Bronze is a great age

I want to look at one element of the CBO score. It is the offered actuarial value of plans. Under the House Bill, out of pocket maximums would be fixed but there would be no age banding. The CBO sees this having an interestingly low effect.

Beginning in 2020, the legislation would repeal those requirements, potentially allowing plans to have an actuarial value below 60 percent. However, plans would still be required to cover 10 categories of health benefits that are defined as “essential” under current law, and the total annual out-of-pocket costs for an enrollee would remain capped. In CBO and JCT’s estimation, complying with those two requirements would significantly limit the ability of insurers to design plans with an actuarial value much below 60 percent.

Mechanically, under the House bill without a follow-on phase 2 or phase 3 bill, insurers can probably design plans that have at least 55% actuarial value (AV) coverage as the minimum level of coverage. Bronze right now is 60% +/-2 points of AV.

It will be very hard for people to buy a non-Bronze plan because insurers won’t offer them except at exorbirant prices. Let’s work through my logic.

Insurers are currently required to offer at least one Silver and one Gold plan if they want to sell on Exchange. Those plans are age rated at 3:1 with subsidies absorbing almost all of the local price increase risk for the Silver plan. Under the AHCA, those requirements are not in place and the subsidy is not tied to local pricing. Young buyers who are healthy will either opt out or buy the lowest actuarial value coverage possible because it will cost them very little.

Insurers then have to look at the people who actually need coverage and cost money to cover. They’ll offer a Bronze plan to get the young people in. But if they see a 58 year old asking for a Silver or Gold plan, they know that this person is going to be hyper expensive to cover as they have just self-identified as being high risk and high expense. Insurers won’t offer actuarial value levels above the minimum requirements because they will lose money on those policies.

So we will quickly see a proliferation of $6,000 to $9,000 deductible plans and very little else. That means the 64 year old who is seeing a $10,000 a year premium increase will also see their deductibles increase by $4,000 to $7,000 a year.



And the canary just died

The First Congressional District in Virginia is represented by a long standing Republican, Rob Wittman. He easily won re-election in 2016 by twenty three points and Trump carried the district by 13 points. This is a district where the traditional threat to a Republican Representative is from their right flank.

Keep that in mind as we look below:

He is bailing.

This is good news for people who don’t want to throw twenty four million people off of their insurance in order to give a tax cut to people who don’t need one. Speaker Ryan has at most twenty three (currently he has 21 spare votes due to vacancies)) votes that he can afford to lose while still getting to 218. He has 23 Republicans who won in 2016 despite representing seats carried by Hillary Clinton. These are the first seats that fall in a Democratic wave if the Democratic base is pissed off. Their behavioral pattern will look a lot like Blue Dog Democrats in 2009-2010. Anything that passes the House needs could afford to have those twenty three most vulnerable Republicans defect by either voting no or finding a way to be outside of DC to not vote. At most one or two of these Representives would have to take a very hard vote that would probably cost them their seat. That is a vote that many Blue Dogs and New Dems took in 2010 and it cost them their seat.

The issue is if people like Rep. Wittman defect. A single defection can be replaced by another hard vote. But if there are a half dozen or a dozen defections from relatively safe Republican districts, then the willingness of marginal Republicans to take one for the team will decline dramatically as they will be looking out for themselves. It would be as if both Representatives from Philadelphia decided that they would not vote for the ACA and thus forcing a pair of Blue Dogs to take the hard vote.

We already know that AHCA was under threat of defections from both vulnerable Republicans and ideological maximalist Republicans. Now if mostly safe Republicans are bailing, there is great difficulty in Speaker Ryan assembling a coalition in the House. Which then leads to the following:

So our mission tomorrow is to call Congress. Demand that your Rep or your Senator will not cut Medicaid nor screw over the 50-64 year olds.



Come on, come on down, you’ve got it in ya

This is great news:

Buoyed by a wave of progressive activism that began after the election of President Trump, Virginia Democrats plan to challenge 45 GOP incumbents in the deep-red House of Delegates this November, including 17 lawmakers whose districts voted for Democrat Hillary Clinton.

Is anyone going to the Not My President’s Day rally today?

My wife and I wrote post-cards to our Senators and Reps telling them to investigate Trump’s ties to Russia.

