An estimated additional 34,000 people are now eligible for essential care for a full year after pregnancy, thanks to the American Rescue Plan and the Biden-Harris Administration’s efforts to strengthen maternal health coverage.
Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy in Hawaii, Maryland, and Ohio. As a result, up to an additional 34,000 people annually – including 2,000 in Hawaii; 11,000 in Maryland; and 21,000 in Ohio – will now be eligible for Medicaid or Title XXI-funded Medicaid expansion CHIP coverage for a full year after pregnancy. With today’s approval, in combination with previously approved state extensions, an estimated 318,000 Americans annually in 21 states and D.C. are eligible for 12 months of postpartum coverage. If all states adopted this option, as many as 720,000 people across the United States annually would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.
UPDATE 8/16/22: President Biden officially signed the Inflation Reduction Act into law this afternoon!
Annnd there you have it: In a strict party-line 220-207 vote, the Inflation Reduction Act (a stripped-down version of the Build Back Better Act, which was originally branded as the American Families Plan) finally passed the U.S. House of Representatives after passing the U.S. Senate 51-50 (with Vice-President Harris as the tie-breaking vote) on Sunday. I presume President Biden will be holding a big, formal signing ceremony sometime next week.
A big chunk of the bill is related to climate change, of course, and another large chunk of it is purely related to deficit reduction. As for the healthcare provisions, here's a summary of what's included:
Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.
The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.
Texas' annual health insurance rate filings are kind of a mixed bag in terms of transparecy. Hardly any of the carriers have Uniform Rate Review Template (URRT) forms or Rate Filing Justification Form Part II available (these are the documents which generally include the actual number of people enrolled in the policies for each market for that insurance carrier), and the Actuarial Memorandum (Part III) is heavily redacted for most of them, making it very difficult to lock in the actual enrollment numbers.
The Georgia Access model would eliminate the use of HealthCare.gov, transitioning consumers to decentralized enrollment through private web-brokers and insurers. The state would establish its own subsidy structure to allow for 1) the subsidization of plans that do not comply with all the ACA’s requirements; and 2) enrollment caps if subsidy costs exceed federal and state funds.
There's not a single part of the paragraph above which shouldn't be setting off major alarms:
In South Dakota, there are only 2 carriers offering individual market coverage next year. Avera has around 21,800 enrollees; Sanford has roughly 23,900. The weighted average rate increases requested are around 11.4%.
For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.3%.
UPDATE 11/01/22: Well, it looks like the individual market filings were approved as is. I'm guessing the small group carrier filings were as well, though I don't know that for sure.
Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.
The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.
In Montana, there are only 3 carriers offering individual market coverage next year. I have hard enrollment numbers for one of them; for the other two, I'm assuming equal enrollment for each based on a rough assumption of ~52,000 total indy market enrollees statewide.
Assuming this is fairly close, that would put the weighted average rate increases at roughly 8.8%. If not...well, the unweighted average would be 9.3%.
For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.9%.
Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available. The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.
In Oklahoma, there are 7 carriers offering individual market coverage next year (it looks like Bright Health Insurance is dropping out). I have hard enrollment numbers for 4 of them; for the other three, I'm assuming equal enrollment for each based on a rough assumption of ~190,000 total indy market enrollees statewide.
Assuming this is fairly close, that would put the weighted average rate increases at roughly 8.8%. If not...well, the unweighted average would be 9.0% anyway, so this is at least somewhat more accurate.
For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 8.1%.
Here's the preliminary 2023 rate filings for Iowa's individual & small-group markets. Unfortunately, I only have the enrollment data for the two smaller carriers on the individual market (and none for the small group market), but based on my estimate of Iowa's total ACA-compliant individual market, I can make an educated guess as to the weighted average, which should be roughly 2.0%.
Unfortunately I can't do the same for the small group market; for that, the unweighted average rate increase is around 5.1%.
I should also note that Iowa also has 35,400 residents still enrolled in pre-ACA ("transitional" or "grandmothered") medical policies, with nearly all of them being via Wellmark:
Unfortuantely, Illinois is another state which doesn't make it easy to analyze annual health insurance premium rate filings.
There's no details on their insurance department website, their SERFF listings don't seem to include the actuarial memos or URRT forms, and even the federal Rate Review listings only include the average requested rate changes; the actuarial memos there are mostly heavily redacted.
Illinois' total individual market enrollment should be roughly 330,000 people. Fortunately, three of the carriers do reveal their 2022 enrollment, including the biggest one in the state (Blue Cross). This allows me to make an educated guess as the the enrollment of the other 7, which in turn means I can make an estimate of the weighted rate increase of roughly 6.9%. The unweighted average is 8.9%.
For the small group market I have to go with the fully unweighted average of 6.8%.
UPDATE 11/03/22: With the official 2023 Open Enrollment Period underway, Illinois final/approved rate filings have been posted to the federal rate review website. Not much changed, however...most of the filings have been approved as is, with the exception of MercyCare HMO and Oscar Health Plan.
With all 50 Republican Senators refusing to lift a finger to fight climate change, tackle prescription drug pricing or extend the enhanced ACA subsidies for over 13 million people, Democrats have watched helplessly as two of their own Senators (Joe Manchin and Kyrsten Sinema) have repeatedly blocked or otherwise stymied efforts to get these vital measures through the Senate.
The drama appears to finally be coming to an end this weekend, however.
Last week Sen. Manchin announced that he & Senate Majority Leader Chuck Schumer had come to an agreement on a heavily modified & pared-down version of what was once called the "Build Back Better Act"...newly christened as the "Inflation Reduction Act of 2022". He then spent the past week pushing the bill heavily on TV appearances/etc, and the rest of the Democratic leadership joined in a coordinated effort to promote the bill.
