Analyzing How Well The Individual Mandate May Work

Politico looks at the practical task ahead for the health law's individual mandate.

Politico: Obamacare Mandate May Be 'Mandate Plus'
Can't get enough of Obamacare's individual mandate? Get ready for "mandate plus." The Obama administration always said there was a practical reason it needed the mandate, which starts next year. It wasn't to be mean to people — it was supposed to pull in enough healthy customers to help pay for all the sick people who will get coverage. That's why the White House stuck with it all the way to the Supreme Court — however unpopular politically, it was the best tool to make the new health system work. Here's the catch: The individual mandate penalties will be pretty weak as they are phased in over two years — only $95 when they start in 2014, much less than it costs to buy insurance. And yet, everyone with pre-existing conditions will have to be accepted for coverage right away (Nather, 1/13).

News outlets also track state implementation developments -- including the latest regarding the health exchanges and the Medicaid expansion --

MPR News: Some Insurers Question Claim Of Same Or Smaller Premiums Under Insurance Exchange
The state Commerce Department says the majority of Minnesotans who buy individual health insurance plans will pay the same or smaller premiums on the state insurance exchange in 2016. But some insurers question the figures. The Commerce Department's April Todd-Malmlov told a state insurance exchange task force that on average, 70 percent of the premiums in the individual market would remain the same in 2016. "There's definitely some that will see higher premiums but most of them are projected to have lower ones with the tax credits that are there," Malmlov said. Insurers question how the department arrived at those numbers. Commerce officials based their conclusions on an analysis by a prominent health economist at M.I.T. The full report won't be released for about a month (Stawicki, 1/11).

Pioneer Press: Federal Health Law Wrinkle Could Penalize Minnesota Insurers
Without a change in proposed federal rules, the continuation of a Minnesota health insurance program for people with costly illnesses could cost health plans and their subscribers more than $60 million next year, state officials say. The issue involves a long-standing program called the Minnesota Comprehensive Health Association, which the Legislature created in 1976. It helps provide coverage for Minnesotans who can't find insurance on the open market, often because of a costly pre-existing health condition. One of the key changes coming in 2014 with the federal Affordable Care Act is that insurers no longer will be able to deny people coverage based on pre-existing conditions. To make sure that the expense of covering these patients is evenly spread among insurers, the federal law will give health plans a chance to receive "reinsurance" payments if they happen to attract many patients with costly conditions (Snowbeck, 1/12).

On the Medicaid expansion front -

The Associated Press: Medicaid Rejection Prompts Look For New Options
Gov. Mary Fallin's decision to reject a Medicaid expansion that would have made health coverage available to roughly 200,000 uninsured low-income, working class Oklahomans has left health officials scrambling to come up with alternative ways to make health care available to this population. Although no concrete proposals have been developed, the Oklahoma Health Care Authority on Thursday approved a $500,000 sole-source contract with Utah-based health consultant Leavitt Partners to develop ways to target the nearly 20 percent of Oklahoma's population that have no health insurance (Murphy, 1/14).

The Associated Press: Focus On Medicaid As Session Begins Monday
Leaders of the Arkansas House and Senate say most questions about the state budget, tax cut proposals or a possible special session depend on how legislators address a Medicaid program that already receives nearly one out of every five tax dollars the state receives in its general revenue budget. Medicaid is the biggest issue facing members of the 89th General Assembly, who gather Monday. For the first time in 138 years, Republicans will control the state House and Senate (1/14).

The Associated Press: Governor Jerry Brown Commits State To Health Reform
Gov. Jerry Brown says he's firmly committed to making national health care reform work in California, but he also is wary of potential costs that could affect state spending for years to come. In releasing his budget for the coming fiscal year last week, Brown pledged to be a reliable partner in implementing the federal Affordable Care Act by expanding Medicaid coverage for low-income Californians (1/14).

Also in the news --

The Wall Street Journal: Public-Private Fund Aims At Health Care, Housing Gap
Hoping to bridge the gap between low-income residents and health-care services, a $100 million fund will be unveiled this week to build community centers near affordable housing as demand for primary-care services is expected to rise. Supporters say it is a new kind of public-private partnership boosted by the philanthropic sector that was inspired by the 2010 Affordable Care Act, which could expand Medicaid coverage by up to 16 million additional people. The act includes about $10 billion for the creation of new, federally qualified health centers. The fund's backers say the financial need is greater still (Dolan, 1/13).

This is part of Kaiser Health News' Daily Report - a summary of health policy coverage from more than 300 news organizations. The full summary of the day's news can be found here and you can sign up for e-mail subscriptions to the Daily Report here. In addition, our staff of reporters and correspondents file original stories each day, which you can find on our home page.