I was on call for the go-live but was able to take a couple of days off work. I got no calls, and my e-mail back-log has only minor implementation concerns such as whether or not Doc X is in Mayhew Product Y as a new member wants to make sure she can see him next week. As a side note, PPACA has probably permantly altered the holiday season for health insurance companies. Traditionally 1/1 had been the big renewal date, which meant a lot of prep work in December and thus minimal holiday time off. However PPACA had quite a few small and medium size groups shift to a 12/1 renewal date so they could avoid community rating underwriting for one more year. That shifted the prep work to October and November, so more holiday time off is now available.
And even better news —
Roughly 6 million people have health insurance through the two major system disrupting changes of PPACA, Medicaid expansion and Exchanges:
These two small updates bring the totals to:
2,104,332 Private Plans
However, these numbers could still go somewhat higher since several states (RI, MA & MN) have extended their enrollment deadlines through midnight tonight, and Oregon has gone even further, allowing for enrollments to be made retroactively up through January 6th for 1/1/14 coverage (I would imagine that there’d be some sort of limit on this in case anyone suffers a gunshot wound or major heart attack during those first 6 days, but that’s their call).
Now back to bitching about being back at work….
With ~3 million under 26 who have insurance through their parents’ plans, that’s more than 9 million total with insurance today who couldn’t get it/ wouldn’t have had it pre-ACA. I call it a win.
@folkbum: I would be reluctant to say that everyone in the Under-26 crowd is only getting insurance through their parents’ plans. Some probably were offered craptastic plans through work, some probably could have gotten covered on the individual market etc.
I think it is safe to say 3 million people under the age of 26 got much better coverage through their parents’ plans and a large chunk of that number is new coverage.
Are the numbers for the individual pool all newly insured? I’ve had an individual plan since 1998 that was actually pretty good (HAP HMO), and am now in a slightly differnt version.
Nunca El Jefe
@Richard Mayhew: this is tangential, admittedly, but is a question that you may be able to answer. Are actuarial tables based on the full population in a coverage area, or just the insured population? I think it must just be the insured population, but I can argue (with myself) otherwise.
Ben Cisco (onboard the Defiant)
Richard, let me add my voice to the chorus of thanks for your contributions to this site. I’m one of the lucky ones who have good insurance, but I am gratified that options have improved for so many others.
So, Sotomayor temporarily blocked the contraceptive mandate. Any odds on whether SCOTUS actually overturns it? And will contraceptive coverage disappear from all employer insurance plans at that moment? (Of course, many had it before.)
GHayduke (formerly lojasmo)
Slightly OT, but Obama’s popularity has jumped 5% according to Gallup
Wife’s bargaining agreement dropped the Mayo Clinic from her insurance. Her employer will pay the difference for out of network costs for the first year.
This is going to be a total clusterfuck for us.
ETA: our member numbers or group number did not change.
@Nunca El Jefe: Both — depends on what table is being used for what purpose. There are general population tables used for screening and basic projections and then specified and usually propiertary tables for actually projecting out what the insured population of a given company will probably claim in a given time period.
@Matt McIrvin: Sotomayer stayed the contraceptive mandate for religiously affiliated but not explicitly religious groups (ie colleges and Catholic Hospitals vs. the Catholic Diocese of NYC is the distinction as contraception was already exempted for the Catholic Diocese of NYC) — contraceptive mandate still on track for Big Evil MegaCorps
Richard: my 2012 W2 employer provided insurance value was $7,780, with $50/month premiums from me. Is this Cadillac? (2013 not posted yet) How will my tax structure be determined? Q #2 are employer-paid insurance plan payments deductible for them? If so, shouldn’t the public be aware of this so there could be more push back when corporations whine about med costs and dump plans. I’ve never seen a clear answer to whether those costs are deductible.
@p.a.: cadillac is considered above $10k per person so no.
@mai naem: tks!
No idea what Mass and Minn are up to, but RI and OR had bloody well better offer their citizens every break they can get. Those two states, especially Oregon, have a serious case of WTF. I hope that somebody gets pilloried when the business of fixing the mess settles down.
Then again at least OR and RI did something. Maryland gets a special booby prize for also botching the rollout worse than the feds did, and then not offering any breaks for late enrollment.
