Posts tagged: ACA
After two conflicting appellate court rulings yesterday - in Washington, D.C. and in Richmond, Va. - about whether federal subsidies apply to those purchasing health insurance in states that haven’t set up their own insurance exchanges, Idaho’s exchange, YourHealthIdaho.org, announced that Idahoans should see no change in their subsidies, the Idaho Statesman reports. Amy Dowd, YourHealthIdaho executive director, said in a statement, “As a state-based marketplace, Your Health Idaho has requested official guidance to confirm that this ruling does not impact Idahoans. … As we have known for some time, the benefits of being a state-based health insurance exchange far outweigh Idaho being on the federal exchange. As Idaho transitions to our own technology, we are even more confident in Idaho’s decision to maintain control of the exchange in Idaho.”
Meanwhile, Gov. Butch Otter issued a statement, the Statesman reported, saying, “While it has no immediate impact on Idaho, I hope the decision in the D.C. case eventually carries the day before the U.S. Supreme Court and leads to the end of Obamacare. But for now, it doesn’t reduce or eliminate federal control over healthcare matters in states with federal exchanges. If anything, the uncertainty from today’s conflicting decisions could make things worse for them.”
Statesman reporter Audrey Dutton reports that almost 70,000 of the 76,000 people in Idaho who bought insurance through Idaho’s exchange are getting subsidies; her full report is online here.
Idaho’s state health insurance exchange, YourHealthIdaho.org, is losing two of its top three staffers – Executive Director Amy Dowd is leaving to become CEO of the New Mexico Health Insurance Exchange, and Alberto Gonzalez, operations project manager and a former bureau chief for the Idaho Department of Health & Welfare, is leaving for a consulting firm.
Steven Weeg, chairman of the board of the Idaho exchange, said the board will work with Dowd, Gonzalez and the rest of the staff on a transition plan; Dowd was hired in 2013, and hired Gonzalez shortly afterward, along with marketing and communications director Jody Olson. The staff also includes finance director Patrick Kelly.
“We are thankful for all Amy has done for us,” Weeg said in a statement. “When she first started, Idaho’s exchange was just an idea. With her leadership we built an exchange from the ground up and beat everyone’s expectations for the first open enrollment period. Amy has put us on the right path and we are confident YourHealthIdaho will continue to succeed in the 2015 open enrollment period and beyond.”
The numbers are in from the YourHealthIdaho insurance exchange open enrollment period, and it turns out that 76,061 Idahoans signed up for health insurance plans through the exchange. The federal government’s expectation for Idaho was 40,000 during the six-month open enrollment period. “We have significantly exceeded those estimated targets,” said Amy Dowd, executive director of the exchange. “It’s very exciting, very, very encouraging that we are on the right path. Idahoans are interested in getting insurance for themselves and their families.” You can read my full story here at spokesman.com.
The YourHealthIdaho board has voted to keep fees at 1.5 percent of plan costs through the end of calendar year 2015; that’s compared to the fee on federally operated insurance exchanges of 3.5 percent. Exchange officials are estimating that Idahoans are saving $4.4 million on their health insurance due to the lower fee for the state exchange. That’s based on the average monthly premium rate of $242. “We are committed to keeping our assessment fees low,” Dowd said.
Idaho launched YourHealthIdaho.org at the urging of Gov. Butch Otter, after two years of extensive debate in the state Legislature. Opponents of starting a state exchange include Senate Majority Caucus Chairman Russ Fulcher, R-Meridian, who is now challenging Otter in the GOP primary. Opponents have maintained Idaho should take no part in health care reform, even though failing to start a state insurance exchange would have meant Idaho would have gotten a federally run exchange instead.
Idaho’s exchange currently is operating on millions in federal grant funding, but starting in 2016, it must become self-supporting, relying entirely on fees. By law, no state funds can be spent on it. Dowd said it’s not yet clear just how many Idahoans must enroll to make the exchange self-supporting, but said the latest numbers are “very, very encouraging that we are on the right trajectory and on the right path to have a financially sustainable exchange.”
