Progressivism Would Work If Not for People

This (via Instapundit) is interesting:

Garthwaite et al. analyzed what happened in 2005, when the state of Tennessee discontinued Medicare health insurance coverage for about 4% of its non-elderly adult population, many of them nondisabled low-income adults without children at home. With a new need for private health insurance, which is often provided by employers, many of these people found new jobs. State employment rose by 6 percentage points from 2004 to 2006. This change mirrors the Congressional Budget Office projections of the decline in employment due to the expansion of public health insurance mandated in the U.S. Affordable Care Act.

Unfortunately, public schools have failed to educate generations of Americans not just about economics, but about critical thinking.  Meanwhile, progressive deconstruction has undermined the more social means by which people learn how to think outside of the classroom.

The REMI model that the state used to promote dismissive projections for large changes to the sales tax is built on very similar, dehumanizing assumptions about how Rhode Islanders would react to changes in policies.  If, for example, a reduction in revenue were to cost highly educated, well paid state employees their jobs, REMI assumes that they’d either leave the state or take much less money in one of the newly created retail jobs — not that they’d find similar jobs in the private sector or even create similar jobs by starting their own businesses.  If (for some inexplicable reason) lawmakers didn’t address the revenue shortfall by removing the many government spending extravagances, and instead cut across the board, then REMI assumes people who would have received subsidized heart surgery and the like would simply go without it — harming the “economically impactful” healthcare industry.

In other words, the government would adjust its spending to mitigate harm to Rhode Islanders, and Rhode Islanders wouldn’t adjust their spending to save their own lives.

At some level of the lefty hierarchy, the people promoting progressive policies must realize what they’re doing, which means they want to further a cycle of dependence on government.  Unemployment and human suffering are just temporary necessities to push people to the total dependence on government that is the only true route to nirvana.

HealthSource: Something They’d Never Do with Their Own Money

A 2009 report by a state government work group warned that a health benefits exchange structured like HealthSource RI would not work, which sheds new light on early estimates that consultants and state government officials projected when seeking federal taxpayer dollars.

Follow Up on HealthSource Math

On Friday, I sorted through some of the arguments for keeping HealthSource RI as a state-government-run start-up company, even though the business model does not appear to make sense for a state the size of Rhode Island.  Among the points I raised was that nobody seemed to know where the exchange’s director, Christine Ferguson, came up with the number of $17.3 million when discussing the total fees that the federal government would charge insurance customers in Rhode Island if it were to take over responsibility for the state’s ObamaCare exchange.

Shortly after that post went live, RI Center for Freedom & Prosperity adjunct scholar Sean Parnell heard back from a HealthSource spokesperson providing some numbers for the calculation.

For fiscal year 2016 (i.e., July 2015 through June 2016), HealthSource’s enrollment targets are 41,000 people in the individual market (the number right now is around 28,000) and 53,000 in the small business market (the number right now is 1,110).  The total market (in and out of HealthSource) is might be bigger than the numbers that the House Fiscal Staff  used for its presentation because businesses with 51-100 employees are included.

It still isn’t clear what average premium HealthSource used to reach $17.3 million.  The current average of $368 per month they provided to Sean produces $14.5 million if the federal government continues to charge a 3.5% fee on plans issued through a federal health benefits exchange.  Using the estimates from House Fiscal — $365.30 for individual plans and $440.46 for small group plans — produces $16.1 million.

For 94,000 people to produce $17.3 million from a 3.5% fee, their average monthly premium would have to be $438.

10 News Conference Wingmen, Episode 33 (Sending HealthSource RI to Feds)

Justin and Bob Plain discuss closing down HealthSource RI and using the federally run version.

Sorting Out the Rationale for Sinking Millions in HealthSource RI

At the May 28, 2014, hearing of the House Finance Committee regarding legislation to switch to a federal health benefits exchange, advocates for HealthSource RI left the impression that their arguments aren’t quite in line with the facts or with their intentions.

Fees for Federal Exchange Not as HealthSource RI Director Claimed

Defending its turf, Rhode Island’s ObamaCare health benefits exchange, HealthSource RI has shed light on a little-known fee that passes costs to health insurance customers even if they do not use the exchange.

