Wisconsin Institute for Law and Liberty loves short term Junk Insurance policies, and a Desperate Public!!!

The Cap Times column, State Debate, pointed me to an article that was so nonsensical, that I just had to pass it along.

This represents the brain trust of right wing "fellows" at the lawsuit mill Wisconsin Institute for Law and Liberty (WILL). WILL has been furiously raising funds in preparation to challenge almost everything Gov. Evers and AG Josh Kaul will put forward as policy.

First up, Covering Preexisting Conditions: Perhaps WILL Research Director Will Flanders thought most readers would just give up and default to his bigger point about gladly buying junk insurance policies if he just wrote a bunch of words that sounded pretty darn official.

Let's look at the "institutes" case for short term junk insurance policies, a big part in Trump's health care reform plan. Democratic Gov. Tony Evers isn't buying into this horrific scheme:

Flanders

Among the executive orders signed by Governor Tony Evers in his first week was a directive for DHS and DATCP to “provide recommendations on how to…. Protect against attempts to undermine the Affordable Care Act marketplace with short term plans that do not comply with Affordable Care Act requirements...” 

Flanders went on to explain why short term plans are nothing more than junk insurance policies that don't cover preexisting conditions:

Short-Term Limited Duration (STLD) healthcare plans were originally designed as a stop-gap measure for people who would be lacking insurance for (appropriately enough) a short time …Critically, such plans were exempted from many of the mandates of the ACA, including language on preexisting conditions...

Down the Rabbit Hole: To be clear, if you get sick while on a short term insurance plan, you are now strapped with a preexisting condition, and you can't get another short term policy. Again, Evers is against short term junk plans. 

But Flanders doesn't get that. In an incomprehensible word salad explanation, Flanders somehow ended up blaming Evers for "exacerbating the problem? I know, you've got to read it to believe it:

One result of placing greater limitations on such plans is that people may be left entirely without coverage options if they get sick while on a STLD … individuals who enroll in short term plans and get sick during that plan may not have coverage options when those plans come to an end. This serves to exacerbate the problem of uninsured that people like Evers purport to be so concerned about. 

Junk Insurance, a Necessary Evil: But wait, Flanders isn't done embarrassing himself. He still wants these junk policies in Wisconsin because...the "public is desperate." Of course they are, isn't that how we want people to feel? You can't make this sick stuff up:  

The second, and perhaps even more critical, problem is that limiting the time frame of these plans removes a viable healthcare option for Wisconsinites who may be struggling to afford insurance coverage. Short term plans represent a viable alternative for a public desperate for affordable options.

Rather than being concerned about protecting the viability of the ACA, let’s consider the healthcare needs of Wisconsin’s low- and middle income families, who perhaps don’t want or cannot afford Obamacare plans.

Note: Evers and Democrats aren't simply "protecting the viability of the ACA" for political reasons, they're trying to give everyone affordable access to health care short of universal care.  

Let's hope Evers tells the insurance commissioner and specifically Cari Lee at enforcement, to examine and negotiate lower rates in Wisconsin: 

Wisconsin’s’ average insurance premiums are among the highest in the nation in both urban and rural parts of the state.

Walker has to keep fixing things he broke, like Health Care.

I was going to "Hulk Smash" Scott Walker's claim that thanks to him, insurance rates will be lower on the ACA exchanges, but then I found a few other wildly important points of interest.

First, Walker is again saving us all from himself and Trump's sabotage of the ACA-ObamaCare. Citizen Action:

Walker’s actions have increased premiums on individual market by at least 17%, and Donald Trump’s sabotage of the ACA has increased premiums by at least 18%.

And Walker's grand 4.2 percent savings in 2019 (a smaller increase)?

A Brookings Institution study estimated that absent federal policies disrupting the marketplaces, premiums would have dropped 4.3 percent nationwide in 2019.

Wow, thanks, Scott Walker.

Tens of thousands more would have health care and tax payers would have an extra $1 billion. That’s if Walker would have expanded BadgerCare," said TJ Helmstetter, Democratic Party of Wisconsin.

This is What Walker Calls Success??? Walker is spending all his time putting out the GOP fires he and Trump have created. Thankfully, you can now send that extra pocket change from Walker's tax cuts to insurers:

1. Minnesota’s premiums are decreasing for 2019; Minn-13% vs Wi-6%.

2. 45% more expensive in Wisconsin in 2018 to 59% more expensive in 2019.