Senate President Pro-Tem Brent Hill, R-Rexburg, has a guest opinion in the Idaho Falls Post Register today lauding Idaho’s decision to establish a state health insurance exchange. Under the headline “Going our own way,” Hill writes, “The choice last year was never between a state-run exchange and no exchange at all. That option had been denied by the courts. It was a choice between state involvement and total federal control. Those states that ignored the law relinquished control to the federal government. Idaho refused to surrender its decision-making authority over health care issues.”
Hill writes, “While the residents of other states have been strapped by a 3.5 percent premium tax to fund the federal exchange, Idaho has kept fees at only 1.5 percent. Idaho's health insurance rates continue to be among the lowest in the country. While the federal exchange requires detailed personal information in order to access its exchange, Idaho allows persons to browse plans and check rates anonymously.” Click below for his full article.
Idaho’s state health insurance exchange, YourHealthIdaho.org, reports today that 32,899 Idahoans have now selected a health insurance plan through the exchange, up 65 percent from a month ago. That ranks Idaho second in the nation for per-capita successful enrollments, behind only Vermont.
“We are excited enrollment numbers have reached nearly 33,000 but we still have a lot of work to do by March 31,” said Jody Olson, communications director. To get coverage effective by March 1, 2014, the deadline to enroll is February 15, 2014. Olson also warned that from noon Mountain time on Feb. 15 to 3 a.m. on Feb. 18, the federal site that handles verification of Social Security numbers and determinations of tax credit eligibility will be down for maintenance work, halting those functions during that time; that means anyone who wants coverage by March 1 needs to apply before noon on the 15th. Click below for a breakdown of the signups thus far.
YourHealthIdaho.org, Idaho's state health insurance exchange, reports today that 19,922 Idahoans have now purchased health insurance plans through the exchange, 48,082 have completed applications, 40,205 have been determined eligible to buy insurance on the exchange, and 26,665 have been found eligible for federal financial assistance to buy insurance. “These numbers show that the marketplace is working for Idaho,” said Amy Dowd, YourHealthIdaho executive director; she noted that the number who have selected plans is up by more than 1,000 times from just a month ago. “With three more months of open enrollment left, our work is far from over but I am confident that our efforts will pay off,” she said. Click below for the exchange's full announcement, including breakdowns of enrollees by age, gender and plan type. So far, 31 percent have been ages 55-64, and 24 percent ages 18-34.
Enrollment in insurance plans through Idaho’s state-run health care exchange has swelled since the federal government fixed the website that residents use to sign up coverage, the AP reports, with about 20,000 Idahoans enrolling in time for their coverage to begin Jan. 1. That’s up from 1,730 people through Nov. 30. Click below for a full report from AP reporter John Miller.
The latest numbers are out for enrollment in health care plans through the YourHealthIdaho.org exchange, and 1,730 Idahoans have now enrolled in plans, up from 338 at the last report Nov. 13. Another 1,854 applicants were determined to be eligible for Medicaid. Applications have been completed for 15,048 Idahoans, and 7,133 of those have been deemed eligible for subsidies.
“We are hearing success stories from all around the state of people getting online and getting coverage, some for the first time,” said Amy Dowd, executive director of the Idaho exchange. You can read the full announcement here.
Here's a news item from the Associated Press: BOISE, Idaho (AP) — The troubled rollout of insurance exchanges in Idaho and elsewhere has prompted the federal government to delay another deadline, this time giving prospective enrollees more time to get coverage before it goes into effect Jan. 1. Your Health Idaho enrollees will have until Dec. 23, back from Dec. 15, to select a plan in order to be insured by the New Year. Amy Dowd, Idaho's exchange director, says this new deadline gives people more time to make a choice about their coverage, required under President Obama's 2010 health care overhaul. Dowd also said in a statement the federal online application form Idaho is using has been improved and is functioning better. Even so, additional improvements are still in the works to remedy the problem-plagued launch of exchanges since Oct. 1.