Consider this an IRL activism open thread.



Moral March tomorrow

The Moral March in Raleigh is tomorrow. The rally and gathering starts at 8:30 and the march itself goes off at 10:00 AM.

Saturday, February 11, 2017
Gather across the street from the Raleigh Memorial Auditorium
2 East South St. Raleigh, NC
Gather and Rally at 8:30 a.m. | March begins at 10 a.m.

The Moral March on Raleigh is part of a love and justice movement. We fight for an intersectional agenda to support public education, economic sustainability, workers’ rights and livable wages, health care For all, medicaid expansion, environmental justice, equal protection under the law without regard to race, immigration status, gender, gender identity or sexual orientation, voting rights for all, and criminal justice.

On February 11, 2017, we will gather at 8:30 a.m. in downtown Raleigh. The opening rally will begin at 9:00 a.m. and the march will begin at 10:00 a.m. after which we will begin the mass People’s Assembly on the doorstep of the State Capitol.

This year, the Moral March on Raleigh will focus on our moral duty to stand against the repeal of the life-saving Affordable Care Act, the legislative tyranny of our extremist-led General Assembly, the racist and unconstitutional gerrymandering which undermines the vote of all North Carolinians, the anti-family, anti-worker, and anti-LGBTQ hate bill 2, and the extremism and lies of Trumpism, which undermine our Democracy at the federal, state and local level. Donald Trump and his administration have undermined our Democracy and democratic institutions by making regressive federal appointments and inviting white nationalists into the White House. They have demonized our immigrant and Muslim brothers and sisters by building a wall on our Mexican border, pushing through an Executive Order which effectively bans many refugees and Muslims from our country, and blaming Latinos for voter fraud that does not exist.

I’ll be there as these are the people and allies who know how to get shit done. I need to hook into their organizing efforts. It will be fun and it will be needed.

Any other Juicers going?



You love me, you really love me

Via Comments by Humboldt Blue:

I’m not sure what you motherfuckers are rambling about but I followed some advice from the front page health care guy who types out dense and incomprehensible phalanxes of text and double checked my policies today with covered California. Saved my stupid ass more than a hundred dollars per month with a far better and comprehensive option. Remember, you smug bastards, it aint easy going through life as a dumbfuck and some of us take longer to catch on.

Sure, that shit may be meaningless by summer, but at least Mr. Mind-numbing Actuarial tables got through to someone.

You love me, you really love me!!!

Really, I can’t tell you how much this means to me. Little wins are what I aim for. I needed this … so thank you.



Trump Radicalization Effect (continued)

Anti-Muslim ban protest in Tampa, FL: 1/29/2017

Tonight was the first post-election meeting of my local Democratic organization. So many new people showed up that the building had to bring in a cop, and breakout sessions weren’t possible because the entire cavernous room was jam-packed.

During the comments portion of the meeting, one guy stood up and said he’s been a Democrat for 40+ years, but tonight was his first party meeting. A couple of people said they’d been independents until tonight but were getting off the fence to join the only party that still acts like Americans.

It was a diverse group: women and men, old and young, gay and straight, black, white and brown. They were fired up and energized by the women’s marches, the immigration support rallies and pro-ACA public meetings.

A lot of organizing happened. We worked out ways to coordinate responses to ongoing issues and expected outrages to come.

More anecdata to support the Trump radicalization effect discussed earlier here and here. Just thought I’d share. Open thread!



It takes a nation of millions

Yesterday’s nationwide Women’s March was by far the largest protest in American history:

 

According to UConn Professor Jeremy Pressman’s Google document of crowd estimates the low-end estimate is 3.66 million marchers. The high-end estimate is 4.57 million. Whether it is the low or high estimate that is accurate the Women’s March On Washington shattered the previous record for the largest one-day protest in the United States.

Consider that the 1963 Civil Rights March On Washington had 250,000 attendees and that the previous record holder was believed to one of either the anti-nuclear protest in Central Park in 1982, the Million Man March in 1995, or the LGBT March for Equal Rights in 1993. Each of these protests had a high-end estimate of 1 million or so.

The Women’s March low-end estimate is more than three and a half times bigger than anything that has ever been done before in the United States of America.