3. $533 per month for premiums in Wisconsin vs. $335 in Minnesota for a 40-year-old purchasing the benchmark plan on their own without a federal tax credit.

Republicans we're Scaring Insurers: It wasn't the ACA so much as it was repeal-and-replace:

Larry Levitt, senior vice president of the Kaiser Family Foundation (said) "There was a repeal-and-replace debate going on. President Trump was out there talking about the law collapsing," Levitt said. Congress and the president ended certain subsidies for low-income Americans. To prepare for that, and for just general chaos, insurers raised rates. But then things turned out to be not as terrible as insurance companies thought ... enrollment stayed remarkably stable this year.

And besides reinsurance...

One reason 2019 premiums will be lower? It has to do with how high they were in 2018. They increased by an average of 36.9 percent for 2018. "These premium decreases are really about returning excess profits," he said.

Here's audio from NPR's Marketplace that explains what happened, and why Walker is just taking credit again, for something that for the most part was happening anyway:

In fact, according to the Kaiser Family Foundation, insurance company profits are higher than they were before Obamacare. And now some insurers are returning to markets they'd abandoned.

But all of this goes out the window if Walker, AG Brad Schimel, and Congress get the court decision they worked so hard to get:

Wisconsin is one of the lead states in the lawsuit that argues the ACA should be scrapped because Congress got rid of the penalty for not having insurance when they passed the GOP tax cut bill.

Private Insurers pad profits, start gaming Affordable Care Act Marketplaces. GOP blames Obama, not blood thirsty Insurance companies.

The Affordable Care Act’s marketplaces are just that, marketplaces set within the for profit private sector.

Republicans may criticize those marketplaces, but their own plans dump everybody into that same free marketplace, with fewer regulations.

It’s an important similarity that makes the GOP’s supposed “patient centered” ideas much worse, affecting every American with no required coverage, policy cancelations for preexisting conditions and small print exclusions that would exonerate insurers from ever paying out a dime. That doesn’t even include the Republican plan to reduce the business deduction for employer insurance coverage, which would result in fewer businesses offering benefits.

And don’t forget, Republicans forced weak kneed Democrats to remove most of the cost controls, including the public option. The public option would have been especially embarrassing for the GOP, who feared it’s overwhelming popularity would have proven them wrong about the public’s supposed distrust in government.

It’s with these caveats that make the following increase in marketplace costs not so surprising. Politico:

Premiums for some of the most popular insurance plans in the Obamacare exchanges will have double-digit rate hikes in 2016 … Analyzed by consulting firm Avalere Health, (they) found that the lowest cost “silver” plan – the most popular option in the law's insurance marketplaces – will rise 13 percent, about four times the increase for plans this past year. The steep increases are certain to rekindle criticism from Republicans that the Obamacare marketplaces aren’t working as promised. 

These weren’t “promises,” but expectations, and the rap when the ACA passed was that it didn’t reign in health care costs enough. Our fears have been realized. Here are Wisconsin's numbers:

It was also just a matter of time our free market insurers and health care providers would find a way to game the ACA system. Imagine the GOP’s deregulated plan in the free market:  

Joe Antos, a health care finance expert at the conservative American Enterprise Institute, argues that the double-digit increases show that insurers set rates too low during the first two years of open enrollment. “What’s basically happening is the insurance companies finally have gotten a little bit of cost experience,” Antos said. “This is getting closer to a realistic set of premiums."

A “realistic set of premiums” isn’t a factor in a single payer system, just the for profit driven model that plays fast and loose with life and death decisions.

Plans will see varying cost swings across the country -- the cheapest silver plan in Oklahoma will spike by 44 percent next year, while exchange shoppers in Indiana will an average decrease of 14 percent.

The administration announced earlier this week that premiums will rise more slowly for a key benchmark plan, which helps determine size of federal subsidies. The benchmark plan, which is the second-cheapest silver plan offered on the exchange, will increase by 7.5 percent on average in 2016.

Thanks to the Affordable Care Act, Americans no longer forced to work full time for Health care coverage, choose parttime jobs instead.

