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You are here: Home / Anderson On Health Insurance / Expansion and elections

Expansion and elections

by David Anderson|  January 2, 20197:12 am| 30 Comments

This post is in: Anderson On Health Insurance

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This happened yesterday:

Medicaid expansion starts today for 400,000 more people in Virginia https://t.co/BNcwGi4fKQ

— Hunter Winn??? (@RoyalSaddler) January 2, 2019

Next month, Maine will expand Medicaid as well with coverage being retroactive to last July.

Elections matter for expansions. And right now our initial evidence is that an expansion is mostly a one way ratchet with some backsliding. Governors and political parties that don’t like expansions can prevent an expansion from happening as we see in North Carolina, Georgia, Florida and Texas. However governors that don’t like expansions can not fully roll back an expansion that has already been implemented. Kentucky is the most aggressive state in trying to limit its expansion of medical insurance coverage (private and Medicaid) after a change in political regimes, but the roll-back is by hassle and hurdle of work reporting requirements and informational FUD rather than explicit repeals.

We should be seeing at least three more states expand Medicaid in the next 365 days, so the ratchet will continue forward.

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Reader Interactions

30Comments

  1. 1.

    rikyrah

    January 2, 2019 at 7:18 am

    Congratulations to my fellow citizens????

  2. 2.

    randy khan

    January 2, 2019 at 7:27 am

    Thank you, Ralph Northam and all of the people who elected Dems to the House of Delegates. I was very proud to live in Virginia on Election Night 2017.

  3. 3.

    Nicole

    January 2, 2019 at 8:29 am

    Obama and Pelosi really reshaped the American perspective on health care. Props to them, and to the Democratic Reps and Senators who lost their seats over their “yes” votes for ACA.

  4. 4.

    Patricia Kayden

    January 2, 2019 at 8:53 am

    Thanks Obama!!

    This is what happens when you put Democrats in control. You can have nice things.

  5. 5.

    HeleninEire

    January 2, 2019 at 8:57 am

    Hi David – I know I asked you this before and you were quite helpful. It was about the fact that I would miss the open enrollment period because I am returning to NY on January 27th from Europe. You told me I would qualify for a special enrollment period. Now I see that NY’s open enrollment ends 1/31/19.

    If I return on the 27th will I have to enroll by the 31st or is there a timeframe like 30 days after arriving that I can enroll? Technically I won’t have a NY address until February 1, the earliest. I can’t find this info on Healthfirst’s website.

    Thank you.

  6. 6.

    Barbara

    January 2, 2019 at 9:16 am

    @HeleninEire: Here is some general information about picking a new plan due to having moved:

    https://www.healthcare.gov/coverage-outside-open-enrollment/confirm-special-enrollment-period/

  7. 7.

    David Anderson

    January 2, 2019 at 9:17 am

    @HeleninEire: I strongly suggest that you call New York’s help center to confirm. I am fairly sure that you will qualify for a Special Enrollment Period but go confirm it with New York State.

  8. 8.

    Amir Khalid

    January 2, 2019 at 9:19 am

    @Patricia Kayden:
    The problem with some American voters is they want the nice things that Democratic politicians bring, but they insist on voting for Republicans.

  9. 9.

    Brachiator

    January 2, 2019 at 9:20 am

    This is great news.

  10. 10.

    Barbara

    January 2, 2019 at 9:32 am

    @Barbara: I should have said, a state marketplace should meet the minimum requirements of the federal marketplace for a special enrollment period, but it might help to state your scenario in line with the Q&A from the federal site:

    You are moving to New York State from a foreign country effective February 1, 2019.
    *What is the earliest date you can select a plan?
    *What documents will they accept as proof of moving to a new market area?

  11. 11.

    p.a.

    January 2, 2019 at 9:34 am

    @Amir Khalid: The paradox of the citizens who don’t know what paradox means.

  12. 12.

    Ohio Mom

    January 2, 2019 at 9:36 am

    This reminds me that now that the holidays are over, I have a denial to contest. Not worth going into the details, just everyone wish me luck.

    Into every life, some rain must fall, along with quarrels with health insurance companies.

  13. 13.

    David Anderson

    January 2, 2019 at 9:51 am

    @Ohio Mom: Have fun storming the castle

  14. 14.

    HeleninEire

    January 2, 2019 at 10:25 am

    @Barbara: @David Anderson: Thank you both. This is very helpful. It looks as though I will have 60 days but I will confirm it with NY State.

  15. 15.

    Ohio Mom

    January 2, 2019 at 10:39 am

    @HeleninEire: For some reason, I am reminded of the advice my favorite aunt gave me when I was a confused college freshman, unsure of what I should major in.

    “It doesn’t matter, just do something where you’ll get health insurance.”

    Even with the ACA, the fear of doing without hangs over our heads and dictates so much.

  16. 16.

    Ronbo

    January 2, 2019 at 11:16 am

    @Ohio Mom: BC/BS is the biggest scams I’ve experienced. I paid them for 7 years just to have them deny hernia surgery as a “pre-existing condition” – 7 years later! Their customer “support” rep said I’d have to sue them to force payment…if I won. After I paid a lawyer and retainer. Instead, I offered the county hospital a check for the 10% co-payment and they accepted!

    What’s worse is that BC/BS is one of the better ‘non-profits’?!? It’s time our government stop these legalized corporate scams. Mandating payments to insurance companies is just a corporate subsidy. Imagine if the government said you’d have to pay corporations (and sue them to get benefits) with Social Security. Your check would be 50% smaller.

    Tell the Neolibs and Republicans “No more corporate subsidies”. Medicare is cheaper and works better BECAUSE it has no subsidies to for-profit corporations.

  17. 17.

