate of any state.

Maryland is studying the Massachusetts Commonwealth Care Trust Fund model, which provides extra subsidies for people who otherwise lack coverage. The Commonwealth Care Trust Fund is funded from various sources, including a tobacco tax, a penalty levied on people who don’t get health insurance, and the state’s general fund.

Maryland is also implementing the Maryland Easy Enrollment Health Insurance Program, the country’s first attempt to use income tax filing as an entry point for health insurance enrollment. By checking a box on their state income tax return asking the exchange to determine their eligibility for free or low-cost insurance, an uninsured tax filer can have relevant information from their return sent automatically to Maryland’s health insurance exchange. The exchange then uses that data and other available records to determine the individual’s eligibility for Medicaid, CHIP, and PTCs.

Health Insurance 101: Preparing for Open Enrollment is a 25-minute on-demand webinar offered by California-based online broker StrideHealth.

Across the Country in ACA World - Oct No. 2

10/14/2019

Colorado made big news last week with its draft proposal for a public option. The proposal is required to be submitted to the CO legislature by Nov. 15. Legislation passed last session required CO’s Division of Insurance and the Department of Health Care Policy and Financing to develop the plan. The public comment period runs through Oct 25. Under the draft proposal, the State Option would:

Be available to all CO residents regardless of eligibility for subsidies, beginning 1/1/2022;
Be offered as a Qualified Health Plan through Connect for Health Colorado;
Be offered by every carrier in CO over a certain size (tbd), both on and off the Exchange;
Boost enrollment by adding 4,600 - 9,200 previously uninsured, unsubsidized people to the individual market, according to Wakely projections.
Offer all Essential Health Benefits; include more benefits that are not subject to the deductible, plus other high-value services like dental, pending savings and federal approval;
Incorporate value-based design elements;
Save money by capping payments to hospitals at 175%- 225% of Medicare rate. Insurers selling plans on the individual market in the state currently pay providers about 289% of Medicare. Additionally the State Option will require at least 85 cents of every dollar of premiums to be spent on health care. That’s more than the current federal requirement of 80 cents of every premium dollar; and
By driving premiums down, save the federal government between $69.7M and $133.6M in premium tax credits.

Where You Live Affects How Long You Live - Check out the amazing new “social determinants of health” tool from the Robert Wood Johnson Foundation. Enter a street address to see life expectancy at the neighborhood, county and state level. See how much a neighborhood can impact people’s health.

New Jersey is investing $2 million in navigators as it starts the shift from healthcare.gov to its own state-based marketplace. New Jersey’s state-based exchange is officially barely a month old.

For a highly impressive use of data based on the California Health Information Survey using brainpower from the UCLA Center for Health Policy Research, check out the AskCHIS Neighborhood Edition© web tool. The tool lets you search for top health indicators by ZIP code, city, county, and legislative district (state and federal). The sample below shows the prevalence of diabetes across California (diabetes increases health care costs which increase premiums…). Of course, the tool is only for California. Connecticut could use its own version. 😊

Across the Country in ACA World - Oct No. 1

10/8/2019

Still waiting! The 5th Circuit Court of Appeals decision in Texas v. Azar is due any time. This is the case that appeals a federal trial court judge’s decision in Dec 2018 that the individual mandate and the entire ACA are invalid now that the tax penalty for being uninsured was dropped to zero. Currently, 18 states, led by Texas, claim the ACA is unconstitutional. 21 states, led by California, are defending the ACA. The federal government also now claims the whole ACA is unconstitutional. Previously, the US Supreme Court said that the tax penalty is what made the mandate and the ACA permissible because Congress has the power to tax. Kaiser Family Foundation explains more.
Healthscore CT’s cost estimator component is now live. Healthscore CT lets people compare the cost of medical care at Connecticut hospitals and provider networks. It also has a quality component, with a scorecard for providers. Healthscore CT is a project of CT’s Office of Health Strategy.
“The ACA at 10” conference at Yale offered excellent perspectives on the ACA’s history, legacy and challenges. Speakers included some of the original architects of the ACA, including Kathleen Sebelius and Rahm Emmanuel, and many of the country’s leading experts on the ACA. Watch any segment you’re interested in: 9/26 video. 9/27 video. Agenda.
In California:
- Covered CA and UCLA conducted research on the role of Behavioral Frictions in Health Insurance Marketplace that was published by the National Bureau of Economics Research. The study found that reducing “behavioral frictions”--the hassles involved in enrolling--counts for a whole lot in getting people to enroll. Significantly, the study found that people who put off completing their enrollment tended to be healthier. Having healthier people in the risk pool helps keep premiums lower down the road. Sending a simple reminder letter was the most effective intervention in getting those people to enroll. The study looked at Medicaid to QHP customers separately from those who visited the exchange on their own initiative. Behavioral Economics Could Increase Obamacare Enrollment and Stabilize Markets.
- California also has its own state health insurance survey which policymakers, researchers, health experts, members of the media and others regard as a critical source of comprehensive data on the health of Californians. More here and here.
- California’s OE starts early, btw, on Oct 15 and ends Jan 15.
Colorado: New results from the Colorado Health Access Survey show that the uninsured rate increased from 9.7% to 11.8% for people who earn two to three times the federal poverty level. The uninsured rate also increased for people between 50-65, and for kids 18 and under. Overall though, CO’s uninsured rate held steady at 6.5%.
In Minnesota:
- MNSure is adding 39 new health plan options for 2020. Window shopping starts Oct. 15.
- MNSure reports that nearly 75 percent of uninsured Minnesotans—over 250,000 people—in 2017 would have been eligible for financial help through MNsure. How do they know? Because Minnesota conducts a Health Access Survey.
- Minnesota also has new interactive data (consisting of a downloadable and interactive Excel spreadsheet tool , and an interactive Minnesota map) on its uninsured population at the zip-code level. Partnering with the Blue Cross Blue Shield Foundation of MN, who provided project funding, and with essential guidance from the MNsure advisory board, this resource is useful for the exchange and policymakers as they develop strategies to reach the remaining uninsured in Minnesota.
Data: What new things should CT be doing with data to stay ahead of the curve? Where can we collaborate? Data lovers might want to attend the free CTData conference Wednesday, November 20 in New Haven. Register.

Across the Country in ACA World - Oct No. 3

Across the Country in ACA World - Oct No. 2

Across the Country in ACA World - Oct No. 1

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