Colorado: 88% ACA exchange retention rate, planning #SilverSwitcharoo in 2019

Louise Norris is an awesome source for all sorts of healthcare policy/insurance data, but she's especially on top of developments in her home state of Colorado, where she and her husband Jay run a small brokerage outlet.

Today Jay and Louise have a couple of interesting tidbits out of The Centennial State (yeah, I had to look up their nickname myself).

First, according to Jay (via the Connect for Health Colorado exchange itself), as of May 7, 2018, C4HCO had exactly 142,474 people enrolled in effectuated ACA exchange policies statewide. This is noteworthy mainly because 161,764 people selected Qualified Health Plan (QHP) policies during the 2018 Open Enrollment Period.

That's (sort of) an 88% retention rate through early May. I say "sort of" because this presumably includes some amount of churn (if 100 people drop coverage and 100 off-season enrollees sign up, that'd be a net change of zero). Even so, it's actually slightly better compared to prior years, when the national effectuation number had usually dropped to around 87% by the end of March.

I'd have to know the retention numbers for a lot of other states to draw any conclusions, of course, but this at least suggests that those who enrolled in exchange plans this year aren't any more likley to drop coverage mid-year than in earlier years. It's still a problem, mind you, but it's a problem which doesn't seem to be any worse in Colorado, at least.

More important is this bit of news from Louise:

Looking ahead to 2019: The cost of CSR will be added to on-exchange silver plans

In Colorado, June 15, 2018 is the deadline for insurers to file proposed rates and plans for 2019 coverage. The state will publish the proposed rates by July 13, and public comments will be accepted until August 3. Rates will be finalized in late summer or early fall, and open enrollment will begin November 1, 2018.

For 2018, Colorado was one of only five states where the cost of cost-sharing reductions (CSR) was added to premiums for plans at all metal levels, instead of just silver plans (you can read more about Colorado’s 2018 approach below). But for 2019 coverage, the Colorado Division of Insurance has confirmed that insurers in Colorado will be adding the cost of CSR to on-exchange silver plan premiums. If the exact same plans are also sold off-exchange, they would also have to include the cost of CSR in their premiums. But as long as the on- and off-exchange silver plans have a difference in benefits, the cost of CSR can be added only to the on-exchange silver plans.

To accomplish this, the Colorado Division of Insurance has proposed allowing insurers to slightly adjust (by $5) the off-exchange ambulance/emergency transportation benefit in order to have a slight difference between the on- and off-exchange plans. Insurers would have the option of using a different approach to creating a slight benefit difference between on- and off-exchange silver plans, but would have to discuss the proposal with the Division of Insurance before proceeding.

In other words, Colorado will not only be jumping on board the Silver Load train next year, they're gonna skip right past that and go all the way to the full Silver Switcharoo! Good for them!