Here's a news item from the Associated Press: BOISE, Idaho (AP) — Idaho will let insurance carriers reinstate coverage for thousands of people who were due to have policies canceled under President Barack Obama's health care overhaul. Gov. C.L. “Butch” Otter said Tuesday he's asked insurance carriers to consider reinstating coverage for individuals and small businesses. But Otter said he won't require it because he's “not going to tell them how to run their business.” Amid criticism last month over canceled policies, President Obama said he'd allow insurance companies to keep selling old plans to people for another year — even if the coverage didn't meet requirements of his 2010 health law. Across the nation, states are coming to different conclusions about whether to follow Obama's lead. For instance, in Washington, regulators declined to allow policies to be renewed for another year.
Click below for Otter's full announcement, in which he says, “If they can see their way clear, I hope they’ll consider reinstating those policies.” Blue Cross of Idaho immediately announced that it will allow its individual and small-group customers that option.
Idaho's state Department of Insurance says no decision will come before December on whether Idaho will allow residents to keep existing insurance policies had initially been due for cancellation under President Obama's health care overhaul, the AP reports. Details on how health insurance companies would calculate rates for extended plans still aren't clear, the department said. Last Thursday, Obama said he'd allow insurance companies to keep selling these existing plans for another year, even if they do not meet certain Affordable Care Act criteria for coverage; the move followed criticism that he'd promised nobody would be forced out of their existing policy under the 2010 overhaul. But the decision requires state approval. Idaho is among numerous states still considering whether to follow Obama's lead.
Idaho’s biggest business lobby, the Idaho Association of Commerce and Industry, has come out in favor of Medicaid expansion, a move that could save the state budget more than $600 million in the next decade and save county property taxpayers $478 million. In a letter to Gov. Butch Otter dated Friday, IACI President Alex LaBeau called for re-convening Otter’s task force on Medicaid redesign – which last year recommended the expansion, along with various changes to the Medicaid program – to look at how best to accomplish it.
“IACI supports Medicaid redesign in a manner that is fair to taxpayers, beneficial to employers, adds provider accountability, addresses the inherent inefficiencies in the county indigent program and the state’s catastrophic program, and minimizes the cost shift to business,” LaBeau wrote, reporting the group’s official position, adopted by its board in September; you can read my full story here at spokesman.com.
LaBeau is among the speakers at a forum tonight at the Boise Public Library entitled, “Opportunities & Obstacles of Medicaid Expansion;” also speaking are Jim Baugh, executive director of Disability Rights Idaho; Rep. Tom Loertscher, R-Iona, the conservative eastern Idaho lawmaker who last year introduced legislation to expand Medicaid; and Corey Surber, executive director of community health and public policy for the St. Alphonsus Health System. The free forum starts at 7 p.m.
The expansion in question would cover under Medicaid adults who make up to 138 percent of the poverty level, roughly $31,000 a year for a family of four; that originally was a mandatory part of the Affordable Care Act, also known as Obamacare, but the U.S. Supreme Court made it optional for states. Idaho Medicaid now covers non-disabled adults only if they have children and have income of less than 20 percent of the poverty level, or $4,584 for a family of four.
When Idahoans who fall into that uncovered category and have no health insurance run up catastrophic medical bills, whether it’s from accidents or cancer, a county-state program steps in to help with the bills, with county and state taxpayers paying 100 percent of the tab. Liens are placed on everything the patient owns, though little is generally recovered. If Idaho opted to expand Medicaid to cover that same population, the federal government would pay 100 percent of the costs for the first three years, then phase down to 90 percent.
LaBeau said his organization is intrigued by a program that’s been approved as a demonstration project in Arkansas, where the state will take the federal Medicaid expansion funds and use them instead to purchase private insurance for those individuals. “It’s more of a private-sector solution,” he said, adding that Iowa has a similar program awaiting approval. “We certainly think it’s worth taking a look at,” he said.
Last year, Idaho lawmakers declined to take any action on the issue.
Nearly 120,000 Washington residents have completed applications for health insurance through the state’s insurance exchange, a federal report revealed today, and more than 10,500 Idahoans have completed applications through their state’s exchange. Those numbers are far higher than the numbers who have selected the plan they want to enroll in through the exchanges – 7,091 in Washington and 338 in Idaho. But they do show that thousands in both states have made their way through the application process, despite initial glitches, particularly with the federal computer system that Idaho’s relied on. You can read my full story here at spokesman.com.
