In the pile-on among Republican-controlled states to impose work requirements on ACA Medicaid expansion enrollees earlier this year, I somehow missed this one:
Wisconsin waiting to hear about requiring work, drug screening for Medicaid recipients
Wisconsin is still waiting to see if the federal government will let it require childless adults on Medicaid to be screened for drugs and work if they are able.
Gov. Scott Walker’s administration also asked in June to add premiums and co-pays for some adults without dependent children on Medicaid, which the federal government also must authorize.
The changes, which Walker said would help people move from public assistance to the workforce, can’t start until a year after approval by the Centers for Medicare and Medicaid Services, or CMS.
...Under Walker’s proposal, childless adults on Medicaid would have to submit to a drug test or enter drug treatment if drug screening called for it.
Open Enrollment is the annual period when new applicants can use the marketplace to sign up for health and dental plans for the coming year. It is also the time that existing members have the option to change plans – an option that many more members than usual will want to consider.
What’s new?
Much more financial help - Subsidized members will receive over $1,200 more in premium subsidies in 2019 than they received in 2018. This is because the premiums for Blue Cross Blue Shield of Vermont (BCBSVT) and MVP Health Care (MVP) on-exchange silver plans are increasing significantly. Premiums for silver plans drive federal subsidies—so when the premiums for silver plans increase, subsidies also increase. Premium subsidies can be used on any metal level plan, bronze through platinum (see illustration of what the typical member pays in 2018 vs. 2019).
In other words, Vermont has finally jumped onboard the #SilverSwitcharoo Express!
HealthSource RI offers the cheapest insurance in RI, nearly half of customers pay less than $100 per month for coverage
EAST PROVIDENCE, RI (October 29, 2018) – Rhode Islanders: it’s time to put health insurance on your shopping list. Individuals and families looking for coverage starting January 1, 2019 should pick and pay through HealthSource RI by December 23.
“HealthSource RI has the cheapest health insurance in Rhode Island, and I’m proud of the work we’ve done to keep costs as low as possible,” said Governor Raimondo. “I urge Rhode Islanders looking for coverage to explore HealthSource RI’s quality, affordable options.”
And now it’s easier than ever to pick the medical and dental coverage from Rhode Island’s leading insurance companies. Rhode Islanders can visit HealthSource RI’s new and improved English and Spanish websites at HealthSource RI.com, plug in some basic information, and quickly compare their options and estimate their savings.
ST. PAUL, Minn.— MNsure is reminding Minnesotans that are currently enrolled in a private health plan through MNsure that they have the option of renewing into the same plan or selecting a new plan during the upcoming open enrollment period beginning November 1. With rates declining across the state from 7 to 27 percent, MNsure recommends that private health plan enrollees use our new comparison tool to find a plan that fits their needs.
Below is a brief guide to assist consumers with coverage options this open enrollment:
DENVER — Connect for Health Colorado opens for business Thursday, November 1, with rate increases lower than the state has seen in years, a streamlined application process that will save Coloradans time obtaining financial assistance and all seven health insurance companies are returning in 2019, in a sign of a stabilizing marketplace.
More than 130,000 Coloradans got help paying for health insurance in 2018. Renewing customers qualifying for financial help will see their net premium – their cost after the Advance Premium Tax Credit – go down 24% on average in 2019.
This is thanks to the Power of Silver Loading and the Silver Switcharoo (Colorado chose to Broad Load in 2018 but is upgrading this year).
CONCORD, NH -- Open enrollment in the individual Health Insurance Marketplace will run from November 1 to December 15. In advance of open enrollment on and off the federally facilitated Marketplace, the New Hampshire Insurance Department offers information and resources for the approximately 54,000 state residents who will purchase health insurance in the individual market for 2019 coverage.
"We are encouraging New Hampshire residents who are buying a plan on Healthcare.gov to update their applications and actively compare plan options, “ said New Hampshire Insurance Commissioner John Elias. “Buying insurance is signing a contract. Once you lock in coverage, your rates and cost-sharing amounts will stay the same all year. But if you don’t sign up now, you will not have another chance to enroll until next year – unless you have a qualifying life event.”
With the 2019 Open Enrollment Period starts in less than 24 hours, it probably isn't the best timing for this, but with the elections also coming up in just six days, perhaps it is.