There were a lot of corporate threats thrown around about turning full-time workers into parttimers due to the Affordable Care Act. It didn't happen when corporate bosses had to deal with reality. Center for Economic and Policy Research:

The claims about low enrollment figures were shot down in April, when it came to light

that enrollment had surged during the previous month. It’s time that we shelved the critique about part-time work as well. 

click to enlarge

The graph to the right shows a huge drop in involuntary parttime work, the kind threatened by employers like Papa Johns, and an increase in people choosing to just work parttime:  

Specifically, there’s good reason to think the ACA could be leading to greater voluntary part-time employment. To explain: if an employee is working part-time and would like to work full-time, his or her status as part-time is a negative; that employee would like to work more, but hasn't been given the opportunity to do so. 

However, if an employee is voluntarily working part-time, it means that he or she is making an active decision to pursue part-time employment. Since health insurance was linked to a worker’s status as a full-time employee before the ACA went into effect, many Americans worked full-time simply to receive health insurance benefits; this was true even for workers who otherwise would have preferred to work part-time. Thanks to the ACA, workers no longer have to work full-time in order to receive insurance, meaning they can work fewer hours if they want to, assuming they can still pay the bills.

Jobs lost...Damn that ObamaCare?

Opponents of the Affordable Care Act will no doubt start trashing Obama for destroying jobs, now that Assurant Health insurance is shutting down in Milwaukee:

jsonline-Guy Boulton: The parent company of Assurant Health said Tuesday that it will sell or shut down the Milwaukee health insurer — which employs 1,200 people in the area — by the end of next year. Assurant Health has struggled to adjust to changes in the health insurance market imposed by the Affordable Care Act … The company specializes in health insurance for small employers and individuals, the two market segments that have faced the most changes from the Affordable Care Act. "They are a casualty of the ACA," said Steven Schwartz, an analyst with Raymond James & Associates.

Oh, the horror. But wait, the ugly truth is even more grotesque. Here's how Assurant Health stayed in business:

The Affordable Care Act barred health insurers from turning away customers because of pre-existing health conditions. That new regulation negated one of Assurant Health's strengths: underwriting, or determining which potential customers were the best risks. "That went away," said Schwartz of Raymond James.

Poor babies, not being able to turn away sick people is so unprofitable. 

What about the free market dream to compare and shop around, lowering prices? ObamaCare does that too:

Assurant Health's losses suggest that any buyer would have to raise the cost of its health plans next year. At the same time, the online marketplaces set up under the Affordable Care Act have made it easier for people to compare prices and move to different health plans each year.

In an interview in 2012, Adam Lamnin, president and chief executive of Assurant Health, acknowledged the challenges the company faced. "Health care reform," he said, "was a watershed event for us."

Funny thing, Assurant had a different story when the ACA started up, which proved to be a big, big mistake:

Assurant Health declined to sell insurance on the Affordable Care Act online marketplace in 2013, and executives with parent company Assurant Inc. say the company gained market share because of the strategy. The higher sales were driven by “significant activity” due to the first open enrollment period under the Affordable Care Act that started Oct. 1, 2013, Assurant Health’s major-medical insurance products for individuals include essential health benefits required by the ACA … In other words, prospective customers could meet ACA's individual mandate by buying Assurant products.

 Thanks to the tweet from Gnarlytrombone.

The Affordable Care Act's Marketplaces covering more Wisconsinites, and Republicans don't like it one bit.

With Republican politicians and their voters salivating over the thought of the Supreme Court taking away federally setup exchange tax credits, it’s important to point out who in Wisconsin is getting the benefit:

Post Crescent: In 2014, 91 percent of Wisconsin consumers who obtained a marketplace plan received aid, according to the U.S. Department of Health and Human Services. Even if clients are able to find manageable premiums, they're often stymied by high deductibles and co-pays. "That sometimes causes them not to obtain insurance, or to later drop it."

The high deductibles and copays, the ones Republicans hate so much now, is a product of the individual "free market" insurance system. It was setup this way to discourage people from overusing medical services. Surprise, the biggest backers of high copays and deductibles; those same angry Republicans. Health savings accounts are also meant to discourage access.  

jsonline-Guy Boulton: In a 2010 essay, Stephen Parente, a health economist at the University of Minnesota and a former adviser to Sen. John McCain's presidential campaign, noted the plans in the marketplaces overall also have high deductibles, which many health economists support because the deductibles encourage people to be better consumers of health care. "That's sort of the dirty little secret in the room," Parente said.