My wife’s aunt signed up for Obamacare 2 or so weeks ago. Her husband retired a year or 2 earlier, and she lost coverage when that happened.
She had 2 choices for providers. Provider A is a known quantity and does excellent work (coincidentally, my wife used to work for them years ago). Provider B is completely unknown by any of us, including my wife, who has experience in the business. Aunt’s reasoning: she knew someone on welfare who used Provider A, and didn’t want anyone to think that she’s on welfare. I’m not sure how it turned out, but there was an effort made to get her to change providers before the deadline.
Still haven’t received insurance cards. This is for an employer plan and enrollment deadline was in October. Called insurance company on December 31 and they could not give me confirmation of 2014 enrollment nor were 2014 cards available on their website. The agent saids cards would be available on January 2nd on the website. No suggestions as to what to do if a hospital visit was needed on the 1st. Very poor customer service. No idea if I’m insured although email confirmation of enrollment did come through but that was from the enrollment website. No confirmation the enrollment website sent it on to the insurance company.
@Richard Mayhew: It’s always seemed to me that many under-26 people don’t have parents with health insurance who can put them on their plans. That’s a kind of upper-middle-class view.
@JoyfulA: 64% of the population has private insurance and thus are eligible to keep their kids on it. I am not sure how upper middle class that is.
@Violet: That would be unsettling, but that confirmation email is your friend.
@Omnes Omnibus: Is that 64% personal or family health insurance?
I’ve never had health insurance that I could cover anyone else with. Of course, I’ve had an individual health insurance policy for decades, and my last group health ended when I quit in 1979.
I got a notice that my PCP was retiring effective 1 Jan, and I was switched to an other doctor in the same group. I doubt he retired simply because of the ACA, although he complained often about the added record-keeping. He had been cutting back on office hours for a while. He was generally a supporter of Obama and not reluctant to discuss politics with me (in the brief time he had to see me.) Still, the timing is interesting. It may have something to do with the medical group’s changes, though.
Just wanted to add another Obamacare success story. My sister and her husband are both self-employed and have 5 kids. They were paying $20,000 a year for a bare-bones health insurance policy because my brother-in-law has a work-related preexisting condition, plus two of the kids had minor birth defects. They were able to get a better policy for $3000 a year on the exchange. (It might actually be even lower than that, as it wasn’t clear to me whether or not they were including the subsidies.) This is so huge for them.
@Richard Mayhew: Oh, so Hobby Lobby doesn’t get a pass? That’s interesting.
If Ball Juice accidental Obamacare troll posts a good news story it must be an even day. Wonder what negative spin he has planned for tomorrow.
@Tim F.: I get the impression that there have been some problems in Massachusetts, but it’s simply not regarded as a major crisis in local news/politics because we went through the big transition several years ago, and the vast majority of people in the state are already covered, either through the state exchange or otherwise. Remember, the ACA is largely modeled on Massachusetts health-care reform, though there are a number of differences in detail and Mass. has had to adjust to take those into account.
The article I linked did not say. However, just under half of the population has employer based insurance. Those policies generally have an option to cover family as well – the company may not subsidize the family portion.
In any case, the ability to keep young adults on insurance only affects those young adults whose parents have a family policy. It looks like there were about three million of those. I tend to doubt that they were primarily upper middle class.
@Richard Mayhew: The Boston Globe had a story today about a group of MA college students who were not covered under their parents’ insurance and who were also not being covered by Masshealth or other cheap insurance (Medicaid) who were being forced by their colleges to pay exorbitantly for insurance coverage while at school. The article was maddeningly imprecise as to actual numbers but a change in the law has forced colleges to somehow offer all students an inexpensive insurance option. I don’t believe it can have been a large number of students but the new amendment was driven by a student led action group which had seen students go into debt and also drop out because of the costs associated with health insurance so it can’t have been insignficant.
All these numbers are imprecise. x% of what? Individuals? Households? Population? (define that, journos), Individuals under 65years old? Individuals between 18-65? 26-65? U S citizens? The non Medicare/Medicaid population? Journo-fail.