This is about as minor a rate filing update as I've had, but I'm posting it separately in the interest of completeness.
Insurance carriers in my home state of Michigan originally submitted their requested 2019 ACA individual market rate filings back in June. At the time, the average premium increase being asked for was pretty nominal, around 1.7%, with a smaller-than-average #ACASabotage factor of around 5% due to the ACA's Individual Mandate being repealed and #ShortAssPlans being expanded by the Trump Administration.
Today, just two days before the 2019 Open Enrollment Period actually begins, the Michigan Dept. of Financial Services finally posted the approved 2019 rate filings...and practically nothing ended up changing.
I just realized that while I've written quite a bit about the potential loss of Medicaid coverage for thousands of residents of Michigan, Kentucky and Arkansas over the past few months due to the new work requirement laws in those states, It's been far too long since I've given a shout-out to the four states which are hoping to add Medicaid expansion (or at least continue it, in one case) exactly one week from today.
For years, elected leaders in conservative states have resisted expanding Medicaid, the government health program for low-income Americans. Now voters in four of those states will decide the question directly.
Last year there was an unprecedented amount of uncertainty and chaos surrounding the Affordable Care Act. On the one hand, you had Congressional Republicans desperately attempting to repeal the ACA altogether a good half a dozen times...and coming within a single "thumbs down" of doing so at one point.
At the same time, you had Donald Trump screaming into the wind about doing everything he could to simultaneously cause the ACA exchanges to "blow up" or "implode", depending on the tweet of the day, culminating in him finally pulling the plug on Cost Sharing Reduction reimbursement payments.
There was practically no change whatsoever between the rate changes requested by Louisiana carriers for the 2019 ACA individual market and the rates approved by the state insurance regulators. However, it's still good to be able to lock in the official rates just ahead of the Open Enrollment Period itself, including the individual filing data.
Overall, unsubsidized premiums should drop around 6.5%, which is good news...except that, once again, if it weren't for the ACA's individual mandate being repealed and #ShortAssPlans being expanded by the Trump Administration, I estimate they'd be dropping by another 9.3%, give or take, for a total premium reduction of more like 15.8% on average.
At $649/month full-price on average this year, that means the average unsubsidized enrollee will be paying somewhere around $724 more apiece next year due to those factors.
OK, this is a pretty minor update, but in the interest of completeness I should post it.
In mid-September, the Washington State insurance commissioner posted the approved 2019 average ACA individual market premium changes for carriers statewide, coming in at 13.8% overall.
The only problem is that the report only included the seven on-exchange ACA market carriers. The four carriers which offer off-exchange policies (which are pretty much identical and are part of the same risk pool, but don't qualify for tax credits) weren't included. They make up roughly 23% of Washington State's total individual market.
Today, just a few days before Open Enrollment begins, the WA Insurance Commissioner posted the complete approved rate change information. The overall average has dropped slightly, to 13.6%:
Eleven insurers approved to sell 74 plans in Washington's 2019 individual market
13.57 percent average rate increase approved
It isn't often that I write about anything Oklahoma-related, and it's rarer still that I post good news out of the...um..."labor omnia vincit" state (that's their slogan, I looked it up...), so today's a rare day indeed.
Here's what he's talking about: The massive searchable/filterable database which CMS maintains every year which includes pretty much every conceivable detail about every ACA-compliant health insurance policy available from every carrier in every region of all 39 states whose ACA exchanges are hosted on HealthCare.Gov (it doesn't include the 12 states which operate their own ACA exchanges, unfortunately).
As regular readers know, every spring/summer I spend countless hours poring over the annual insurance carrier rate filings, plugging in increases (and occasionally decreases) in ACA-compliant premium changes for every carrier in every state. I actually do this twice for most states (and occasionally even three times), as the process moves from preliminary/requested rate changes to "semifinal" rates to "final/approved" rates throughout the fall.
For 2018 and again for 2019, I've taken this one step further; instead of simply running the overall weighted average premium changes in each state, I've also attempted to break out what portion of the change is caused by various factors...in particular, what portion is caused by legislative or regulatory changes by Congressional Republicans and/or the Trump Administration.
There's so many Republican candidates running around trying to gaslight America into completely ignoring their relentless, repeated attempts to strip away protections for people with pre-existing conditions that I've alread stopped bothering to try to keep up with them (I think my Rogues Gallery post stops at around 24 or so at the moment).
