We’re in the biggest open enrollment period of my lifetime. Open Enrollment is when people who don’t have a plan can get a plan and those who have a plan can change plans without penalty. Open Enrollment is a common feature in any non-NHS system including the German, Dutch and Swiss as well as the …
Anderson On Health Insurance
Better MLS referees in 2019
I am a bad soccer player but a pretty good referee. Last night, I was working a high school game with a former MLS official and an up and coming USSF-5 who has a plausible path to the MLS, on my lines. I set the tone early with a caution for a dive in the box …
Notes from day 1
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 …
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.