Rhode Island on Cutting Edge of Common Sense with ObamaCare

Josh Archambault has a great article on Forbes.com pointing out that bipartisan, bicameral legislation currently submitted in the Rhode Island General Assembly could put the Ocean State on the cutting edge of common sense when it comes to the Affordable Care Act (ACA).  If H7817 and S2740 pass, Rhode Island would be the first state to hand its health benefits exchange (HealthSource RI) over to the federal government not because it was an abject failure, but because its limited success proves that the concept just doesn’t make sense:

For context, Rhode Island, a state with a population of 1.05 million, is looking to spend at least $23 million a year, while Massachusetts, a neighboring state with a population six times as large, has run an exchange with an annual budget of around $40 million. Yet putting that comparison aside for a moment, it should be noted that many have questioned the return on investment of the Massachusetts exchange.

Archambault quotes a Providence Journal op-ed by Gary Alexander, Rhode Island’s former secretary of Health and Human Services and director of Human Services, with whom the RI Center for Freedom & Prosperity worked on a report that’s also out today.  This is from the report:

As the Center predicted in a 2012 report discouraging creation of the exchange, the cost to Rhode Island of operating it is set to become a budgetary problem. Although data may be some time coming, it remains likely that, as the Center predicted in a 2013 report detailing the incentives surrounding the exchange, HealthSource RI will not meet its goal of providing coverage to most uninsured Ocean Staters.

The combination of high costs with low enrollment levels creates an extreme challenge of identifying funding sources for the state’s exchange.

The report makes a variety of additional arguments for handing HealthSource RI back to the federal government that mandated its existence and has paid for it so far.

I note, by the by, that HealthSource has called a press conference for later this morning to offer the other side.  That brings to mind something Rep. Jared Nunes (D, Coventry, West Warwick) said to Archambault for his Forbes article:  “HealthSource RI has been spending money like drunken sailors.”  As Monique Chartier has pointed out on the Current-Anchor, a significant amount of that spending has gone to the media entities that are likely to be in attendance.

Sudden Deficits and a Need for Better Decision Making

The surplus with which the Rhode Island government ended last fiscal year has turned into a deficit, this year, according to a story by Randal Edgar in yesterday’s Providence Journal.  Why?  Well, here’s a big reason:

The rising Medicaid costs are the result of increased enrollment under the Affordable Care Act, as well as a smaller-than-expected savings in Rite Care, the state’s health program for poor families, after the state reduced the income eligibility threshold from 175 percent of the federal poverty level to 133 percent.

Also contributing are delayed eligibility reviews for Medicaid enrollees. State officials say the federal government encouraged the delay with the advent of the Affordable Care Act, thinking states were already busy with the Obamacare rollout. The reviews typically identify cases in which recipients are no longer eligible, for reasons ranging from a rise in income to death, so the delay is adding to the state’s costs.

This is really no surprise.  The RI Center for Freedom & Prosperity pointed out the costs of the ACA back when Rhode Island could have avoided them.  There is surprisingly little interest in debating decisions (like the expansion of Medicaid) as they’re made, which is indicative of the degree to which Rhode Island government suffers from a short-term-thinking approach.

An unsigned editorial calling for Rhode Island’s health benefits exchange to be transferred to the federal government points to another one:

As a further benefit to taxpayers, the federal website appears to be much more efficient than the Rhode Island one, covering people for a much lower cost per applicant. And there are other costs associated with the state program. According to Mr. Alexander, a related initiative, the Unified Health Infrastructure Project, is projected to cost state taxpayers more than $51.3 million between now and 2020.

The cost of implementing UHIP is only the beginning.  The project is designed to link social-service programs together, increasing bureaucrats’ ability to find non-paying customers.  Don’t be surprised when the state government finds we suddenly have new deficits and less money to spend on things that government really ought to be doing, like maintaining infrastructure.

Health Benefits Exchange, Benefiting Whom?

I’ve been calling HealthSource RI — Rhode Island’s health benefits exchange under the so-called Affordable Care Act (ACA) — a government start-up company, because that’s exactly what it is.  The government thought up a product, invested loads of money (loads of our money) to build up a system of franchises, and modified the law to its venture’s advantage, much like a big-dollar start-up might lobby government to change the law to its advantage.

One of the many problems with this approach is that businesses by their nature are designed to make money and absorb market share.  They often do so by providing better products at lower prices, but those are the means to the objective of revenue creation.  Because it can change the laws and take people’s money away, government shouldn’t have revenue and market share as its primary objectives.