Here in Michigan, while I'm pretty sure all nine of our Republican members of Congress who voted for the AHCA last year are lying through their teeth about how they suddenly support "protecting coverage of pre-existing conditions", the one which seems to be getting the most attention is Mike Bishop (MI-08). Part of this is no doubt because Bishop is embroiled in one of the two closest races in the state (the other is MI-11, where Dave Trott also voted for the AHCA, but he's retiring so it's an open seat).
One of the great strengths and dangers of the ACA is that it includes tools for individual states to modify the law to some degree by improving how it works at the local level. The main way this can be done is something called a "Section 1332 State Innovation Waiver":
Section 1332 of the Affordable Care Act (ACA) permits a state to apply for a State Innovation Waiver to pursue innovative strategies for providing their residents with access to high quality, affordable health insurance while retaining the basic protections of the ACA.
State Innovation Waivers allow states to implement innovative ways to provide access to quality health care that is at least as comprehensive and affordable as would be provided absent the waiver, provides coverage to a comparable number of residents of the state as would be provided coverage absent a waiver, and does not increase the federal deficit.
Fire up the Wayback Machine, Peabody, and take us to September 2015:
AP's NEW "HC.gov Security Flaws" story attacks problems FIXED UP TO A YEAR AGO.
Last night I posted what seemed, at first, to be a merely-amusing (if a bit depressing) story about a Florida news station website accidentally (?) reposting a year-old AP newswire story about potential security vulnerabilities at Healthcare.Gov:
WASHINGTON -- The government's own watchdogs tried to hack into HealthCare.gov earlier this year and found what they termed a critical vulnerability - but also came away with respect for some of the health insurance site's security features.
Those are among the conclusions of a report released Tuesday by the Health and Human Services Department inspector general, who focuses on health care fraud.
With dozens of GOP candidates running around trying to gaslight America by pretending they didn't spend all last year (and in most cases, years before that) trying to rip away healthcare coverage for people with pre-existing conditions, here's a shorter, simpler version of last year's video which explains exactly WHICH conditions they tried to kill off...and the sole one they didn't, which they're now using as a feeble excuse.
As I've written about many times before, my home state of Michigan is, unfortunately, among the states which are trying to institute work requirements for ACA Medicaid expansion for 680,000 Michiganders. As I've also written about many times before, work requirements for Medicaid are not only burdensome and cruel, they're counterproductive in terms of efficiency, economics and even in the stated goal of such programs, which is supposedly to "inspire" low-income people to get a job.
Last year I wrote a LOT about Silver Loading and Silver Switching for 2018...basically, the way which ACA individual market enrollees can save hundreds or even thousands of dollars on their 2018 insurance policies by taking advantage--perfectly legally and ethically--of the unusual pricing of different metal level policies this year.
The short version is this: Due to the way the ACA's tax credit formula works, Donald Trump's attempt at sabotaging the ACA exchanges by cutting off Cost Sharing Reduction (CSR) reimbursement payments to insurance carriers actually (partly) backfired on him, resulting in an unusual situation in which several million subsidized enrollees ended up benefitting from the pricing fallout, while millions of unsubsidized enrollees ended up being hurt by it...but other unsubsidized enrollees ended up being able to avoid being hurt by switching to a special off-exchange Silver plan (thus, the "Silver Switch").
OK, I had kind of forgotten about this. Back in early June, insurance carriers in Pennsylvania submitted their preliminary 2019 ACA market premium change requests. At the time, they averaged around a 4.9% increase statewide, which seemed pretty impressive under the circumstances.
Then, late July, the PA insurance department issued a press release stating that state regulators had modified the 2019 requests, and that the new, revised average was much lower...a mere 0.7% average rate hike. However, the individual carriers as well as the insurance department made it very clear that this nominal increase included a 6 point rate increase to account for the ACA's individual mandate being repealed and the Trump Administration's expansion of non-ACA compliant short-term and association plans.
However, the DC exchange board was also working quickly in an attempt to counter the Trump Administration's #ACASabotage factors, by voting to restrict short-term plans, to lock in DC's Open Enrollment Period at a full 3 months as in years past, and to reinstate the ACA's individual mandate penalty at the local level.