@GHayduke (formerly lojasmo): Daily fluctuations in an individual poll mean nothing. But one thing I did start to notice, once I looked further into all the “Obama’s popularity sinks meteorically to record low” stories that were driving me to total despair over the last few weeks, is that the record low was almost always something like 41% or 42% (I think there had been one or two outliers below 40%, but they were weeks ago), and yet the shocking stories kept coming as if this new low had just now happened and was worse than the one in the last story I read. And it probably just did now happen, in that one particular poll. But actually there seems to have been some stabilization over the past month or so.
Of course, Obama’s approval rating really isn’t as important as, say, the House and Senate races. But there doesn’t actually seem to be some kind of free fall toward a Republican landslide happening; I think the big freakout finished about a month ago.
@Matt McIrvin: Nope, different challenges and different arguments. Hobby Lobby is basically arguing that they should get all the benefits of corporate personhood but not the restrictions so the individual owner can pierce the corporate veil and impose his religious preferences on his employees’ compensation. The Little Sisters of the Poor Home for the Aged case is a statutory interpretation case that argues the contraceptive mandate is still an infringement on the religious liberty of a group that is fundamentally religious in nature and any thing that vaguely acknowledges that some of their employees may want to use birth control is an infringement on their religious liberty.
Everyone agrees that non-profit charities can have a religious nature. Very few people think that privately held corporate entities have religious natures.
@Richard Mayhew: Ah, I think that I read the headlines and just carelessly assumed that this was the Hobby Lobby case.
…My favorite one of the tendentious “Obama in free fall” articles was actually in Russia Today (rt.com, I guess): the headline was something like “Obama’s 2nd-term popularity worse than Bush, worst since Nixon.”
The cherry-picking they did to get there was epic: they compared second-term Presidents at this exact point in their second term, which of course meant that they got to ignore everyone who didn’t get reelected, and ignore all the downward movement in GWB’s popularity toward the end of his second term. The number they had for Obama was like 1 percentage point below GWB on the analogous day (which was after Katrina, but while the wingnuts of America were still valiantly defending him). Whereas Nixon at that point was in his final pre-resignation slide and way, way down in the basement. The only other two-term Presidents since Nixon were Reagan and Clinton.
It’s an interesting dilemma, though — should secular employees of religious institutions be forced to abide by the beliefs of those institutions? (Obviously, religious employees — nuns, priests, brothers, ministers, etc. — are already supposed to abide by those rules.)
My example is usually a Hindu radiologist working in a Catholic hospital — should she be forced to follow the dictates of the Catholic Church, and if so, how far does that go? Can a Catholic hospital require its employees to attend Mass every morning?
@WaterGirl: The idiot customer service rep for the insurance company actually suggested I take the confirmation email to the doctor’s office and show it to them to “prove” I have insurance. Uh huh. I’m sure that’ll go over well. I don’t know if she could hear my jaw hitting the floor when she said that, but when I asked her how the email would provide the doctor’s office with the insurance company’s contact phone number and my ID number, etc. she did not have an answer.
That is not the argument being made. The Little Sisters are not arguing that their employees must adopt church approved birth control practices, but rather that they, the Little Sisters, should not be forced to pay for practices that violate church doctrine. I think their argument is wrong. Health insurance as currently constituted is a form of compensation and the employer has no right to tell the employee what to do with it.
But, in practice, isn’t that the same thing as requiring non-church members to follow church doctrine if you decide they’re not allowed to have access to birth control through their work insurance? I know there’s probably some narrow legal argument to be made, but the reality is that someone is being required to follow the rules of the Catholic Church even if they’re not Catholic.
More accurately, Justice Sotomayor blocked (until tomorrow) the small slice of the contraceptive mandate that applies to employees of actual religious institutions (note that the plaintiff in the case is an order of nuns).
Marty Lederman has a long post up at Balkinization, which explains to my satisfaction why the arguments being made by the Little Sisters of the Poor ( and by Notre Dame University in a related case) are crap. YMMV.
@Mnemosyne: They always have the option of self-insuring, at which point they can dictate coverage options.
Who is “they,” the Catholic hospital? They can dictate up to a point, but even self-insured companies have to meet the minimum coverage required by PPACA, which includes co-pay free birth control.
For the first time in the entire ACA enrollment process, I’m pissed.
This is not the right day for the BS of CA website to be experiencing a “temporary technical problem” that is preventing me from printing or downloading temporary ID cards.
@Mnemosyne: There is nothing stopping the people from purchasing birth control on their own. Didn’t many insurance policies fail to cover birth control pre-PPACA?
