Nearly 7 million covered by ACA reports that despite demand crashes at trends are on track to breach at least 6.9 million, a number that surprisingly makes congressional estimates of how many would get coverage by this point correct.

Essentially, demand trumps goofy implementation. Once word got out that the sites were finally mostly fixed, the promise of actual Health Care was more compelling than the hiccups and annoyances that came before. As one of those 7 million (or at least, someone who will be starting in May), I can say that it is a little easier to sleep at night.

And the best news of all: Even if you only start your sign-up today, you can still come back to the exchanges, finish by April 15, and enroll in coverage for May.

Dem-NPL convention Day 1

Ryan Taylor, Ag Commissioner candidate

Ryan Taylor, Ag Commissioner candidate

Leaguers from across North Dakota gathered for the state convention in Fargo today.

Former State Senator Ryan Taylor was nominated for Agriculture Commissioner, easily the high point of the afternoon.

Afterward, the Democratic-NPL policy platform was adopted, including floor amendments adding the need for truck weigh stations (suggested by someone tired of seeing the Highway Patrol struggle with mobile scales).  A proposed policy on GM crops was removed on the floor.  Despite the numerous changes, the entire document was approved in less than 80 minutes.

The platform also notably includes a concrete commitment that the Dem-NPL will circulate petitions on as many as 5 measures following the next Legislative session, if policies with broad public support fail to pass as bills.

BCBSND blows Maryland Health Exchange

Noridian Healthcare Solutions, one of the many faces of the Blue Cross Blue Shield North Dakota complex of companies, reportedly botched the Maryland Health Exchange so severely that the state was forced to re-open the insurance market to private brokers, and the local health insurance co-op has had to scale back as no one can access its plans.

Even among the health exchanges, characterized so far mainly by bad performances, Maryland’s site sticks out as one of the poor showings.  There’s been serious talk of reverting to the federal exchange for next year, but starting Tuesday, it will be federal exchange provider QSSI running their show.

Canadian farmers also waiting on the railroad

North Dakota farmers are having trouble this year, and there’s also problems in Canada, where the shipping backlog exceeds 40,000 carloads. Speaking in Winnipeg today, Opposition leader Tom Mulcair called on the Harper Government to do more to get rail traffic flowing.

For years, Canada operated a single market for grain under the Canadian Wheat Board. The monopsony was removed in 2012, and by 2016, what remains of the CWB will be completely privatized.  American farmers frequently derided the CWB’s market power, but clearly its dismantling has brought more chaos than expected.

In Health Insurance, the silver lining is the cloud

The government “can’t tell you” which plan to pick, but it’s pretty obvious which ones are going to leave you higher and drier than others. Subsidies apply only to Silver-level plans.  For this reason, only Silver-level plans are being rated here.

Cost sharing subsidies – the hidden bonus

As the “new normal” for health insurance is apparently supposed to be 70% coverage, only silver plans are being subsidized with cost-sharing reductions for less-fortunate taxpayers. With cost-sharing, the 70% coverage silver plans are turbo-charged to cover up to 98% of medical costs.

Anyone can tell you what your premium subsidy will be, and both Morse and Kaiser say that to what extent you qualify for cost-sharing, but if you’re looking for exactly what your reduced co-pays would be (for example, $20 instead of $50 for a doctor visit) — the Health Insurance Exchange Hotline companion website seems to be the only place to go, where the numbers will pop up as you compare plans.  Plans that nominally call for percentage or fixed copays may be reduced significantly.

Traditional plans

Blue Cross Blue Shield
BlueCare 80 2500
It’s the option I went with. Only time will tell if it was the smart move, but its lower deductible is likely to insure more routine health expenses, even if the higher out-of-pocket limit will cost me significantly in a disaster.

You pay 100% below: $2500
You pay 20% between: $2500 and $21750
Plan pays all costs over: $21750
Copays: Fixed-dollar copays for common expenses, others percentage-based

BlueCare 70 3000
Costs will rack up fast with this plan, but it also has the lowest ceiling of any on offer. Would seem to be the way to go for people with expensive chronic conditions.

You pay 100% below: $3000
They pay 70% between: $3000 and $9666.67
Plan pays all costs over: $9666.67
Copays: Fixed-dollar copays for common expenses, others percentage-based

Sanford Health
Simplicity $2500
Sanford’s sole offering to the North Dakota consumer might look good to someone on a cocktail of expensive medications, but that’s about it.

You pay 100% below: $2500
They pay 60% between: $2500 and $11250
Plan pays all costs over: $11250
Copays: Medication is covered by co-pays before the deductible. Fixed-dollar copays for common expenses, others percentage-based.

Applause Silver Copay
Little better than a catastrophic plan. If this really is the best Medica can do, it’s not going to be taking many customers from Blue Cross.

You pay 100% below: $2200
They pay 60% between: $2200 and $12325
Plan pays all costs over: $11250
Copays: Fixed-dollar copays for common expenses, others percentage-based

Health Savings Account options

HSA plans are financially complex and mainly of benefit to healthier, wealthier people who can afford to set aside funds ahead of time. Not recommended for anyone who qualifies for a cost-sharing reduction.

Blue Cross Blue Shield
Choosing between these two options seems a bit farcical. 80-2300 seems better on the top end, but you’re guaranteed to be on the hook for $900 more every year.

BlueDirect 80 2300
You pay 100% below: $2300
They pay 80% between: $2300 and $13300
Plan pays all costs over: $13300
Copays: All co-payments are percentage-based

BlueDirect 70 1400
You pay 100% below: $1400
They pay 70% between: $1400 and $17900
Plan pays all costs over: $17900
Copays: All co-payments are percentage-based

About the strongest offering Medica seems to be able to muster, but it’s also the most expensive on the exchange.
Applause Silver HSA
You pay 100% below: $1300
They pay 60% between: $1300 and $11675
Plan pays all costs over: $11675
Copays: All co-payments are percentage-based

Health Exchange Hotline open 24/7 in last mad dash

heatlhcarecallAfter months for failures using the website alone, I can report that the Health Insurance Exchange is a phone hotline with some online form pre-filling features, rather than a fully functional website with a technical support line.

With less than a week to go to insure millions of Americans, the lines are open 24 hours a day, and prior roadblocks concerning data verification have been removed from the website and replaced with mail-in forms.  At long last, there is very little to prevent you from signing up for health insurance this week — you just need to sacrifice 90 of your precious phone minutes.

Get in touch with the Exchange: 800-318-2596 is the number to call for the federal Health Insurance Exchange.  “” is a website where you can type in personal data that the hotline operators will then make you slowly go back over, which is better than wasting time on typos at multiple stages, though your mileage may vary.

After about 45 minutes of form-filling and 90 minutes on the phone, you too can reach the part of the exchange where you can finally choose insurance coverage along with your proper subsidy level.  After I do the same, I’ll report back my final analysis on health insurance options in North Dakota.

Heitkamp: Cuba boycott “pretty phony”

heidi-hall-20mar-0 –video link–

About 90 people from across North Dakota and some from Minnesota crowded into the cafeteria of Schroeder Middle School for a town hall with Senator Heidi Heitkamp (DNPL).  The crowd was a hodgepodge of concerned interest groups, League and Farmer-Labour supporters, and citizens, even some of school age.  I’ll be posting a more descriptive narrative of the event when I can.

Heitkamp said of her hotel block in Havana filled with people from New York, the Cuba boycott is “one of those things that get to be pretty phony”  All the major North Dakota Agriculture groups support normalization of trade with Cuba, and opinion polling in Florida is reportedly hopeful for some breakthrough in relations.