The consulting firm Oliver Wyman has projected what each state would receive from the American Health Care Act (ACHA) State Stability Fund during calendar year 2018. They are making some assumptions in the distribution but the they seem reasonable. In 2018, the Fund would be 93.5% Federal money and 6.5% state matching money. The goal would be to use these funds to take a significant amount of high cost risk out of the premium paying insurance pool and transfer those costs to the fund. It is a reinsurance fund.
And since it is a reinsurance fund with external money, it will result in lower net premiums. Alaska is an extreme outlier as they are a very high cost state with a single insurer. The contiguous forty eight states have an average Stability Fund cash infusion of $91 per member per month (PMPM). However that is not even distributed throughout the country. There is significant variation from Iowa’s $45.68 PMPM to Wyoming’s $136.19 PMPM cash infusion.
The South overall is better off than the North while the Great Lakes and the Plains are seeing less of the Stability Fund flow to them.
Spreadsheet data is here. Massachusetts and Vermont excluded per Wyman’s calculations. Alaska ($209 PMPM) and Hawaii ($100.90 PMPM) are excluded for visual presentation purposes.
Richard, if you were currently getting your health insurance through the ACA in a non-expansion state and you wanted to move to a state best suited to ride out whatever shenanigans Republicans will cause, which states would you pick?
Semi-relevant, Yglesias makes an important point that should be hammered home against the freedumbos in Congress.
Paul Ryan almost always starts with false propositions; it’s the only way to make his obnoxious ethos seem palatable.
Dave or anyone else: If you were attending a town hall held by a Republican knob who is fully on board with Trumpcare, what question would you ask him if you had the opportunity to speak? Asking for a friend…
@MomSense: Wouldn’t Massachusetts be the obvious choice?
@Betty Cracker: Why does a bill supposedly about improving health coverage have hundreds of millions in tax cuts for the rich buried in it?
@smintheus: If they pass phase two and three, they would rid states of pesky health regulations. Federalism for all, and heck with state rights.
That’s what I’m thinking. California could be a good choice, too.
@smintheus: Good one! Thanks!
@MomSense: FWIW, five states ban discrimination against preexisting conditions: MA, ME, NJ, NY, VT.
Hey, I have a question, does the TrumpRyanDontCare plan come with an open enrollment period ? If it does not, isn’t there then a YOOGE adverse selection problem. I understand the 30% penalty is supposed to motivate people to sign up, but once a person is uninsured, and stays healthy for more than 108 days would they not break even? And then once past that point, it seems like there would be NO motivation to buy insurance unless you became sick. This seems like a big problem. No incentive for healthy people to sign up?
@randal sexton: It would have an open enrollment period in 2018.
@smintheus: Massachusetts is always the obvious choice!
@schrodingers_cat: Agreed, it seems to be a good choice, but MomSense should check the details to make sure she understand how they might affect her and her family.
@Betty Cracker: If he’s fully on-board with Trumpcare, then arguing specifics of the bill probably is a lost cause. You risk a blizzard of facts and figures that can’t be countered in time – the Gish Gallop.
So keep it to big picture items:
1) The AARP says the bill is bad for seniors. Why are they wrong? Why should people between 50 and 64 pay a new Age Tax?
2) It took almost 15 months to pass Obamacare (January 2009 – March 2010) and it had dozens of hearings, amendments, town-hall meetings, etc. Ryan and Trump are trying to rush through this bill without “regular order” and without a full evaluation of the changes by the CBO (including the effects on the economy as a whole). Why are they trying to jamb these changes down our throats? What are they trying to hide?
3) Trump and Price said that the replacement would be better, cheaper, and nobody on the system would lose coverage. Do you agree with that? The CBO says that 24 M people will lose coverage. Supposedly Trump’s White House internal estimates were even higher. Do you think Trump should veto Ryan’s bill? If not, why not? Do you think passing huge tax cuts to a relative handful of the wealthy are worth breaking the promise he made to 60+M people?
If you can find some his early campaign promises and throwing that in his face, that usually works pretty good, also too (that’s how Tim Russert made his name, after all). “In October 2013 you said and I quote “I will never vote to take benefits away from the elderly…!” – why are you breaking that promise now?!!?”
@David Anderson: Hey thanks for the answer, and I am a YOOGE fan of yours, though a somewhat quiet lurky type.