Nationally, just 106,185 individuals have selected and enrolled in plans through exchanges, but more than 1.5 million have completed applications, 1.08 million of those were deemed eligible for exchange plans, and 326,130 qualified for new federal subsidies.
Board members of the Idaho health insurance exchange said Tuesday that they will keep secret the findings of a $15,000 taxpayer-funded investigation into how one of its own members won a lucrative no-bid contract, the Associated Press reports. Your Health Idaho board chairman Stephen Weeg said the two-week-long review by a private lawyer uncovered “lapses in judgment,” though nothing illegal. Exchange executive director Amy Dowd last month awarded a technology contract worth up to $375,000 to board member Frank Chan, who quit the same day the contract was announced.
Dowd gave Chan the contract without advertising it or allowing others to compete. It was later canceled after House Speaker Scott Bedke, R-Oakley, joined critics who called Dowd's deal with an exchange insider “indefensible.” Boise lawyer Frederick Mack was hired to scrutinize the deal. He presented his report Tuesday during a three-hour, closed-door exchange board meeting at the Idaho Capitol.
“The key finding was: We violated no law, that lapses of judgment were made around the procurement policy and conflict-of-interest policy,” Weeg said following the meeting. “He had recommendations for us to move forward as an organization.” However, Weeg said the public will never be able to see Mack's recommendations or findings. “It deals with personnel, and it's done under attorney-client privilege,” said Weeg, a retired Pocatello health care industry executive who heads up the volunteer board. He declined to detail the judgment lapses Mack found or who committed them; click below for the full report from AP reporter John Miller.
Yourhealthidaho.org, Idaho’s state health insurance exchange, is not planning to raise its fee per health plan from the current 1.5 percent level, executive director Amy Dowd told lawmakers this morning. “There has been some confusion on this issue based on work that my staff engaged in to fulfill some reporting requirements recently,” Dowd told the Idaho Legislature’s Health Care Task Force. “We are required to evaluate a full range of possibilities and what-if scenarios. Some of those projections contemplated a far higher rate. In no way was that evaluation a proposal for the future. In Idaho, we can, and are expected, to run a system more efficiently than the federal government. I understand that the expectation is that we run the exchange at a 1.5 percent fee.”
Idaho’s health insurance exchange executive director, Amy Dowd, told lawmakers this morning that the state won’t get any numbers from the feds on how many Idahoans have enrolled in health insurance through the exchange until the end of November; she had earlier said she expected to have figures by this week. “We do know that there are Idahoans enrolling,” she told the Legislature’s Health Care Task Force.
Dowd told the lawmakers, “Your Health Idaho is doing two things right now: One, we are preventing federal intervention in Idaho, and two, we are providing a much-needed resource for thousands of Idahoans looking for insurance.” She said Idaho’s exchange is relying on the federal technology platform for its first year. “At the federal level, we all know it is not working,” she said. “We were not notified in advance… Your Health Idaho has had to quickly respond to the federal failure.”
Though she’s received no specifics, Dowd said she’d heard that last-minute changes prior to the rollout cased the failures. Idaho is in the middle of a request for proposals process for its own technology platform, which Dowd said should be up by fall of 2014. In the meantime, the Your Health Idaho board has directed Dowd to develop a tool where Idahoans can shop anonymously on the yourhealthidaho.org website and compare plans, without first setting up an account and submitting all their information. Dowd said the exchange is looking into developing such a tool, but it likely will take four to six weeks; in the meantime, it’s posted an online booklet with all plan information. That booklet is lengthy, but it’s a useful tool for brokers and agents to be able to access, she said. An Idaho-specific calculator will be posted on the site later this week, she said, to help Idahoans determine how much they might qualify for in subsidies.
Until all the technology works, Dowd said, Idahoans who go to yourhealthidaho.org can complete paper applications and get help over the phone.