    Barbara

    January 2, 2019 at 11:24 am

    @Ronbo: Respectfully, Medicare is administered almost totally by private companies, and Part D (prescription drug coverage) is funded exclusively through private plans. 40% of Medicare beneficiaries participate in Part C plans (offered by private plans subsidized by the government) and a high percentage of Medicare beneficiaries feel the need to purchase private supplemental coverage because the fee for service (original) arm of Medicare has no out of pocket spending limit for beneficiaries. The lack of understanding of how Medicare actually works is astounding.

  18. 18.

    HeleninEire

    January 2, 2019 at 11:44 am

    @Ohio Mom: Absolutely. One of the things I do not have to worry about here. It’s top of my list going back.

  19. 19.

    lurker dean

    January 2, 2019 at 11:51 am

    excellent. lepage should be in prison for refusing to implement expansion. how many people died while he f-ed around.

  20. 20.

    Nicole

    January 2, 2019 at 12:16 pm

    @Ohio Mom:

    This reminds me that now that the holidays are over, I have a denial to contest. Not worth going into the details, just everyone wish me luck.

    Into every life, some rain must fall, along with quarrels with health insurance companies.

    Me too! In my case, I think the blame falls on the doctor’s office where someone put in the wrong code, but no one let me know until 18 months later, when I started getting bills for $3K. And somehow it’s still not sorted out.

    Best part (and by “best” I mean, “not best”) is that somehow the billing departments manage to time their bills so that they arrive in my mailbox on Friday (we’re towards the end of the route, and mail doesn’t get to our box until after 5PM), so I can do nothing about it until Monday. We had a miscoded incident that came with a $35K tab a few years ago and I can’t tell you how many weekends the billing office ruined for us. Truly amazing, this gift they have.

  21. 21.

    Barbara

    January 2, 2019 at 12:19 pm

    @HeleninEire: Yes, I am sure it’s much better so long as you are not a woman with a difficult pregnancy.

  22. 22.

    Ohio Mom

    January 2, 2019 at 12:50 pm

    @Nicole: Oh, I know exactly what happened here. It’s not a coding error.

    It’s Anthem “overlooking” a positive test result because it means they have to continue to pay for an expensive medication.

    I’ve already left a message for the pit bull who is the nurse. My situation is not urgent, I can let this play out for a while.

    Meanwhile, Anthem is also dragging their feet on approving the insulin pump Ohio Dad’s diabetes doc wants him to get and start using.

    We are assuming that now it’s a new year and the deductible is back to its full amount, they will be approving it shortly. They just didn’t want to pay the whole bill for the pump if they could get us to chip in.

    I never thought I’d say anything nice about a health insurer, but the old UHC Plan was easier to navigate. But they all play games (like not correcting obvious coding errors) and they all stink.

  23. 23.

    Ohio Mom

    January 2, 2019 at 1:00 pm

    @Ronbo: As I understand it (David correct me if I’m wrong), BC/BS dropped their nonprofit status after Nixon changed the law, allowing health insurers to make profits.

    @Nicole: Oh, I know exactly what happened here. It’s not a coding error.

    It’s Anthem “overlooking” a positive test result because it means they have to continue to pay for an expensive medication.

    I’ve already left a message for the pit bull who is the nurse. My situation is not urgent, I can let this play out for a while.

    Meanwhile, Anthem is also dragging their feet on approving the insulin pump Ohio Dad’s diabetes doc wants him to get and start using.

    We are assuming that now it’s a new year and the deductible is back to its full amount, they will be approving it shortly. They just didn’t want to pay the whole bill for the pump if they could get us to chip in.

    I never thought I’d say anything nice about a health insurer, but the old UHC Plan was easier to navigate. But they all play games (like not correcting obvious coding errors) and they all stink.

  24. 24.

    Ohio Mom

    January 2, 2019 at 1:02 pm

    @Barbara: Did you miss the historic Irish vote last year? One of the year’s highpoints.

  25. 25.

    HeleninEire

    January 2, 2019 at 1:09 pm

    @Barbara: @Ohio Mom: Not only is abortion now legal, the Prime Minister (himself a physician) and the Health Minister have said it will be part of the public health care system. Abortions will be free of charge. For everyone.

  26. 26.

    Barbara

    January 2, 2019 at 1:21 pm

    @HeleninEire: I didn’t miss the vote last year, but the fact that abortion is legal won’t necessarily change the attitude of Irish doctors and nurses. I would be happy to be wrong.

  27. 27.

    Barbara

    January 2, 2019 at 1:23 pm

    @Ohio Mom: Some BC/BS plans changed and others didn’t. Anthem did, but it was much later than the 1970s.

  28. 28.

    Nicole

    January 2, 2019 at 1:59 pm

    @Ohio Mom:

    It’s Anthem “overlooking” a positive test result because it means they have to continue to pay for an expensive medication.

    I’ve already left a message for the pit bull who is the nurse. My situation is not urgent, I can let this play out for a while.

    That’s ridonkulous. In my case, it was for a routine test that is not usually covered until after 50 (colonoscopy) but because of a genetic test result, my GP recommended I get one early. All was fine, but I think the office that did the test put in as a routine colonoscopy when they billed (why, I don’t know, as Empire Blue let me know the procedure had been approved prior to my getting it so I know someone there new my GP felt it was necessary). I think I’ll eventually have to call the office myself and tell them they have to deal with it.

  29. 29.

    Duane

    January 2, 2019 at 3:01 pm

    @p.a.: Paradox: What I have now that I’m covered by the ACA.
    Thanks Pelosi! Thanks Obama!

  30. 30.

    Ohio Mom

    January 2, 2019 at 5:21 pm

    @Duane: Groan.

    Oh to be young again, and have only two doctors!

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