Insurers on the District of Columbia’s Obamacare insurance exchange want to raise rates by nearly 15 percent in 2019, while Minnesota’s insurers propose to reduce rates by up to about 12 percent.

Insurers in Minnesota can take advantage of a reinsurance program in which the state helps subsidize the biggest insurance claims on Obamacare’s insurance exchanges. Efforts to create a federal reinsurance program ran aground in the Senate because of disagreements over abortion funding.

In Minnesota, all of the state’s five Obamacare insurers are asking for proposed rate reductions of 3 to 12 percent for certain plans. That is a major difference from the final rates for the 2018 coverage year, which ranged from a 16 to 32 percent hike.

. . .

The Republican-led Michigan Legislature on Thursday gave final approval to a bill requiring able-bodied adults in the state’s Medicaid expansion program to meet work or job-related requirements, sending it to Gov. Rick Snyder for his expected signature.

Starting in 2020, adults age 18 to 62 would have to show workforce engagement averaging 80 hours a month — through work, school, job or vocational training, an internship, substance abuse treatment or community service. Michigan would first seek a federal waiver to implement such requirements that have been embraced by President Trump’s administration.

. . .

Gov. Ralph Northam (D-VA) signed a bill into law Thursday that will allow more people to sign up for health care coverage paid for by the Medicaid program. This is projected to move 400,000 low-income residents onto the program. Lawmakers arrived at a compromise on Medicaid and on other parts of spending in part by setting a tax on hospitals. Under Obamacare, the federal government paid for all of the cost of Medicaid expansion in states beginning in 2014, but this support will fall to 90 percent of costs by 2020. In some states, that will mean billions of dollars in additional spending.

Even health insurers that don’t expect many of their plan members to drop insurance coverage after the individual mandate penalty is zeroed out still may have to raise individual market premiums in 2019 as their payments from the ACA’s risk adjustment program change thanks to the mandate loss.

Buffalo, N.Y.-based insurer Independent Health doesn’t expect a large number of its 5,000 ACA exchange members to drop their coverage when the individual mandate penalty is effectively repealed starting in 2019. Its population skews older and sicker, and most members need their insurance coverage. Its average member is about 49 years old, and about half receive federal premium subsidies.

. . .

Health insurers are asking Washington state regulators to allow them to raise the price of Obamacare premiums in 2019 by an average of 19 percent.

Under the latest proposals made public Monday, no county in the state will be left without an Obamacare insurer, a type of medical coverage offered to customers who do not get health insurance through a job or government program. Still, 14 counties would have only one insurer to choose from, which will limit their options and the doctors and hospitals that will be in their network.

State Insurance Commissioner Mike Kreidler blamed the Trump administration’s changes to Obamacare for the increases.

. . .

Two self-employed Texans, John Nantz and Neill Hurley, have leading roles in the latest legal effort to kill Obamacare.

The men are the named plaintiffs in a lawsuit by 20 states that argues Congress fatally undercut the law when it repealed the individual mandate penalty in tax cut legislation. Nantz and Hurley say the mandate compels them to buy costly insurance that doesn’t fit their needs — even though the financial penalty for not complying is disappearing next year.

. . .

Gov. Phil Murphy on Wednesday signed a law preserving a critical yet controversial part of the Affordable Care Act that President Donald Trump‘s administration repealed last year.

One of the laws creates a statewide individual mandate, which will require all New Jerseyans who don’t have health coverage through a government program like Medicare or their jobs to buy a policy, or pay a fee at tax time.

. . .

Utah voters will decide on ballot measures to expand Medicaid and to legalize medical marijuana this fall.

Lt. Gov. Spencer Cox released Tuesday what measures will be on the ballot in the 2018 elections this November.

A measure to expand Medicaid under Obamacare got enough signatures to make it onto the ballot.

Activists behind the measure are hoping to have the same success as Maine, which approved the Medicaid expansion in a ballot measure last year. However, Republican Maine Gov. Paul LePage has vowed to not abide by the ballot measure, prompting a lawsuit.

. . .

Virginia is on the cusp of expanding Medicaid after the Senate on Wednesday narrowly approved a budget that would allow the state to cover as many as 400,000 low-income people.

The House, which already voted in favor of expansion earlier this year, will have to vote again before the bill can go to Gov. Ralph Northam (D). Northam has made expansion one of the top priorities of his administration.

When it passes, Virginia will become the 33rd state, along with Washington, D.C., to expand Medicaid under ObamaCare.

. . .

A Maine state judge said Thursday that Gov. Paul LePage’s administration has a “duty to enforce” a voter-passed law to expand Medicaid to low-income adults.

Kennebec County Superior Court Justice Michaela Murphy’s comment came during oral arguments in a lawsuit brought by advocacy groups to force the LePage administration to implement the Medicaid expansion overwhelmingly passed by Maine voters last November.

The judge did not indicate when she would issue a ruling, though it’s expected she will rule within a week or so. The losing side is almost certain to appeal.

. . .