(Parente also said) that "the roots of the law lie far more with Republican market-based health reform solutions than the single-payer and Medicare-for-all national health insurance programs proposed by Democrats since the end of World War II." Parente said the law has similarities to McCain's proposal in his campaign, such as using refundable tax credits to enable people to buy their own health plans. "Last I checked, that's what this is" … believes the marketplaces could lead to more competition and more options in the insurance market over time.

The Affordable Care Act is based on Republican values, which are now suddenly being abandoned for something not yet defined by the party (hint: it looks a lot like the ACA...doh!).

The law ... partially relies on commercial health plans and enables people to shop online for a plan of their choice — all concepts championed by conservatives. It also puts an emphasis on personal responsibility, a conservative mantra, in requiring most people to buy plans with high deductibles as well as in requiring people to have health insurance. "The huge irony is that Democrats are trying essentially the Republican idea," said James Morone, a political science professor at Brown University who has written extensively about the politics of health care reform.

The law is not projected to increase the federal budget deficit … "This is not about spending," Morone said. "And anybody who thinks this is about spending just hasn't looked at the numbers and is just not going to understand what's going on."

The overreaction to the ACA is also kind of weird, because so few people get to use it:

The law affects a small piece of the health insurance market: the market for people who don't get health benefits from an employer. It is a market that many health economists consider dysfunctional. An estimated 19.4 million people get coverage through the so-called individual market. That includes roughly 180,000 people in Wisconsin, a state with a population of 5.7 million people.

In contrast, 156 million people were covered through an employer in 2012.

So what’s the big deal? I just posted a piece on that here. 

Walker still doesn't understand the Health Care Problem, pushing Subsidies on the open market.

Scott Walker doesn't get it. He doesn't understand the individual health care insurance marketplace, he's been a career politician getting taxpayer health benefits. Walker is getting support from low information voters and leaders of the legislature. Here’s Walker idiotic plan:

Two weeks ago, Walker requested that consumers be allowed to use the federal subsidies to buy any health plan offered in Wisconsin. That request, which would represent a substantial change of policy for the Affordable Care Act, is unlikely to win approval from the Obama administration.

What, a substantial change? Not a big deal for a law breaking dictatorial president like Obama, right. But wait, it appears Walker would make that illegal and substantial change if he were president, no matter how the Affordable Care Act was written.

It’s a terrible idea that would only raise rates dramatically, crushing people with what would inevitably be unaffordable premiums:

jsonline: Jonathan Gruber, an economist at the Massachusetts Institute of Technology said he didn't agree with the larger proposal by Walker to allow consumers to use the federal subsidies to buy health policies not offered on the exchanges. Gruber said the point of the exchange and its more limited coverage choices is to ensure that everyone gets robust insurance and that the market is financially sustainable.

"Right now, the Wisconsin insurance market is highly discriminatory, with young and healthy folks able to get products at low prices and older and sicker folks left out of the system. A primary goal of the ACA is to remedy this...But that can raise average prices as the (insurance) pool gets sicker," Gruber said. "If the young and healthy can use the tax credit to stay out of the reformed insurance market, then it will worsen the price increase in that market."

Makes sense, doesn't it? But Rep. Robin Vos has never been a guy to make sense out of anything, as he heartily, eagerly jumps on board:

But Assembly Speaker Robin Vos (R-Rochester) said he … especially favored the larger one giving consumers the greatest number of options. "I like that even better. More choice is good," Vos said.

Disconnected from the realities of the private individual market? You bet. Despite the much higher prices, as predicted by the creator of the health care marketplaces, Vos likes the free market, because…well, just because? Freedom and liberty!!

Is the Media trying to make Health Care Marketplaces confusing? Ya Think?

Confusion reins as clueless business whiners continue to get the ear of the media and their clueless reporters.

That's been the problem all along, reporters don't care to know the facts or care to ask the right questions about Obamacare. There are real questions to ask, like how up-to-date can a person or family be in reporting their income if they work on a commission? But instead, media plays up the myths and stupidity of business owners too lazy to read up on the details.