I offer this bit of commentary by way of context for this passage in a Providence Journal op-ed by Gary Alexander, former secretary of Health and Human Services and director of Human Services in Rhode Island and current adjunct scholar for the RI Center for Freedom & Prosperity:

The cost differential is stunning: The state House of Representatives’ fiscal office analysis shows that at an enrollment of 70,000 (we’re at fewer than 30,000 currently), annual administrative costs per person would be $343. If the current mix of HealthSourceRI policies were issued via the federal exchange, it would cost just $186, or 46 percent less — nearly half the price.

From my point of view, government shouldn’t be in the business of brokering health insurance, but since legislative maneuvers, party-line votes from Congressional Democrats, lies from the president, and ridiculous reasoning in the Supreme Court have allowed it to enter that line of business, the goal should be maximization of benefits for the cost, not maximization of the amount of revenue collected or number of government workers employed by the franchise.

Another Massive Database: Getting Healthcare Backwards

The federal government’s release of Medicare data mainly raises the question of whether the system should work the way it does.

But wait, the President just said…

… that the Affordable Care Act was bringing health insurance premium increases down.  And yet:

[Morgan Stanley]’s April survey of 148 brokers found that this quarter, the average premium increase for customers renewing an insurance plan is 12 percent in the small group market and 11 percent in the individual market, according to Forbes’ Scott Gottlieb.

The hikes — the largest in the past three years, according to Morgan Stanley’s quarterly reports — are “largely due to changes under the [Affordable Care Act],” analysts concluded. Rates have been growing increasingly fast throughout all of 2013, after a period of drops in 2012.

 

HealthSource RI Numbers in Perspective

Coverage of HealthSource RI results is setting Rhode Islanders up to be blindsided by budgetary reality, as a massive fraud and failure is presented as a success.

Stepping Out of the Government-Focused Lala Land on ObamaCare

Politicians and members of the media who spin ObamaCare (and HealthSource RI) enrollment as a positive aren’t equipping the public to assess their investment or preparing them for what’s to come.

Media Advertisements, Paid and Unpaid

Monique’s post, this morning, about HealthSource RI’s advertising in Rhode Island media brings to mind Phil Marcelo’s Providence Journal article on Saturday, which ended with this:

Those interested in enrolling may visit HealthSource RI’s “Contact Center” at 70 Royal Little Drive in Providence or its temporary location at 250A Centerville Rd. in Warwick’s Summit Executive Park.

Both locations will offer extended hours on Sunday, March 30 (noon to 9 p.m.) and Monday, March 31(8 a.m. to10 p.m.).

Rhode Islanders may also enroll by phone at (855) 840-4774 or online at www.healthsourceri.com.

Now, I don’t think Marcelo was consciously catering to a big-money advertiser. (HealthSource had given the Providence Journal $85,050 in the five months ending March 14.) Inasmuch as the health benefits exchange is a government agency, publishing the information can arguably seen as a public service announcement for readers’ benefit.

Two points must be made, though. First, it is explicitly part of HealthSource’s mission to compete with private companies offering similar products. As I’ve noted, UnitedHealth is planning a small-business product similar to the one that HealthSource provides. How would it look if United were to buy $90,000 in advertising over a few-month period and Providence Journal reporters started weaving product placements into their stories?

Maybe journalists should start being wary of the blurring line between government and profitable interests.

Second, the RI Center for Freedom & Prosperity has come under attack, recently, including in the Providence Journal, based on allegations about our funding. I’ve complained that this amounts to connecting dots without any dots. We share some political philosophy with a national movement in which certain large donors play a role, and that alone is insinuated to be evidence that our work is somehow suspect.

Yet, here is a direct pair of dots, between HealthSource RI and the Providence Journal. The link in that relationship is much more specific and conspicuous than a general link between billionaire libertarians and the Center’s work on eliminating the sales tax, and yet it isn’t even disclosed in Saturday’s story.

Is that evidence that the Providence Journal “operates largely in secret,” the phrase reporter Randal Edgar’s used about the Center?

HealthSource RI’s Million Dollar Media Buy

HealthSource RI has spent $1,115,666 on advertising for the five-month period from October 13, 2013, to March 14, 2014.

HealthSource Shooting for Small-Business Insurance Monopoly?