WASHINGTON (Reuters) - Republicans could try again to repeal Obamacare if they win enough seats in U.S. elections next month, Senate Republican Leader Mitch McConnell said on Wednesday, calling a failed 2017 push to repeal the healthcare law a “disappointment.”
...except that the headline understates what McConnell actually said:
...On Nov. 6, Americans will vote for candidates for the Senate and the House of Representatives.
McConnell’s Republicans now hold majority control of both chambers. Democrats will try to wrest control in races for all 435 House seats and one-third of the 100 Senate seats.
Despite their dominance of Congress and the White House, Republicans dramatically failed last year to overturn former President Barack Obama’s signature healthcare law, known as Obamacare. McConnell called it “the one disappointment of this Congress from a Republican point of view.”
(note: this is a work in progress...check back soon for more additions.)
As I noted yesterday, as the 2018 midterm election rapidly approaches, there's been a sudden and complete change in strategy when it comes to healthcare policy campaiging by practically every Republican running for office this year. After nearly a decade of doing everything in their power to attack, undermine, sabotage, hack away at, trash and especially repeal the Patient Protection and Affordable Care Act (that's the full title of the law, after all), GOP candidates have suddenly decided that "protecting coverage of pre-existing conditions" is a swell idea after all.
Premium Rates for Individual and Small Group Markets Individual plan premium rates may vary by age, rating area, family composition and tobacco usage. For example, a person living in Manhattan, KS (rating area 3) may pay a different rate than someone living in Pittsburg, KS (rating area 7) based on the claims data by rating area. A map of the counties included in each rating area is provided on the next page. Kansas is an effective rate review state, which means the actuarial review is conducted by the Kansas Insurance Department. KHIIS (Kansas Health Insurance Information System) claims data is utilized during the rate review process to verify the claims experience submitted by the companies. The following table provides details regarding the average requested rate revisions for companies writing individual policies in Kansas. Rate increases will be partially offset for individuals receiving a premium tax credit.
Back in June, Indiana's 3 individual market carriers submitted their requested 2019 ACA rate changes, which averaged around 5.1%. At the time I also pegged the impact of #ACASabotage on 2019 rates (mandate repeal + #ShortAssPlans) at around 13 percentage points.
The Department of Insurance received preliminary 2019 health plan information from insurance carriers on June 1 and began reviewing the proposed plan documents and rates for compliance with Idaho and federal regulations. The Department of Insurance does not have the authority to set or establish insurance rates, but it does have the authority to deem rate increases submitted by insurance companies as reasonable or unreasonable. After the review and negotiation process, the carriers submit their final rate 2019 increase information. The public is invited to provide comments on the rate changes. Please send any comments to Idaho Department of Insurance.
A few days ago, Jonathan Cohn of the Huffington Post wrote about a new phenomenon sweeping the nation: Republican candidates, all of whom have repeatedly either voted to repeal the Patient Protection & Affordable Care Act or who have repeatedly called for it to be repealed, are suddenly falling all over themselves to try and claim that they support patient protections for those with pre-existing conditions...usually by invoking family members who suffer from various ailments.
Cohn's examples include GOP Congressman Mike Bishop (MI-08), who claims his wife has rheumatoid arthritis; Dana Rohrabacher (CA-48), who says his daughter survived childhood leukemia; John Faso (NY-19) and Mario Diaz-Balart (FL-25), both of whose wives survived cancer; and Josh Hawley (MO-AG, running for MO-Sen), whose son has a rare chronic disease.
Yes, that's right...while the 2019 Open Enrollment Period doesn't start for the rest of the country until November 1st, the Golden State has decided to kick things off two weeks early (16 days early, technically): Covered California, the largest state-based ACA exchange, is officially open for business for 2019 enrollment as of today!
In addition, while you can't actually enroll for 2019 coverage in any other state until November 1st, in several states you can window shop to find out what your 2019 policy options and pricing will be, along with estimates about what sort of financial assistance you'll qualify for once you actually do go through the enrollment process.
The states which are already open for window shopping already include:
UPDATE 10/30/18: Thanks to some additional reviews/checking by Dave Anderson, Louise Norris, Andrew Sprung and myself, I've been able to update the spreadsheet further; the blog post has also been updated correspondingly.
Last year, while Congressional Republicans were doing everything possible to officially repeal the Affordable Care Act via legislative means, Donald Trump spent months repeatedly threatening to cause the ACA individual market exchanges to either "explode" or "implode" (depending on the day) by, among other things, cutting off Cost Sharing Reduction reimbursement payments to insurance carriers.
