I have to admit, I was a bit too dour and pessimmistic in evaluating the probability of Republican dominated states expanding Medicaid in 2015. I figured it might be just the Mountain West submitting applications for program starts on either July 1, 2014 or January 1, 2015, but I was wrong. Tennessee is submitting a waiver to their legislature for approval to expand Medicaid. And given the circumstances, it looks to be a fairly reasonable waiver application.
The first part is very similar to Utah’s premium support model for people who work at places with employer sponsored coverage but can’t afford it:
Tennesseans 21 to 64 years old will be offered a choice of the Healthy Incentives Plan or the Volunteer Plan.
The Volunteer Plan would provide a health insurance voucher to participants that would be used to participate in their employer’s health insurance plan.
This is reasonable. The second portion is a modification of the Healthy Indiana’s HSA model that has not yet been waivered:
Participants in the Healthy Incentives Plan may choose to receive coverage through a redesigned component of the TennCare program, which would introduce Healthy Incentives for Tennesseans accounts, modeled after Health Reimbursement Accounts, which can be used to pay for a portion of required member cost-sharing.
I have not seen the actual waiver language as it has not been written yet. However if this is a deal in principle that the Centers for Medicare and Medicaid Services has signed off on, then the probable cost sharing maximums will be split into two groups. For people who make between 100% and 138% FPL, maximum cost sharing will be roughly the equivilent of cost-sharing Silver maximums, so they’ll be seeing 94% or 95% acturial value coverage. For people who make under 100% FPL and would not otherwise have qualified for Tennessee Medicaid, maximum cost sharing is probably under $300 per year if we use Utah as a benchmark for what CMS will approve.
This program should cover 150,000 more people.
So this is a good day for Tennessee and human decency.
Mike E
So, my eligible subsidy increased even though my estimated income will be higher than my 1st application…but, the silver plan I have now is way more than when I enrolled on 12/13. A similar silver plan at about the same monthly premium has a $3,000 deductible, compared to my $1,000 plan I currently have, plus copays per visit goes up ($25/$50 really ain’t bad, but $5/$10 was better): Oh well. Let’s hope I can finally get hired full time at one of my 2 current jobs!
Fair Economist
The conservatives on the Supreme Court are obviously anxious to repeal Obamacare, precedent be damned. But the economics strongly encourage the states to adopt it anyway, and I wonder if they realize what a bind Republican states will be in if they cancel subsidies for the federal exchange states? They got away with the comparisons in 2014, but if 2016 involves a comparison to other states doing much better *and* their own states having done better with Exchange subsidies.
Matt McIrvin
@Fair Economist: This is assuming that the political process in these states has anything to do with comparing things in the real world and making reasoned decisions.
I’ve always assumed they’ll just blame Obamacare for taking the subsidies away, and push to repeal it entirely. Then when all the benefits go away, they’ll say Obamacare took away Obamacare and repeal Obamacare again. Or possibly blame ACORN.
gussie
So I tried logged onto the CoveredCA website to update my insurance. My username didn’t work. I answered the security questions. The site sent me my username. I entered it. It said ‘invalid.’
I used the Live Chat tool, and after 30 minutes, someone told me to call the 800 number.
I called the 800 number, and it says that due to the high volume, they’re not answering calls.
I used the Live Chat tool again, and after 30 minutes, someone told me to call the 800 number.
I called the 800 number, and it says that due to the high volume, they’re not answering calls.
Because I’m OCD, I kept entering the same username. For some reason, after an hour and a half and a dozen attempts–same username–it accepted it. Yay!
Except the website won’t let me change my income. It says there should be an ‘Add Income’ button. There’s not. So I’m going to apply with information that I know is 300% wrong. But fine, it’s literally all it will let me do.
I hit ‘Renew.’ It reloads the page. I hit ‘Renew.’ It reloads the page. I call the 800 number. They’re not answering. I hit ‘Renew’. It reloads the page.
I can feel myself turning into a Fox viewer.
Florida Frog
@gussie – try calling an agent. It took us about 30 minutes to choose a new plan and sign up.
Here in Florida (north part anyway) Florida Blue was the only company writing policies last year. This year we have two new companies Assurant and United Health something. The Blue policies went up a crazy amount over last year – mine (and Mr. Frog) went from roughly $1300/month to @1700/month for a middle of the road silver plan with high deductible. I am worried that many people won’t check their new rates and choose a new policy before the deadline. They might be very unhappy with the results but the other two companies are offering decent policies at roughly last year’s prices.
MazeDancer
Thanks for this update. Never in a zillion years would I – from TN – imagine anything even remotely bordering on reasonable or, basically, even slightly verging on helping poor people happen in Tennessee. Wow.