Come for the politics, stay for the snark.

Human rights are not a matter of opinion!

We can show the world that autocracy can be defeated.

The arc of the moral universe does not bend itself. it is up to us to bend it.

Finding joy where we can, and muddling through where we can’t.

Fear or fury? The choice is ours.

I am pretty sure these ‘journalists’ were not always such a bootlicking sycophants.

Dear elected officials: Trump is temporary, dishonor is forever.

This year has been the longest three days of putin’s life.

Someone should tell Republicans that violence is the last refuge of the incompetent, or possibly the first.

Stay strong, because they are weak.

If ‘weird’ was the finish line, they ran through the tape and kept running.

Never entrust democracy to any process that requires Republicans to act in good faith.

Thanks to your bullshit, we are now under siege.

Democracy is not a spectator sport.

I swear, each month of 2025 will have its own history degree.

One way or another, he’s a liar.

It’s pointless to bring up problems that can only be solved with a time machine.

Mediocre white men think RFK Jr’s pathetic midlife crisis is inspirational. The bar is set so low for them, it’s subterranean.

Take hopelessness and turn it into resilience.

When your entire life is steeped in white supremacy, equality feels like discrimination.

They are lying in pursuit of an agenda.

Conservatism: there are people the law protects but does not bind and others who the law binds but does not protect.

You can’t attract Republican voters. You can only out organize them.

It may be funny to you motherfucker, but it’s not funny to me.

You are here: Home / Anderson On Health Insurance / Where did the on-exchange user fees go?

Where did the on-exchange user fees go?

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Healthcare.gov collects user fees from insurers. Insurers in states that delegate all authority to the federal market place pay 3.5% of premium to Healthcare.gov. Insurers in states that use Healthcare.gov as a front-end but perform significant backend functions pay 3.0% of premium to Healthcare.gov in 2019 and they paid 2% of premium in 2018.

Healthcare.gov is supposed to use these fees to fund operations. It pays for the server racks. It pays for the Help Desk. It pays for file loads. It pays for advertising. It pays for outreach. The fees are designed to make the system work well.

However over the past two years, advertising has been slashed. Navigator funding is a figment of the imagination now. Open Enrollment is half the time it used to be. On-Exchange enrollment has barely moved down since 2017 even as average premiums have increased significantly due to the termination of Cost Sharing Reduction (CSR) payments which is then looped into silver premiums and general medical trend. The total premium going through Healthcare.gov has increased significantly without a concurrent increase in opeational expenses or outreach.

So where is that money going?

House Democrats want to find out:

We know that more revenue should be hitting the federal accounts for Healthcare.gov user fees. We know that outreach expenses have been slashed. So where is the money that is not being visibly spent compared to 2017? Is it just sitting in an account? Or did someone get a no bid PR contract to talk down the ACA? Where is the moola?

Reader Interactions

8Comments

  1. 1.

    Patricia Kayden

    Thank goodness Democrats are in the House and can challenge Trump on healthcare. We deserve answers.

  3. 3.

    daveNYC

    @WereBear: Probably, though with these idiots the money could just be sitting there because they’re too stupid to even do proper looting.

  8. 8.

    SectionH

    FSM bless em, but I’m on record as one of the first (only?) people who ever had to argue with California that we Shouldn’t have been on MediCal. Because Covered California – in spite of repeated calls from me – kept sending us there. To the point when we had an actual telephone hearing with a Real Judge, to basically establish that we’d never applied for Medical, we had insurance, we weren’t eligible for Medical… I AM NOT MAKING THIS UP.

    It was insane. Fortunately, I had my emails to Covered California, and importantly, their actual records of my calls… And basically, the Judge looked at all of it, said *hint* I’m ruling that Mr S, in his stroke event, was totally covered by Medical, because Covered California fucked up big time, so Covered CA has to deal with it.

    Covered CA? Most of the ppl I talked with on the phone were so bright – over and over again, ppl on the phone would “see the problem” and send a fix… it was so not their fault. Hello, IT? Fuck you.

    And if the default is to cover people who are marginal? Fucking Yes, if my adopted state goes out of its way to cover everyone they can, I approve.

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