Just a few notes from Day 1 of the Exchanges and what they mean: From Business Insider: About 2.8 million people visited healthcare.gov – the main website for the 36 state exchanges being run by the federal government – between midnight and mid-afternoon, theU.S. Department of Health and Human Services said…. Kentucky’s exchange, kynect, saw 57,625 unique visitors …
Preach it
Commenter Emerald: HaHaHaHa! I’ve been without coverage for nearly 13 years. (Took care of my Dad for 10 of those). I qualify for the “Enhanced Silver” plan in California. Cheapest for me would be $3 per month for an HMO. Most expensive would be $159 for the Anthem Blue Cross HMO. But unless my doctor …
The Prussians are coming
The Prussians are emerging from the Bois de Paris… Is tonight the end of freedumb in America? Or is it the start of people being able to buy standardized, subsudized private insurance on transparent marketplaces. I report, you decide.
Wave around the Waiver
In the previous post, there were a couple of good questions about the Arkansas Medicaid “private option” waiver. The big one is would the Bronze plans on the Exchange be effectively useless to someone making 75% of FPL as they could not even look at the co-insurance and deductible as plausible payments. Here is a …
Arkansas waiver news
CMS approved a waiver for Arkansas for Medicaid expansion. Instead of doing the mechanically simple thing of just expanding Arkansas Medicaid for individuals up to 133% of poverty line, Arkansas will engage in premium support. Individuals who are newly qualified for Medicaid in Arkansas will get a voucher to buy a policy on the Exchange. …
Arkansas waiver newsPost + Comments (35)
First, as a purely technocratic wonk, this is asinine. It is reinventing the wheel and adding some right angles to the second prototype for the hell of it. Medicaid has a system for enrollment that is scaleable and a set of providers who are willing to take it. Premium support will lead to the ineffecient use of a couple billion federal dollars over the next ten years. It will also lead to the waste of a few hundred million Arkansas dollars.
However, screw that. This is a political exercise that will make sure that tens of thousands of people who otherwise would not have gotten coverage will get coverage. A 8% or 10% inefficiency tax that allows people to benefit from Obamacare without calling it Obamacare is a net societal win. Furthermore, since it now builds in a layer of middle men that have minimal real value, there is a rentier class in Arkansas that will now be interested in keeping their income stream. A new advocate for Medicaid will be created which will make Medicaid sustainable in Arkansas.
Furthermore, several other states (Indiana and Iowa) have applied for very similar waivers from CMS. I think they will get the same waiver in the next couple of weeks. Pennsylvania’s expansion request will not be going through the same expedited approval. Pennsylvania wants to do a premium support model, but Gov. Corbett also wants to do some serious poverty shaming and lifetime limitations on both expansion and current Medicaid populations. I don’t think that waiver request has been filed yet, nor do I think that we can draw any conclusions from the Arkansas waiver to the Pennsylvania plan.