In light of both Nevada and New Mexico moving towards their own exchanges (a move I support, I should note), here’s my post asking a dumb question about the HC.gov user fee: acasignups.net/18/02/13/updat…
It’s actually a pretty obvious question: the user fee is 3.5% of premiums for every enrollee, and has stayed that way since 2014. Yet premiums have doubled since then (as the GOP loves to point out, even though much of that is their doing) while enrollment is up 45% since 2014...
...at the same time, Trump has SLASHED HC.gov marketing and outreach budget by 90% and 40% respectively. Revenue should be like 3x as much as it was in 2014, while most of the tech costs should’ve been sunk 3 years ago. So my Q is...WHERE IS THAT MONEY GOING?
Nevada and New Mexico’s fees are INCREASING from 2% to 3% even though they do a lot of the exchange work themselves. If anything, assuming the $ isn’t needed, the fee should be REDUCED for the other states DOWN to their 2% or so. This would instantly LOWER PREMIUMS by 1.5 points.
To be clear, I don’t know for certain that keeping the fee at 3.5% is unjustified. There could be legit operational expense increases that I don’t know of. But in the age of Scott Pruitt, Ryan Zinke and Tom Price, this seems like a reasonable question to ask.