Something caught my eye in Phil Marcelo’s Providence Journal article, last Thursday, concerning the Rhode Island House Finance Committee’s hearing on funding HealthSource RI, the state’s ObamaCare health benefits exchange:

Christine Ferguson, executive director of Health-Source RI, argued that the pool of potential payers could be much larger.

Another 247,000 people, she said, could be enrolled in health-care plans through the exchange, if more small businesses take advantage of a unique option offered only by HealthSource RI.

As I noted a few weeks ago, a projection of enrollment that HealthSource gave the federal government last May estimated just 17,000 Rhode Islanders covered through small-business accounts. Even the more-optimistic projection back in 2011 only went so far as 77,000. As of March 8 of this year, only 795 people had materialized.

Responding to a question I sent by email, HealthSource spokeswoman Dara Chadwick said Ferguson’s latest number is the entire market, in Rhode Island, for this sort of insurance product: “The 247,000 represents the estimated number of SHOP-eligible lives in the under 50 employees small group market.”

Asked if HealthSource intends to become a monopoly for small-business health insurance in the state, Chadwick replied that the organization is just “actively reaching out to small employers across Rhode Island to make sure they’re aware of options available through HealthSource RI, particularly the Full Employee Choice model, which allows the employer to select a reference plan at an affordable contribution level and then allow each individual employee to pick from any of the 16 plans offered on the SHOP Exchange.”

The silver lining of having captured only 0.3% of a possible market in five months of operation, apparently, is being able to say that there’s still 99.7% of the market left to conquer. Be that as it may, Ferguson’s intentions in this direction might help explain her reaction (“What the hell?”) when she found out that UnitedHealth intended to offer a similar product to small-business clients, without government involvement.

HealthSource RI “Nag Toolkit”: Invasive Government or Catalyst for Libertarianism?

Small government Rhode Islanders have a lot to dislike about HealthSource RI, the state’s ObamaCare health benefits exchange. But never mind that the agency is spending public dollars to remedy much-lower-than-expected paying customers, but instead attracting many-more-than-expected free Medicaid recipients (including many in the non-expansion group for whom the federal government isn’t picking up the whole tab).

Never mind that it’s simply inappropriate for the government to take our money and change our laws in order to create a market space that it can fill with a $100 million start-up with no plan to pay for itself and nobody whose livelihood is really on the line if it fails.

Never mind all of that, because HealthSource has stepped into the realm of self-parody with regard to how invasive government can get when money is no object and behavior must be changed. Welcome to HealthSource’s “Nag Toolkit.” As Christine Rousselle of Townhall explains:

The website for the “Nag Toolkit” features tutorials to teach adults how to use the mobile apps Snapchat, Twitter, Vine, Tinder, and OkCupid to connect with their children. While Snapchat, Twitter, and Vine are apps mostly used for communication and sharing things with friends, Tinder and OkCupid are dating/hookup apps. The goal of the “Nag Toolkit” is to assist parents with bothering their kids about health insurance in places where children would not typically expect to find their parents.

So, parents, pick a “provocative username,” and ambush your children on social media, encouraging them to sign on to an overreaching top-down plan to rope them into dependence on government. It gets even better, at the bottom of the page, where the government suggests that confused (or squeamish?) parents can just hand over their kids’ email addresses, and “we’ll do the nagging.”

We can only hope that such efforts have the unintended consequence of pushing young Rhode Islanders toward a gut-level distrust of government and lead them to rebel.

(Click “continue reading” for addendum.)

10 News Conference Wingmen, Episode 22 (HealthSource Results & Government as Give-Away Business)

Justin and Bob Plain review the failure of HealthSource RI to accurately predict its results and discuss whether it’s government’s role to find people in order to give them things they didn’t know they needed.

Costs upon Costs with HealthSource-Related Data

Government spin and incomplete reportage of HealthSource RI’s results leave Rhode Islanders with little understanding of how short the health benefits exchange will be of covering its expenses or how much greater the Medicaid handouts will be than projected.

Akash Chougule: CBO in February, Confounding Liberals and Vindicating Conservatives

The nonpartisan Congressional Budget Office (CBO) spent February releasing research findings that showed the flaws of progressive policies.