Idaho's insurance exchange board backed new rules Wednesday meant to keep insiders from profiting inappropriately from ties to the Internet health care marketplace, the AP reports, in the wake of a now-canceled no-bid contract with a former board member. The board decided that members who leave the volunteer panel appointed by Gov. C.L. “Butch” Otter must wait at least 12 months before securing paid work with the exchange unless two-thirds of the panel votes to waive that restriction. “I think it's appropriate,” said state Sen. Jim Rice, R-Caldwell and an exchange board member; click below for a full report from AP reporter John Miller.
Idaho Gov. Butch Otter says he wants a delay in the individual mandate to purchase health insurance under the Affordable Care Act, or Obamacare, to allow Idaho's insurance exchange to get its own technology platform up and running, rather than piggybacking on the troubled federal tech site. “Of all the challenges we’re facing with Idaho’s state-based health insurance exchange, none have been more disappointing than the chorus of those who attribute each setback to cronyism or conspiracy, and those whose most constructive criticism is 'I told you so,'” Otter wrote in a statement distributed to Idaho news media today. “When we run into a problem, Idahoans fix it. When we encounter difficulties, Idahoans overcome them. We always have, and we’re working hard to do the same in this case.”
Click below for Otter's full statement. He writes, “The technology consulting contract awarded to a former Exchange board member was expeditiously and correctly voided last week. Yes, it should never have happened to begin with, but when it did the process worked.” Then he says he wrote to HHS Secretary Kathleen Sibelius, requesting the delay. “They say the first step to getting out of a hole is to stop digging. Folks, we can stay mired in the would have/could have/should have of this situation and let our partisan or philosophical petulance overtake us, or we can focus instead on climbing out of this hole and asserting our Idaho independence and sovereignty by finishing the job we started last winter,” Otter writes. “I choose to climb.”
Billboards bashing Idaho legislators for their votes on a state insurance exchange have begun popping up in their legislative districts. Idaho Freedom Foundation chief Wayne Hoffman says the signs are part of his group’s lobbying campaign to get Idaho’s exchange repealed in the legislative session that starts in January, but others say the effort appears aimed at Idaho’s upcoming 2014 elections, in which every seat in the Idaho Legislature will be on the ballot.
“That looks a lot more like campaigning than lobbying to me,” said Jim Weatherby, Boise State University professor emeritus and a longtime observer of Idaho politics. “It’s not a traditional way of lobbying the Legislature to use billboards – in fact, I’m hard-pressed to give an example of that.” Rep. Fred Wood, R-Burley, who is among those targeted by name on the signs, said he views his local billboard – which is right near the hospital where he practices medicine – as an “effort to try to gin up a political opponent” for him in May’s GOP primary. “I think that’s what it’s designed to do, to be very blunt about it,” he said. “It’s political advertising.”
Hoffman, whose organization, a tax-exempt charity, is prohibited by law from engaging in campaigning, said, “We don’t get involved in elections – this has nothing to do with elections. It has to do with public policy.” He added, “They are a vehicle for lobbying lawmakers as well as the general public on an issue that will be before the Legislature in the 2014 legislative session.” Wood countered, “They push that envelope all the time.”
Two of the billboards have gone up so far; Hoffman said more are in the works. The first, in Burley, targets Wood, House Speaker Scott Bedke, R-Oakley; and Sen. Dean Cameron, R-Rupert. The second, in Mountain Home, names Rep. Rich Wills, R-Glenns Ferry, and Sen. Bert Brackett, R-Rogerson; you can read my full story here at spokesman.com.
Here’s a link to my full story at spokesman.com on today’s Idaho insurance exchange board action, immediately ending a no-bid contract that was awarded to a former board member last week, forbidding issuance of any contract for more than $15,000 without board approval, and commissioning an independent review of what happened. Said board member Jim Rice, “I think we’ve made some progress on getting to where we need to be.” Board Chairman Stephen Weeg said, “We’ve operated under a crisis mode for five months, and it’s time to stop and take a breath.”
Last week, former board member Frank Chan, head of the exchange board’s technology committee, was awarded a $375,000 no-bid contract with the exchange to oversee tech vendors, and resigned from the board the same day. The choice of a replacement for Chan on the board is up to Gov. Butch Otter.