For as much as I write about healthcare policy, I actually don't write about Medicare itself all that often...at least not Medicare as it's defined today.
CMS announces 2019 Medicare Parts A & B premiums and deductibles
Today, the Centers for Medicare & Medicaid Services (CMS) announced the 2019 premiums, deductibles, and coinsurance amounts for Medicare Parts A and B.
"Seriously, though, HHS should really start releasing the official (accurate) numbers of actual signups for all 50 states (or at the very least, the 36 states that they're responsible for) on a daily--or at least, weekly--basis. I don't care if it's a pitifully small number. 100,000? 10,000? 100? 10? Even if it's in single digits, release the damned numbers. Be upfront about it. Everyone knows by now how f***** up the website is, so be honest and just give out the accurate numbers as they come in."
Two days later, on October 13th, I registered "ObamacareSignups.net" (which soon changed to ACASignups.net, not because I had a problem with "Obamacare" but because it was easier to type) and posted an announcement over at dKos, asking for some crowdsourcing assistance.
Wisconsin has an interesting situation. On the one hand, the state has what should be a robust, highly-competitive individual insurance market,with over a dozen carriers offering policies throughout the state. Granted, some of them are likely limited to only a handful of counties, but in theory they should be doing pretty well compared to rural states like Oklahoma or Wyoming, which only have a single carrier on the exchange.
On the other hand, last year Wisconsin ahd among the highest average premium rate increases in the country. Rates were projected to increase by an already-awful 36%, but when the dust settled the average unsubsidized ACA enrollee in Wisconsin was paying a whopping 44% more than they did in 2017 (it was around 45.8% higher as of the end of Open Enrollment but later dropped a bit as the year has passed and net attrition has tweaked the enrollment base).
I ran the numbers for Illinois' requested 2019 ACA individual market rate changes back in August. At the time, the weighted year-over-year average was a mere 0.7% increase, with Cigna and Health Alliance's 10% and 7.5% being mostly cancelled out by Celtic's 1.1% and especially Blue Cross Blue Shield's slight drop of 0.9%. Since BCBSIL holds something like 3/4 of the state's individual market share, that alone mostly wiped out the other increases.
Unfortunately, I don't have access to the hard enrollment numbers, so this was a rough estimate based on 2017's breakout. Here's what it looked like at the time:
The final unsubsidized rates are down about one point more, down 6.3% from 2018 rates. However, as all three current carriers clearly noted in August, the repeal of the ACA's individual mandate and expansion of short-term and association health plans (aka #ShortAssPlans) still caused a significant premium increase, which means without those factors, 2019 rates would likely be down significantly more...likely nearly 20% instead of 6.3%:
With the 2019 Open Enrollment Period quickly approaching, I'm spending a lot of time swapping out the requested carrier rate changes from earlier this summer with the approved rate changes from state regulators.
Hawaii only has two carriers participating in the ACA-compliant individual market: HMSA and Kaiser, which requested rate increases of 2.72% and 28.6% respectively back in August. With a roughly 57/42 market share split, this resulted in a weighted average rate increase of 13.8%, which would likely have been closer to 3.8% if the ACA's individual mandate penalty hadn't been repealed.
With just 3 weeks to go before the 2019 Open Enrollment Period begins, the dust has mostly settled on my 2019 Rate Hike Project. Over half the states have provided their final, approved individual market premium changes, and while I haven't found the final rates for the other half yet, their preliminary rates are all on record, so I don't anticipate the needle moving too much at this point.
New Hampshire is among the states which I haven't found final rate changes for yet. The three carriers in the state have requested average price reductions of around 13.5% on average, which is well below the 3.2% increase which is the average nationally, but I still don't know what the state regulators are going to approve.
This makes the following press release rather surprising:
NH Insurance Department to Hold Oct. 30 Annual Public Hearing on Health Insurance Premiums
U.S. SENATOR TAMMY BALDWIN AIMS TO BLOCK PRESIDENT TRUMP’S PLAN TO ALLOW INSURERS TO SELL JUNK PLANS WITH LEGISLATION TO GUARANTEE PROTECTIONS FOR PRE-EXISTING CONDITIONS
“The Fair Care Act is an opportunity for lawmakers to keep their word on guaranteed protections for pre-existing conditions.”