People Still Want Their “Substandard” Health Plans

The Kaiser Family Foundation has released some interesting poll results regarding people’s impressions of the Affordable Care Act (ACA; aka ObamaCare; aka destroyer of American healthcare; aka stepping stone to socialized medicine). The Providence Journal‘s Felice Freyer tweeted the poll by highlighting the suggestion that “those most likely to enroll in Obamacare don’t mind limited choice of providers, latest Kaiser poll finds.”

By “those most likely,” she means people who are “uninsured or purchase own insurance,” and I think it layers in an erroneous assumption about their emotions to say that they “don’t mind limited choice.” What they actually say is that they would “rather have… a plan that costs less money but has a more limited range of doctors and hospitals” than one “that costs more money but allows [them] to see a broader range of doctors and hospitals.”

That’s quite a different statement than reported, and it ought to raise questions about the presumptions underlying ObamaCare. When it became obvious that President Obama brazenly lied to the American people about being able to keep their plans and doctors, his partisans and progressives took up the talking point that just a few people on “substandard” plans were not being permitted to keep them.

But to people who chose those plans out of the available options — who determined that at this particular time in their lives, having money for other purposes outweighed having more-comprehensive insurance — the plans weren’t “substandard.” It looks like a majority of health-exchange users are inclined to make the same decision, to the degree that the government allows it.

This conclusion ties in with the chart that I think actually ought to be the headline about the poll. About two-thirds of the way down the page, we find that the uninsureds’ opinion of the ACA has swung dramatically since November, from 39% unfavorable and 36% favorable to 56% unfavorable and 22% favorable.

For some of them, at least, the government is not allowing the options that they would want, which might be cheaper plans that fall below the “standards” of our incompetent superstar president.

Improving RI’s Image by Tarnishing Others

Maybe it all makes sense — from offering Rhode Island as a testing ground for federal experiments to backing an all Democrat, far-left federal delegation. After all, if the federal government can inflict on the entire country what the Rhode Island government has inflicted locally, then the Ocean State won’t be that much worse than anywhere else.

The country will be a vast landscape of high unemployment and hopelessness.

That’s hyperbole, but it’s the general sense I get from Felice Freyer’s column in the Sunday Providence Journal,Surprising data on R.I. insurance costs“:

Does health insurance cost too much in Rhode Island? … It may surprise you: Costs are not higher here. When the price of similar coverage is compared around the country, premiums in Rhode Island fall near the middle. …

Last week, Cynthia Cox, a Kaiser senior policy analyst, did a data run for The Providence Journal. She compared the rates that a 40-year-old would pay for the lowest-cost “silver” plan offered in each area. The median premium nationwide is $259. That plan in Rhode Island (Blue Solutions HSA 2600/5200) costs just a little more: $274.

Because Cox did the analysis for the Projo, the data doesn’t appear to be available, so we can’t know exactly how comparable “the lowest-cost ‘silver’ plan” actually is in each state. But even so, a 6% higher premium for a middle-aged individual is “just a little”? Rhode Island is as much as 15% more expensive than Massachusetts.

All of this elides the critical point, though: Freyer and Cox are comparing Affordable Care Act plans. In essence, ObamaCare has inflicted on the entire country many of the mandates that Rhode Island had inflicted on its own people, which had driven our insurance up and made it a tough market for insurers.

If I were a resident of anywhere else, I’d invert the spin and be very, very worried that my state’s insurance rates were starting to make Rhode Island’s look comparatively reasonable. I’d also worry which of Rhode Island’s other failing metrics are soon to be improved by reducing the contrast with other states.

America Once Was a Land of Laws and Freedom

Some mornings America’s new reality hits you the moment you turn on the computer. The point is driven home, deep within blue country, with parallels of national concerns at the state level, with the “bizarre” backroom maneuvering on pension reform (to quote House Minority Leader Brian Newberry), and at the local level, with Tiverton’s farewell to the rule of law.

But it’s the Obama Administration that wins the spotlight, today. There’s the new innovation in abusive use of the IRS that requires businesses to swear, under threat of perjury, that their layoffs have nothing to do with ObamaCare:

Obama officials made clear in a press briefing that firms would not be allowed to lay off workers to get into the preferred class of those businesses with 50 to 99 employees. How will the feds know what employers were thinking when hiring and firing? Simple. Firms will be required to certify to the IRS – under penalty of perjury – that ObamaCare was not a motivating factor in their staffing decisions.

At the very least, that will keep a lid on news stories giving the legislative affront to the Constitution the blame for continued economic suffering.

