The Boston Globe, Associated Press -- and reportedly members of the Massachusetts Association of Health Insurance Plans -- is all atwitter the week of December 14 over the fact that no one allegedly is actually signing up for and paying for Grubercare1 in Massachusetts during the Commonwealth's ongoing second try at bringing Obamacare to Massachusetts (after the failed first attempt in late 2013/early 2014).
All the hand wringing is a little nutty. Not to worry. Believe me, Jonathan Gruber and the rest of the Massachusetts Health Connector board and the whole Massachusetts state government is expert at giving away free stuff. And for most of us in Massachusetts the whole discussion is totally irrelevant. Here's how we in Massachusetts break out.
About 94% of the Massachusetts population2 has yet to go anywhere near the state's web site... ever. Not the old primitive RomneyCare web site. Not 2013's disaster web site, Not the new third-web-site-in-six-years web site rolled out in November 2014. That leaves about 6% of us that might maybe care at all about Grubercare (see image above) as of December 10, 2014 (based on the Connector Authority Board report pictured in top left of image):
- A. About half of a percent of the population so far has filled out the forms on the state's new web site and are not qualified to receive a subsidy of any kind,.. ever. Who knows why they bothered? They must make a lot of money because a typical family making up to about $90,000 a year can get some kind of subsidy for Obamacare insurance.
- B. A little more 1% of the population (72% of the group that has been processed so far) have been newly "determined eligible" for free health care insurance or Medicaid as of 12/10/2014 and will owe nothing... ever. So their payments aren't late. They will have no payments. (They have probably received free or almost free RomneyCare for the last six years.)
- C. A very very very small percent of the people who have been "determined eligible" so far (so small the sliver does not really show up on the pie chart) need to pay a token amount but they have been paying a token amount historically. This is probably the small group of people who have paid their bill or will pay it.
- D. About a quarter of a percent of the Massachusetts population have gone onto the Obamacare exchange and have been "determined eligible" but need to pay a token amount for 2015 insurance. But they are on Medicaid/MassHealth this year paying nothing... They are on Medicaid/MassHealth either provisionally because of last year's exchange fiasco or would have qualified anyways historically. They are probably thinking twice about doing anything next year because even the token amount they would owe is more than the nothing they are paying now. Since they make a relatively small amount in income (but too much to qualify for Medicaid/MassHealth), they probably will not owe any IRS/John-Roberts tax even if they do not "buy" health insurance and they can still go to the ER or Community Health Centers and have it covered by the free care tax being paid for by the other 95% of Massachusetts people who do get insurance.
About 3%-4% of the population still needs to call Jonathan Gruber and check in. Some of this group was purposely staggered to smooth sign-up work by the state's out of state contractors; their provisional Medicaid/MassHealth does not run out until February or March of 2015. Some of this group has never had health insurance despite six years of the RomneyCare mandate and probably will still not have healthcare insurance (see the Massachusetts free care tax program -- which is like insurance but, like Medicaid/MassHealth, is not really insurance -- described in this blog post here but not included in this image)
1It's time to retire the term 'RomneyCare' except for research that applies to the time period 2007-2013. RomneyCare litterally referred to the free or almost free Commonwealth Care insurance that was avaialble during those years to people in Massachusetts who applied for but did not qualify for Medicaid. And who better to associate with the RomneyCare replacement, Connector Care, than the longest serving Connector Authority Board member, Democratic political strategist and insurance consultant Jonathan Gruber. Consistent with the way Obamacare is often mixed up between the law -- the Patient Protection and Affordable Care Act of 2010 as amended -- that enabled some minor national insurance reform, the insurance itself, and the web site -- healthcare.gov -- from which you can buy the insurance with a subjsidy (pending a Supreme Court hearing and ruling) if your state does not have its own web site, I am doing the same thing with Grubercare.
2These percentages are based on state figures released consistently during the RomneyCare years but released since 2011 only whenever the state's propagandist wants to make some political point. The U.S. Census Bureau percentages indicate a higher rate of uninsured but I am using the state statistics because those are the statistics the Connector Authority Board consistently uses. The trend lines are the same for both sets of statistics; no one disagrees that Massachusetts has one of the lowest if not the lowest rates of uninsured in the country and that the RomneyCare law moved 4%-6% of the populationf from the free care tax program to Medicaid or RomneyCare