WASHINGTON, D.C. – Following the Trump Administration’s recent proposed rule allowing insurance companies to once again sell ‘junk’ health care plans, U.S. Senator Tammy Baldwin today announced new legislation to block the rule and guarantee protections for people with pre-existing conditions.
*(OK, that's hyperbole...unsubsidized enrollees are still left holding the bag for thousands of dollars in unnecessary premium payments for at least another year or so, and there's still no guarantee of the final ruling...see below...)
Almost exactly a year ago, Donald Trump, after 9 months of bluster about doing so so, finally pulled the trigger on his threat to cut off Cost Sharing Reduction reimbursement payments to insurance carriers for the deductibles, co-pays and other out-of-pocket expenses which they agree to cover every month for around 7 million low-income ACA exchange policy enrollees.
Trumps stated goal in doing so was, of course, to "blow up" the ACA, to cause it to "implode" (which is actually the opposite of blowing something up, but that's a different discussion) and ultimately fail in the process.
When I last posted about 2019 ACA-compliant individual market premium changes in Tennessee back in August, I noted that premiums statewide had gone from dropping 5.7% to dropping 10.8% on average after the Trump Administration first stated that they were going to unnecessarily "freeze" the ACA's Risk Adjustment fund transfers in response to a lawsuit ruling only to reverse themselves a week or so later and state that they were going to go ahead and process RA fund transfers after all.
In other words, the Trump Administration once again deliberately caused a panic across the industry only to "save" the industry from the very threat which they had posed in the first place.
In any event, here's what I thought the Tennessee's premium situation looked like when the dust settled:
Back in August, Blue Cross Blue Shield of South Carolina, the only carrier offering policies on SC's individual insurance market, asked for a 9.2% average premium rate increase for 2019 statewide. This consisted of 9.3% for their most popular plans (which cover over 200,000 South Carolinans) and 6.9% for 6,800 BlueChoice plan enrollees (BlueChoice is only available off-exchange).
2019 PRELIMINARY HEALTH INSURANCE PLANS RATE CHANGES FOR INDIVIDUAL MARKET COVERAGE
The SCDOI has approved the rates and forms for health insurance issuers that are planning to offer ACAcompliant products in the individual market in 2019.
Most Connect for Health Colorado® Customers Will See Decrease in Premiums for 2019 as Marketplace Stabilizes
DENVER — With rate increases lower than the state has seen in years, Connect for Health Colorado® customers who qualify for financial help are looking at an average decrease in their net (after tax credit) premium of 24 percent next year.
The Colorado Division of Insurance today issued final approval for individual health insurance plans that will increase by an average of 5.6% in 2019. The relatively small increase in monthly premiums and the return of all seven health insurance companies to the Connect for Health Colorado, the state’s health insurance Marketplace, are signs of a stabilizing market for Coloradans who buy their own health insurance coverage.
I just received the following press release from the Iowa Insurance Division...
2019 Health Insurance Enrollment Deadline Approaches
Des Moines – Open enrollment begins November 1 and ends December 15 for Iowans purchasing or changing their Affordable Care Act (ACA) individual health coverage to become effective January 1, 2019.
“As the open enrollment season begins, Iowans should thoroughly research all coverage options. The ACA-compliant insurance market is available to Iowans, however, most Iowans have been priced out of that market if they are not currently receiving federal subsidies to help pay premiums and, in some instances, deductibles. I would encourage consumers to meet with a licensed insurance agent to determine the best plan for themselves and their families,” Iowa Insurance Commissioner Doug Ommen said. “Changes made at the Iowa state legislature and by the federal government have provided a few more options in addition to ACA-compliant coverage for Iowans to review as they plan out their health needs for 2019.”
UPDATE 3:50pm: OK, it sounds like you can completely disregard all the Medicaid-related stuff below; apparently there was a communication error. I've confirmed with the Whitmer campaign that the proposed reinsurance plan would not be tied in with Michigan's ACA Medicaid expansion program at all, nor would it have any impact on the Medicaid eligigibility threshold, which means this would indeed be a standard ACA individual market reinsurance program after all...which is what I assumed in the first place, and which would be perfectly fine!
