• Bad news in Mississippi for the uninsured

    Interesting story at Kaiser Health News about many counties where no policies will be available in the exchanges:

    Tens of thousands of uninsured residents in the poorest and most rural parts of Mississippi may be unable to get subsidies to buy health coverage when a new online marketplace opens this fall because private insurers are avoiding a wide swath of the state.

    No insurer is offering to sell plans through the federal health law’s marketplaces in 36 of the state’s 82 counties, including some of the poorest parts of the Delta region, said Mississippi Insurance Commissioner Mike Chaney.

    As a result, 54,000 people who may qualify for subsidized coverage would be unable to get it, estimates the Center for Mississippi Health Policy, a nonpartisan research group.

    These are, of course, many of the countries with the highest levels of uninsured people. They also seem to have the most problems with quality and access.

    Mississipi’s insurance commissioner wanted to run the exchange at the state level. That might have allowed Mississippi to make rules that required insurance companies to offer coverage in all counties if they wanted to participate in the exchanges. But evidently, the governor of the state fought hard against him to make sure that the state would not be involved. So the feds are running Mississippi’s exchange, and this type of selective offering at the county level may be permissible.

    It appears that Mississippi is also not going to get the Medicaid expansion, and it’s traditional Medicaid seems jeopardized as well. Things don’t look good for the poor uninsured there.

    @aaronecarroll

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    • My guess is in the first few years after you insure the poor and uninsured, you get a large number of previously untreated problems. How many doctor visits does it take to stabilize blood sugar or blood pressure?

      The other thing this proves is that the free market doesn’t work all that well for health insurance.

      • Let’s not confuse this with the “free market.” Anyone who claims that America’s health insurance market pre-ACA represented a “failure” of the free market is being disingenuous. Likewise, it’s hard to argue that post ACA there is a “free market” of health insurance. Insurance in the ACA world becomes ever-more regulated (for better or worse), and still keeps some of the poorly constructed regulations of the past (limitation on selling insurance across state lines, for instance).

    • In Oktibbeha county, which does have insurance options, 21% of the population is obese and 6% has diabetes. In Bolivar, which one of the counties with no option, the obesity and diabetes rates are double.

    • Maybe this will be an opening for a “public option”!

    • Federal regulation has created the problem where the poor have only two choices, Medicaid and the exchange. I see a logical disconnect in blaming the governor for regulation which he had no hand in. If a federal program is, by its own construction, poorly executed in a state, don’t blame the state.

      • The state made the decision not to expand Medicaid – that’s the part that is causing the poor to not have any option in certain counties.

        • My point was a rejoinder to the author’s point that there are few choices. But my reply to you is that you should read the linked article. Here’s the money quote:

          “But Democrats in the House rejected the reauthorization bill. Their objection? Republicans will not permit a debate on expanding Medicaid under the health law, which would add 300,000 people to the Medicaid rolls. They have said they will not reauthorize the program without such a debate.”

          So Democrats would rather kick the poor under a bus than vote vor the status quo because the republicans won’t “discuss” the expansion. Nice.