Posts tagged: ACA
Here’s a news item from the Associated Press: BOISE, Idaho (AP) — An Idaho work group has tweaked its recommendations on expanding Medicaid eligibility in a last-minute effort to make their plan more politically palatable to lawmakers. Work group facilitator Corey Surber says the 15-member group approved a hybrid model Friday. The group had finalized a proposal to Gov. C.L. “Butch” Otter back in August. However, lawmakers warned the proposal's blanket support of Medicaid expansion would fail to even be considered when the Republican-controlled Legislature convenes in January. Unlike in August, this proposal won the support of three out of the four lawmakers who sit on the work group, with only House Majority Leader Mike Moyle, R-Star, voting no. Under the new plan, adults earning 100 percent to 138 percent of the poverty line could purchase private insurance on Idaho's health insurance marketplace using federal dollars. Adults below 100 percent of the poverty line, Idaho's lowest-income participants, would be provided Medicaid coverage. Idaho currently doesn't cover adults on Medicaid unless they're disabled or have children; non-disabled parents are covered only up to 26 percent of the poverty line.
The successful launch of Idaho’s new health insurance exchange website is part of a big success story for a Silicon Valley tech firm that's providing the software through a $37 million contract, and also working with exchanges in California, New Mexico and Mississippi. GetInsured, headed by two tech entrepreneurs with a history of successful startups, formed as a private insurance exchange company in 2005, then got into the state exchange business after the Affordable Care Act passed; it beat out companies 10 times its size for the New Mexico contract, which is worth $39.9 million. Idaho's paid it $26 million so far; the project's on budget and on time.
“It was a great implementation,” said company spokeswoman Andrea Riggs, in Palo Alto, Calif. “It went very smoothly. … It’s a testament to the power of software as a service and the platform that we’re using.” The company’s co-founders, Chini Krishnan, above, and Shankar Srinivasan, at right, both have two-decade track records in the high-tech industry. Krishnan, the CEO, earlier played a key role in an innovative secure browser released by Enterprise Integration Technologies, and his last company, Valicert Inc., went public in 2000 and merged with Tumbleweed Technologies in 2003. Srinivasan, the chief operating officer, served as vice president of eBusiness services at JP Morgan Chase, co-founded CyberBills, and was a member of the founding team behind WebMD. You can read my full story here at spokesman.com.
Idaho’s state health insurance exchange – unlike Washington’s – reported a flawless launch over the weekend to its second open enrollment period, as the state shifted from relying on a federal technology platform to its own home-built one. “It’s 360 degrees different,” said Pat Kelly, Your Health Idaho executive director. At last year’s launch, he said, “It just plain didn’t work.” This time, he said, “We had a very successful first couple of days, no technology problems to speak of.” The Washington state exchange went down early Saturday due to a glitch over calculating tax credit information; it started back up on Sunday.
Idaho had one of the nation’s strongest enrollment rates through its state exchange last year, with 76,000 Idahoans using it to enroll in health plans and, if they qualified, receive tax credits to offset some of the costs. That made Idaho third in the nation for exchange participation, behind only Vermont and Florida.
Idaho’s exchange, approved by state lawmakers two years ago after a big fight and at the behest of GOP Gov. Butch Otter, allows the state to control the marketplace, the carriers and the plans that are offered, and to use Idaho insurance agents and brokers. Had Idaho not started its own exchange, under the federal Affordable Care Act, its residents would have used a federal insurance exchange, which charges higher fees – 3.5 percent of premiums, vs. Your Health Idaho’s 1.5 percent fee.
But Idaho wasn’t ready last year to have a website up and running for its exchange, so it relied on the federal exchange website, making Idaho’s exchange a federal-state partnership. Now, that’s all happening in-state. You can read my full story here at spokesman.com.
Idaho's state health insurance exchange, YourHealthIdaho.org, is gearing up for the launch of its own Internet sign-up system on Nov. 15, the start of the next open enrollment period for health plans through the exchange, the Idaho State Journal reports. “Launching our own technology platform brings all elements of the exchange into Idaho and puts Idahoans in control of our own fate,” exchange board Chairman Stephen Weeg said. “The technology will be ours, our customer service representatives will be in Idaho, and we will continue to work with Idaho agents and brokers.” When Idaho's exchange first began operating, it routed customers through the federal health insurance exchange online platform, while starting work to develop its own in-state. Click below for a full report from the State Journal and the Associated Press.
Idaho’s state health insurance exchange, YourHealthIdaho, has named a new executive director: Pat Kelly, the former finance director for the exchange who was named interim executive director in July. “Pat has been with us since the very beginning and has a deep understanding of our commitment to our customers and to our state,” said Stephen Weeg, board chairman for the exchange. “After a very competitive nationwide search, we realized we already had the right leader in place.”
Kelly replaces Amy Dowd, who left in July to head New Mexico’s state health insurance exchange. Prior to joining the exchange, he was a Boise businessman, working in telecommunications, manufacturing and business consulting. Weeg said, “Pat has kept YourHealthIdaho on track during a critical time. We are less than two months away from launching our own technology platform. It has been a challenging process but Pat has been able to bring key stakeholders to the table to ensure we take care of our customers when open enrollment starts on Nov. 15.”
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.”