I probably won't have any other blog posts today as I'm off to Lansing, Michigan this morning to attend this:
The fight to stop health care repeal isn’t over yet — far from it. At stake right now: Higher costs. Medicaid. Medicare. Coverage for pre-existing conditions. Prohibitions on discrimination against women and people over age 50.
If you’re sick and tired of the Republican war on health care, join people across the country who are joining Protect Our Care’s nationwide bus tour. Make your voice heard at the Protect Our Care bus stop in Lansing.
Join us at the Michigan State Capitol in Lansing on Wednesday, October 3 to voice your opposition to Republicans’ repeal-and-sabotage agenda, which has cut health care coverage and driven up health care costs for millions.
Minnesota, currently entering their second year of their official reinsurance waiver program to help keep unsubsidized premiums down, announced their preliminary 2019 rate hikes way back in June. At the time, the carriers were looking at roughly an 8% average reduction in rates next year...although they would be dropping prices by more like 15% if not for the ACA's individual mandate being repealed and the expansion of #ShortAssPlans.
Today the Minnesota Dept. of Commerce posted the approved 2019 premium changes, and there's been some dramatic reductionsfor three of the five carriers offering policies in the state. Group Health and Medica were approved as is, but Blue Plus was told to drop their rates a whopping 27.7% instead of the 11.8% they were planning on. Ucare was shaved down from a 7 point reduction to 10 points, and PreferredOne (which only sells individual market policies off-exchange and only has 300 enrollees anyway) was knocked down from a 3-point reduction to 11 points.
The official annual ACA Open Enrollment Period (OEP) starting and ending dates have jumped around a lot since the exchanges kicked off back on October 1, 2013.
For the first OEP, people were given 6 months since the technology and the process were brand new to everyone...and thank God they were given the technical mess that the federal exchange (HealthCare.Gov) as well as many of the state-based exchanges experienced at launch. Things were eventually worked out, but not only was that extra time in spring 2014 vitally important, many people still needed some extra time beyond that as well. The official deadline to enroll for 2014 coverage was March 31, but the HHS Dept. gave people who had started their application by then an extra 15-day "overtime" period to complete the process.
For the 2015 OEP, the official dates were from November 15 - February 15th, cutting the time period down to three months. This time there was a one-week "overtime" period tacked onto the end.
For 2016 and 2017, HHS settled on November 1st - January 31st, which seemed to make sense since it was easier to remember: November, December, January.
I ran the numbers for Nevada's preliminary 2019 ACA individual market rate changes back in July. At the time, the average requested rate increase was around 2.3% statewide.
With the 2019 Open Enrollment Period coming up fast, I checked on the approved rate changes and found that state regulators had cut down on the rates quite a bit...although mostly for carriers which only offer off-exchange plans and only have small numbers of enrollees anyway.
For instance, HMO Colorado (dba HMO Nevada) originally requested a 20.9% increase; this was reduced to 9.5%...but they only have 200 people enrolled anyway, so it's not even a rounding error. Rocky Mountain was cut from 34.4% to 18.5%...but only has 300 enrollees, and so on.
The three carriers which hold the vast bulk of the market had far less dramatic changes, although Silver Summit was cut from a 5.2% increase to a 1.1% decrease for 2019.
eHealth Insurance is a leading private online health insurance exchange, and is licensed to sell health insurance in all 50 states and the District of Columbia. They also publicly post survey results of both their membership and insurance carriers from time to time. While eHealth isn't necessarily fully representative of the entire individual health insurance market, the fact that they cover every state +DC means their surveys should provide at least some big picture insight into the landscape.
(For those wondering: No, this is not an endorsement, they aren't paying me to promote them, and I haven't a clue whether or not they're a good or bad company to do business with.)
New Mexico has a unique exchange; the state runs the small business portion, and while the individual exchange is also technically state-run, Healthcare.gov is used to enroll people in individual insurance (ie, a federally-supported state-based marketplace). But the exchange is planning to establish its own enrollment platform that will be in use by the fall of 2020.
Normally I'd just use a snippet of the entry, but Norris manages to cover all the relevant angles in just a few paragraphs; I think she'll be OK with me cribbing more of it:
Initially, the state had planned to establish a state-run website for individual enrollments fairly soon after the exchanges went live in the fall of 2013, and that was still in the works until early spring 2015. But in April 2015, the exchange board voted to continue to use Healthcare.gov, as that was viewed as the less-costly alternative.