Speaking of news stories, here’s one that’s gotten surprisingly little play:

The U.S. under President Obama, who once promised to run the “most transparent” administration in the country’s history, fell from 32nd to 46th in the 2014 World Press Freedom Index, a drop of 13 slots. The index, compiled by the press advocacy group Reporters Without Borders, analyzes 180 countries on criteria such as official abuse, media independence and infrastructure to determine how free journalists are to report.

It appears that we’ve got a long way to go to the freedom of Namibia, but at least we’re still edging out Haiti (barely).

What I can’t help but wonder is this: How can we trust the American news media to protect our freedoms when they aren’t making much noise about their own?

Concern for the Community or Preparation for Submission?

So the local Twitterverse has exploded with commentary on CVS’s decision to stop selling tobacco products, even though it will cost the chain $2 billion of its roughly $125 billion annual revenue.

Ted Nesi puts it in context of the company’s move toward the health-services space, what with the MinuteClinics that it announced an intention to open, in November. In Ted’s telling, it’s a peer-pressure, good-for-the-image thing, perhaps to defuse some of the opposition that had the clinics on the receiving end of Rhode Island’s infamous licensure blockade back in 2005.

Amy Payne, from Heritage, proclaims it as evidence that corporations can do the right thing without government coercion.

Of course, it’s also possible that the company has been given reason to believe that the government is preparing to change the rules of the game. One indication of that possibility is House bill 7166, which would prevent any “health care facility” from having a license for tobacco sales “issued, renewed, or maintained.”

It’s win-win. The government makes a threat, and the company gets to respond to that threat by shooting for some good publicity. The only losers are consumers buying the legal product from their local stores, taxpayers who find the government shifting the tax burden to other collections than cigarettes, and company shareholders whose stocks lose value to the extent that the company can’t continue selling a profitable product while also branching out into new healthcare services.

When the Government Goes into Business

“What the hell?”

That’s what a high-paid government director said to an audience of local small businesspeople upon learning that a private business was planning to offer a service that would compete with a government program.

According to ConvergenceRI, it’s a direct quote from Christine Ferguson, director of Rhode Island’s ObamaCare health benefits exchange, HealthSourceRI. Stephen Farrell, who runs UnitedHealthcare of New England, had just announced that his company is planning to open a health insurance exchange for businesses and their employees. And that’s the response from the woman who’s been given around $100 million by the federal government in order to try her hand at a healthcare-related start-up business at taxpayer expense.

She went on to express a view of competition that must only make sense in the halls of the bureaucracy:

“On the exchange, you can choose Blue Cross, Neighborhood and United – and next year, Tufts.

“[On the UnitedHealthcare exchange], the only option is with United, the only option given to employer [and employees] is within United.” …

“Let’s be clear. It’s a strategy that makes sense for their perspective – if they want to keep market share.

“What we want to do is open up the options, and to drive, from a consumer and provider perspective, competition.”

So “competition” is when all options are offered through a government monopoly.

But yes, let’s be clear. This is a government agent making a competitive sales pitch to a group of potential clients, making derogatory statements about a private company’s offering, and it’s entirely inappropriate.

Going forward, how can United or the people of Rhode Island have any confidence in the fairness of the taxation and regulatory activities of the government? (It’s a trick question; no Rhode Islander should have such confidence, as is proven again and again.)

10 News Conference Wingmen, Episode 16 (Chafee & Tea Party)

Justin and Bob Plain talk Chafee’s State of the State and the influence of the Tea Party in Rhode Island.

RI Center For Freedom & Prosperity: “State Cannot Afford Operation of HealthSourceRI”

As readers may know, ObamaCare RI, a.k.a., HealthSourceRI (funny that they had to give it a different name), was created via Executive Order by Governor Chafee with federal funds that disappear next year. HealthSourceRI has turned into the consummate bloated, expensive and unnecessary governmental bureaucracy without even accomplishing one of its important claims of increasing […]

The Story of the Budget

The flow of money through the State of Rhode Island’s budget illustrates the perpetual scam that is government budgeting and should inspire Rhode Islanders to realize that they are allowed to make the machine run the other way.

Imbalance in the Health Benefits Exchange

The enrollment picture for HealthSource RI brightened a little as the deadline for January coverage approached, but if anything, the long-term picture for the health care reform darkened.

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