The government says about 500,000 fewer Americans had no health insurance the first three months of this year, but that slight dip was not statistically significant from the same period in 2016.

Progress reducing the number of uninsured appears to have stalled in the last couple of years, and a separate private survey that measured through the first half of 2017 even registered an uptick.

. . .

Under the ACA, insurance companies must sell polices to people with chronic diseases and charge the same premiums paid by healthy people. But patients with pre-existing conditions in fact are being denied coverage when their insurance plans don’t cover medically-recommended treatments or when they place significant obstacles in the way. Many plans impose “utilization management” rules restricting access to drugs. Dr. Blinderman suggests a “preauthorized trial period” for all medications. Following this trial period, physicians could be asked to justify continuation of the therapy. Doing this would relieve patient suffering due to delays or disruptions in the amelioration of symptoms, reducing health-care costs in the process.

. . .

The second-lowest silver plan is one of the most popular plan choices on the marketplace and is also the benchmark that is used to determine the amount of financial assistance individuals and families receive. Based on preliminary 2018 rate filings, the second-lowest silver premium for a 40-year-old non-smoker will range from $244 in Detroit, MI to $631 in Wilmington, DE, before accounting for the tax credit that most enrollees in this market receive.

. . .

The individual market shrank by 15% between March 2016 and March 2017, including a 25% decline among unsubsidized policyholders.  The individual market is not “sound.”  Because of rising premiums, millions of people who are not receiving subsidies can no longer afford to buy individual policies, and millions more may forfeit their policies in the next round of rate hikes.

Relinquishing at least some regulatory authority to the states might produce more functional markets where insurers can offer consumers the coverage they want at a price they can afford.

. . .

U.S. health insurer Anthem Inc said on Monday it will no longer offer Obamacare plans in Nevada’s state exchange and will stop offering the plans in nearly half of Georgia’s counties next year.

The moves come after Republican senators last month failed to repeal and replace Obamacare, former President Barack Obama’s signature healthcare reform law, creating uncertainty over how the program providing health benefits to 20 million Americans will be funded and managed in 2018.

. . .

After 20 of the 24 Obamacare non-profit health insurance cooperatives collapsed, despite the influx of $2.4 billion in taxpayer funds, it shouldn’t surprise anyone that its trade association would also fail.

The National Alliance of State Health Cooperatives (NASCHO), the Obamacare co-op health insurance trade association, has quietly closed its doors, The Daily Caller News Foundation Investigative Group has learned.

NASCHO once represented as many as 24 Obamacare non-profit co-ops that were intended to compete with for-profit commercial health care insurers and perhaps even drive them out of business. The Obama administration underwrote the experiment with $2.4 billion in long-term, low-interest loans.

. . .

Arguably the most significant data point in the entire debate about the Senate health care bill has been the CBO’s claim that in 2026, 22 million fewer people would have health insurance under the Senate bill than under Obamacare.

Democrats have seized on this number to stoke fears about the bill’s impact; moderate Republicans, intimidated by the negative headlines, have been reluctant to support the bill.

But buried within the CBO’s reports is a key fact: the vast majority of those coverage “losses” occur because the GOP bills repeal Obamacare’s individual mandate. In its July 20 estimate of the most recent version of the Senate’s Better Care Reconciliation Act, or BCRA, CBO says that in 2018, 15 million fewer Americans will have health insurance under the bill, two years before its repeal of Obamacare’s insurance subsidies takes effect.

Why? It’s “primarily because the penalty for not having insurance would be eliminated.”

. . .

 

The most recent version of the Senate Republican bill to repeal and replace ObamaCare would result in 22 million additional people without insurance over the next decade, the Congressional Budget Office (CBO) reported Thursday.

The number of uninsured is essentially unchanged from the original draft of the legislation released last month.

. . .

Minuteman Health of Massachusetts and New Hampshire announced it is withdrawing from the Affordable Care Act exchanges in 2018, leaving only four co-ops in operation. The co-op will stop writing business on January 1 and organize a new company, Minuteman Insurance Company, instead.

The company cited issues with Obamacare’s risk-adjustment program, which is the program that shifts money away from those with healthier customers to those with sicker enrollees. Minuteman Health said that the negative impact of this program had been “substantial.”

. . .

On Monday the Congressional Budget Office released its cost estimate of the Republican Senate Better Care Reconciliation Act.  CBO calculated that the proposed bill would reduce the deficit by $321 billion over the next decade. That is welcome news.

Less welcome, however, was CBO’s conclusion that the Senate bill would result in an additional 15 million uninsured in 2018 due to a lack of penalties. By 2026, CBO reports 22 million more Americans would be uninsured, primarily due to lower Medicaid coverage.

No matter that the number of Americans on the Obamacare exchanges is shrinking due to higher prices and fewer companies offering coverage.

Dave Hoppe, former chief of staff to House Speaker Paul Ryan, asked me in an email, “If there are few insurance companies offering insurance through the exchanges in 10 years, how are people without insurance losing anything?”

. . .