Take this ridiculous article in today's paper from the AP. I won't go to far into the mind numbing details:

Small companies fear they will have to cut coverage

Funny thing though, small companies have been cutting coverage for years, last decade or two. The increases of 20 percent mentioned in the article ain't nothin' folks, I had increases topping off at 32 percent almost every year my family was insured. And even more infuriating were the business owners in the story who complained about their insurer threatening to raise their premiums a year from now, by over 20 percent. Am I missing something? Tell them to go to hell, you'll take your business elsewhere. How do these people manage their money anyway?

That's why the reasons listed above are so misleading. Small businesses under 25 get major subsidies from ObamaCare, yet the conservative jackass business owner interviewed by Greta Van Susteren, who had only 10 employees complained about how much it'll cost him, not to mention the "threats" by his insurer to raise premiums 25 to 40 percent. He even complained about the insurance tax that doesn't affect him, just the insurance company. He said he wants a payback and break...and that's what he would be getting if he just did a little reading:

Here's what this lazy business man doesn't care to know:

Starting in 2014, the tax credit is worth up to 50% of your contribution toward employee premium costs (up to 35% for tax-exempt employers). This will make the cost of providing health coverage lower.

Beginning in 2014, the small business health care tax credit is available only if you get coverage through SHOP.

And if you're a business under 50, but adding up to 20 employees, you get a first year exemption on the new employees. a kind of grace period to encourage hiring. Make sense? Odd how that works.

WISC recently covered the new exchanges and the insurers trying to get the message out:

Dabble around at Healthcare.gov for awhile, you might learn something.

Scott Walker, GOP, try to Vilify ObamaCare before public finds out about Lower Small Business Insurance premiums through Exchanges.

While the following is great news for Americans, the bad news is we’re still talking about INSURANCE COMPANIES. The rate savings below are insurance company rates, not the actual cost of care. We've still got to tackle rising doctor fees and hospital costs. 

So with that in mind, Obamacare, and not the phony un-passable proposals Republicans continue to churn out as a way to look like they’re doing something, continues to lower prices. The GOP’s summer home campaign in August will attempt to convince constituents they shouldn't buy health care coverage. It may sound ridiculous, but to their supporters, a vengeful attack on ObamaCare is worth freeloading off the responsibly insured. I guess freeloading is just another word for freedom. 

So when it comes to these supposed business friendly guys like Scott Walker, who has personally done everything he can to sabotage the new marketplaces (all the while whining that implementation has been slow), their efforts are falling short of angering and hurting small businesses. 

Washington Post: Obamacare driving down health insurance costs for small businesses in Washington, DC.: District officials last week announced that, for the third time since they started posting proposed plans on a new health insurance marketplace for small businesses, an insurer has lowered its initial prices for coverage. It is a sign, they say, that the marketplace will help bring down health costs for businesses, which have skyrocketed in recent years.

Kaiser Permanente is the most recent to drop its rates, lowering premiums by 4.4 percent. United HealthCare previously dropped its rates by more than 10 percent, and then again by about 5 percent, while Aetna has lowered its prices by more than 5 percent. “These lower rates are more incontrovertible proof DC Health Link is already bringing competition to the insurance market,” William P. White, the city’s commissioner of the Department of Insurance, Securities and Banking, said in a statement.

Scott Walker’s “business friendly” image also doesn't automatically mean small businesses will suddenly and magically save money. He would have to create policy, and Republicans aren't into that right now. And some small businesses (large too) don't want to provide health care for their employees.

This isn't the only success story either:

The District’s exchange isn’t the only in which prices are falling. The Department of Health and Human Services recently evaluated proposed insurance premiums in 11 states, reporting that prices … in those states have come in an average of 18 percent lower than the premiums employers were paying prior to the Affordable Care Act.

Again, don’t confuse free market competition between insurers to actual lifesaving health care, which isn't a market based consumable product, but a human necessity. Everywhere else in the world, it's a right. There’s even more savings coming for small businesses:

In April, the administration announced it would delay for one year a requirement that business owners be allowed to choose different plans for different workers through the health insurance exchanges, a feature meant to provide added flexibility and help drive down costs for employers.

Republicans and other critics of the law have (been) pitching them as evidence the legislation is not working. Mila Kofman, the executive director of the DC Health Benefit Exchange Authority, suggested the opposite, noting the plummeting prices … “It is exciting to see that insurance companies in the District are already aggressively competing for business through the online marketplace,” she said.

Republicans are doing everything they can to prevent Americans from having what they have. Health care.

It was no big deal when Republicans opposed health care for all, we kind of knew they would.

