(Note: I've had to re-work some of this entry thanks to clarifications from Adam Cancryn about the RBC rule; too many little edits to document each one).
Last week I posted about the latest ugly Co-Op meltdown, this time Land of Lincoln Health (LoL) of Illinois.
As pointed out in my follow-up entry, given the precarious financial state LoL was already in last year, it made little sense that they only asked for fairly nominal rate hikes:
Now, since LoL went belly-up mid-year regardless, obviously even those massive rate hikes weren't enough to save them, so the question is, what would have happened if LoL had gotten their nominal increases as requested?
The most recent ACA/healthcare news out of Illinois was the ugly announcement that Land of Lincoln Health is the latest ACA-created Co-Op to go belly-up, leaving 49,000 people (39,000 on individual plans and 10,000 in the small group market) having to scramble to find new coverage in the middle of the year. This was on top of recent news that UnitedHealthcare is pulling out of dozens of states including Illinois (Humana is also dropping out of a bunch of states, but I don't think Illinois is among them).
Well, nature (and the market) abhors a vacuum, so guess what?
One of the nation's largest health insurance companies plans to enter the Obamacare marketplace in the Chicago area for the first time, bringing new competition as other insurers exit or go out of business.
My posts have been pretty light of late; between being on vacation, a big work backlog when I got back, and getting wrapped up in the RNC and DNC craziness, I've been a bit off-track. I'm hoping to catch up a bit over the next week or so.
As of 6/12, MNsure had 95,637 QHP selections, so this is an additional 1,286, or 34/day over the past 38 days. This is down substantially from the June report, when it averaged a whopping 179/day.
For the entire off-season period, MNsure has added 11,533 QHP selections, or an average of 68 per day. Extrapolated out nationally, that would be about 10,300 per day nationally, although in prior years off-season SEPs have averaged between 7,000 - 9,000 per day.
Avik Roy is a well-known conservative, anti-ACA healthcare pundit, writer and advisor. As the article I link to below describes him:
Avik Roy is a Republican’s Republican. A health care wonk and editor at Forbes, he has worked for three Republican presidential hopefuls — Mitt Romney, Rick Perry, and Marco Rubio. Much of his adult life has been dedicated to advancing the Republican Party and conservative ideals.
Regular readers know that he and I have butted heads several times in the past:
This is a quick post...to be honest, it's mainly here just to remind myself to refer to the link again for a later project. But I just wanted to remind everyone that in addition to the exchange-based Qualified Health Plan listings at HealthCare.Gov (which cover 38 states) and the rate review database where you can search through the proposed (and, eventually, approved) rate hikes for every ACA-compliant individual or small group policy by carrier, there's also a third HC.gov database: The Plan Finder.
This Plan Finder website is provided by the federal government to help you find private health plans available outside the Health Insurance Marketplace. We want you to find health insurance that best fits your budget and meets your needs.
Getting subsidies for Affordable Care Act health plans is about to become easier.
Additional verification of eligibility will only be required if the difference between stated income and Internal Revenue Service or Social Security data is at least 25 percent, or $6,000, underguidance from the Department of Health and Human Services.
Currently, additional verification is required if the discrepancy is only 10 percent or greater.
The change, which is for the 2017 plan year, “will reduce the number of consumers who have to follow-up and submit documentation to verify their household income while maintaining important program integrity controls,” the Centers for Medicare & Medicaid Services said in the guidance.
I hereby admit that a) I don't know much about Medicare (remember, my major focus is on the ACA exchanges, Medicaid expansion, the individual/small group market and so forth) and b) I'm swamped at the moment so don't have time to do a real analysis/write-up on today's announcement, but it appears to be a Pretty Big Deal, so I'll just present the press release/statement for the moment:
U.S. Department of Health & Human Services • Monday, July 25, 2016 • News Release • 202-690-6343
Today, the Department of Health & Human Services proposed new models that continue the Administration’s progress to shift Medicare payments from quantity to quality by creating strong incentives for hospitals to deliver better care to patients at a lower cost. These models would reward hospitals that work together with physicians and other providers to avoid complications, prevent hospital readmissions, and speed recovery.
CMS approves Arizona’s plan to re-open CHIP program
Today, the Centers for Medicare & Medicaid Services (CMS) announced that it has approved Arizona’s plan to allow new enrollment in the Children’s Health Insurance Program (CHIP) after enrollment was frozen for several years. Now all states provide CHIP coverage to eligible children.
“Today’s approval is a step forward for the health of Arizona children in low-income families,” said Vikki Wachino, CMS Deputy Administrator and Director of the Center for Medicaid and CHIP Services. “With Arizona’s decision, all states in the nation now provide CHIP coverage to any eligible child who applies. More children in Arizona will have access to coverage early in their lives, which helps kids grow into healthy adults and provides parents with the peace of mind that comes from their children having affordable coverage.”
Having coverage through CHIP improves children’s health and increases their ability to succeed in school. Recent research on Medicaid and CHIP shows that these gains are long lasting, with children who gained coverage experiencing better health, higher educational attainment, and higher earnings as adults.
Every year, Republicans insist that the ACA is guaranteed to cause a rate hike "death spiral" as increasing premiums cause healthier people to drop out of the individual exchange market, causing higher medical expenses, causing even higher premiums, causing more healthy people to drop out and so forth...and every year, for three years in a row so far, this has failed to be the case nationally. While premiums have obviously continued to increase for many people, the individual insurance market has grown each year, from around 11 million in 2013 to 15.6 million in 2014, around 17 million last year and up to 19-20 million or so today.