I really hope you’re just channeling the wingnut argument rather than making it yourself. ;-) PPACA says that birth control is covered preventative care. If we’re going to ignore that requirement of the law, what other requirements can we ignore because the employer doesn’t feel like paying for them? Can an employer who’s a Jehovah’s Witness refuse to cover blood transfusions because there’s nothing stopping the employee from paying for that on their own if they feel they need one?
ETA: Can a Christian Scientist employer refuse to cover cancer screenings because God will decide if you get cancer or not?
The way this is supposed to work is that the employees contraceptives are paid for by the insurance company out of a fund that isn’t traced to the premiums paid by the religious organization, and the insurance company is reimbursed by the Feds.
The wrinkle here (as I understand it) is that the Little Sisters self-insure, and their ASO is also church-related.
@Mnemosyne: Read my original comment on this. Your characterization of the Little Sisters of the Poor’s argument was incorrect. I was correcting it. At no point did I advance any argument in favor of their position. Look, one cannot effectively argue against a position if one does not define the position correctly. Otherwise one is setting up and fighting strawmen.
“Roughly 6 million people have health insurance through the two major system disrupting changes of PPACA, Mediaid expansion and Exchanges”
YAY! That’s great news. The Dems need to boast about the successes of the ACA in the upcoming mid-term elections.
What are you disputing with the “no”? Is the final effect not of enforcing church doctrine on employees?
Again, we’re not talking about the workarounds and the legalistic sneaky ways to get around it. We’re talking about reality, which is that employees are being required to conform to the Catholic Church’s restrictions against birth control.
I was not characterizing their argument. I was pointing out that, in reality, the effect of their argument is to enforce church doctrine on their employees, even if those employees are not Catholic.
Do you disagree that the ultimate effect of allowing Catholic institutions to void portions of PPACA would be to enforce church doctrine on their employees? Not the institution’s stated intention, but the actual results of the policy?
I guess this is my argument to counter theirs: their policy has the effect of enforcing church doctrine on their employees. Are judges not allowed to look at the expected outcome of letting a law stand or fall, or are they only allowed to look at the narrow legal question and not think about the consequences at all?
@Mnemosyne: The effect of the LSP succeeding would be that birth control would still be available to its employees but it would need to be purchased by the employees at their own expense.
The dilemma you posed was this: should secular employees of religious institutions be forced to abide by the beliefs of those institutions?
No one is suggesting that they should. It is a mischaracterization of the argument being advanced by the LSP – whose actual argument is crap, IMLO.
@Violet: Not to make light of your situation, but I laughed out loud at your first sentence!
The argument to counter them is that the purpose of the health insurance they provide is provide health care to their employees. The specifics of that healthcare is between the provider and the patient- it is really none of the employer’s business.
So we’re not allowed to look at the actual effect that a policy has and can only look at it through the argument advanced by the LSP?
IMO, forcing employees to pay for healthcare out of their own pockets due to the beliefs of the employer is forcing employees to abide by their employers’ religious beliefs. I’m not sure how there can be any other honest real-world characterization of it. The only reason these organizations have gotten away with it so far is because the healthcare involves ick, ladyparts! It wouldn’t even be a question if the religious belief was whether or not the employer should have to pay for blood transfusions or if the employee should have to pay that out of their own pocket so their employer didn’t violate their religious doctrine.
ETA: Also, too, the only place you can use a secular argument to counter a religious one is inside the walls of a courtroom. In the realm of public opinion, you need to counter religious arguments with religious arguments.
Burnsesq linked to a blog post about the case:
The interesting/tricky part about this specific case is not that they’re self-insured, but that their third-party administrator is ALSO a Catholic organization (Christian Brothers Services), so you have two primarily Catholic organizations that both want to opt out of offering contraception, which would leave employees with no options other than paying out of pocket. I’m assuming it’s this weird doughnut hole that led Justice Sotomayor to accept the case.
@WaterGirl: Yeah, it is pretty unbelievable. Laughter is a good response.
I wasn’t aware that this part of self-insuring had changed. Thanks
The way it was explained to me is, PPACA leveled the playing field by requiring a “floor” under which no health plan is allowed to go below — all insurance policies have to offer the listed preventive care (including contraception) as a minimum, but can offer more if they choose.