But the dynamic has changed…dramatically. And now everyone in the U.S. should be, I hope, fed up to here with their tantrums. The difference is a national health care plan. 

Simply put; Republicans are now doing everything they can politically, to kick families of Medicaid and keep Americans from getting subsidized health care for themselves and their families.

It’s under this new reality that we should all be “mad as hell.” Where are the conservatives who hate it when somebody else gets something they don't have? 

Republicans want to take our health care away in every way possible, day after day, vote after vote...while we pay for theirs? They're rubbing our faces in it. 

After all this, it's time to pull their taxpayer health care plans in the event we lose ours.

Here's Chris Hayes, who first got me thinking:



What fired me up was this article in Mother Jones:

Kevin Drum: The Republican Temper Tantrum Against Obamacare Continues.

Still, the absolute fury that it continues to generate even now, three years after passage, is remarkable. The fury is so deep that an expansion of healthcare to the poor and working classes has become a part of the culture wars every bit as bitter and divisive as guns, gays, and abortion. Jon Cohn revs himself up to write about this today:

"As you have read … the federal government is starting a public education campaign about Obamacare—not to promote the law, mind you, but simply to inform the public about the new insurance options that will be available once the law takes full effect. In 2005, the Bush Administration ran a similar campaign to let seniors know about the Medicare drug benefit. 

As word spread that the Obama Administration had approached professional sports leagues about forging a similar partnership, GOP leaders warned the leagues to stay away. “It is difficult for us to remember another occasion when [a] major sports league took public sides in such a highly polarized public debate,” (said Sen.’s) Mitch McConnell and John Cornyn."

Conservatives remain so spittle-flecked angry about it that they can't even abide the thought of a sports league helping to run a public education campaign that reduces confusion about who's entitled to what. Even now, they desperately want it to fail. And they're going to do everything they can to help it fail, even if that means screwing over their own constituents. It's a temper tantrum possibly unequalled in American political history. And it's revolting.

Health Care Exchanges adding more insurers, resulting in more Competition.

While Wisconsinites have to wait for the federal government to put together our Obamacare exchanges, the other states that have moved way ahead are already reporting the number of insurers participating. Taking into consideration a states size and population, the following interactive graph tells the story so far. More insurers will probably added along the way. WP:

I hope to have more when it comes to rates soon.

Health plan participation on state exchanges | Create infographics

Health Care Marketplace Whining Already?

I loved this. After hearing the Republicans whine and complain for years that people should know the cost of health care and have some “skin in the game,” they’re now crying about all the hoops they’ll have to go through to signing up for Obamacare.

What a bunch of cry babies.

Leader Telegram: Applying for benefits ... could be as daunting as doing your taxes. The government's draft application runs 15 pages for a three-person family. An outline of the online version has 21 steps, some with additional questions.

The idea that getting health insurance could be as easy as shopping online at Amazon or Travelocity is starting to look like wishful thinking. At least three major federal agencies, including the IRS, will scrutinize your application. Checking your identity, income and citizenship is supposed to happen in real time, if you apply online. That's just the first part of the process ... The government asks to see what you're making because Obama's Affordable Care Act is means-tested, with lower-income people getting the most generous help to pay premiums. Once you're finished with the money part, actually picking a health plan will require additional steps, plus a basic understanding of insurance jargon.

Oh no, this would have never happened with an insurance agent? 

And it's a mandate ... The law says virtually all Americans must carry health insurance starting next year ... Some are concerned that a lot of uninsured people will be overwhelmed and simply give up.

The government estimates its online application will take a half hour to complete, on average. If you need a break, or have to gather supporting documents, you can save your work and come back later. The paper application is estimated to take an average of 45 minutes.

Sounds like the amount of time it took for me to sign up for Badgercare. Big deal.

HHS estimates it will receive more than 4.3 million applications for financial assistance in 2014, with online applications accounting for about 80 percent of them. Because families can apply together, the government estimates 16 million people will be served
.
HHS spokeswoman Erin Shields Britt said in a statement the application is a work in progress, "being refined thanks to public input." It will "help people make apples-to-apples comparisons of costs and coverage between health insurance plans and learn whether they can get a break in costs," she added.

But what if you just want to buy health insurance in your state's exchange, and you're not interested in getting any help from the government? You'll still have to fill out an application, but it will be shorter.