Maine

Me, 8 days ago:

More to the point, however: What other significance does not including CSR funding have?

...That means that even if there's a last minute change to the bill, at this point, CSR payments are virtually certain not be guaranteed next year.

...I wouldn't be at all surprised to see more 11th-hour drop-outs next week. Donald Trump and the Republican Party's open sabotage of the ACA will likely bear even more fruit.

Today, literally 11 hours before the contract signing deadline:

Anthem leaving Maine ACA marketplace, citing uncertainty

Anthem Blue Cross Blue Shield has withdrawn nearly all of its offerings from Maine’s Affordable Care Act health insurance marketplace, and the insurer is citing market uncertainty and volatility as the reasons.

The state of Maine's insurance regulatory agency has announced the approved 2018 individual market rate hikes for the three carriers operating in the state. Louise Norris beat me to the punch:

Regulators in Maine published rate proposals for the three Maine exchange insurers in June, and finalized the rates in early September. Insurers proposed two sets of rates: one that assumes cost-sharing reduction (CSR) funding will continue, and another that assumes the federal government will not fund CSRs in 2018.

The Maine Bureau of Insurance initially rejected all three insurers’ rate proposals on August 10, and asked them to submit new rates. The revised rate filings were then approved on September 1. These average approved rate increases all assume that CSR funding will continue in 2018:

(sigh) OK, this is getting very confusing now.

The good news for me out of Maine is that they've released the filings for all three individual market carriers for 2018 (Aetna has around 1,000 enrollees but they're leaving the individual market entirely), and all three include the exact number of current enrollees, making the average rate hike request simple enough on the surface: 21.2% for Anthem, 39.7% for Harvard Pilgrim (HPHC) and 19.6% for Maine Community Health Options (one of the few remaining ACA-created CO-OPs*), for a weighted average unsubsidized increase request of 25.2%.

*UPDATE: My mistake! I accidentally confused MCHO with Evergreen Heatlh of Maryland, which is in the process of converting itself from a Co-Op into a private carrier! Thanks to Louise Norris for the catch!

As I noted when I crunched the numbers for Texas, it's actually easier to figure out how many people would lose coverage if the ACA is repealed in non-expansion states because you can't rip away healthcare coverage from someone who you never provided it to in the first place.

My standard methodology applies:

Normally I post screenshots from the revised/updated SERFF filings and/or updates at RateReview.HealthCare.Gov, but it takes forever and I think I've more than established my credibility on this sort of thing, so forgive me for not doing so here. Besides, #OE4 is approaching so rapidly now that this entire project will become moot soon enough, as people start actually shopping around and finding out just what their premium changes will be for 2017.

The other reason I'm not too concerned about documenting the latest batch of updates/additional data is because in the end none of it is making much of a difference to the larger national average anyway; no matter how the individual carrier rates jump around in various states, the overall, national weighted average still seems to hover right around the 25% level.

Still, for the record, here's the latest...in four states (Iowa, Indiana, Maine & Tennessee) I've just updated the requested and/or approved average increases. In the other four (Massachusetts, Montana, North & South Dakota) I've added the approved rate hikes as well.

I originally estimated Maine's 2017 avg. rate hike requests back in May. At the time, I came up with a weighted average of 20.7% based on the original rate filings:

Since then there have been two major changes: First, Aetna, which had been planning on entering the Maine ACA exchange, infamously pulled a complete 180 and not only decided not to expand, but actually pulled out of the exchange in most of the states they're already in. This doesn't really impact Maine since they were only available off-exchange anyway. The second change does, however: Several of the carriers submitted revised requests, pushing the average up higher, to 23.9%.

It turns out the various revisions were approved by the Maine dept. of insurance, mostly as is, although they did shave 1.4 points off of Anthem BCBS:

Just last week I ran the rate filing numbers for Maine and came up with an overall weighted 20.6% average hike request. Today I've learned three things:

Here's what it looks like with the revisions...the overall average barely changes at all, but it's still a more complete picture:

As numerous sources have already indicated, after 2 years of (relatively) low average premium rate increases on the individual market (around 5.6% in 2015 and 8.0% in 2016...compared with the 10-12% average rate hikes over the previous decade), it looks like 2017 will finally see the higher rate hikes that ACA critics have been screaming about every year.

So far, Virginia and Oregon have reported requested rate increases of 17.9% and 27.5% respectively, while California may be looking at 8.0% increases (which is high for them).

A couple of days ago I noted that after two years of nothing but doom & gloom (and coming just a week after UnitedHealthcare pulled the plug on the individual market in over two dozen states) there seems to finally be some positive developments, with companies like Centene and Anthem reporting better-than-expected results. They may not be making a profit yet, but at least they aren't losing money hand over fist the way they did the first couple of years.

I also made a brief mention of the Maryland Co-Op, Evergreen Health, which reported their first quarterly profit since launching 2 1/2 years ago.

Well, according to Adam Cancryn, Evergreen has been joined by at least two other positive Co-Op stories:

Consumer operated and oriented health plans in Maryland, New Mexico and Massachusetts will report profits in the first quarter, in a sign that some of the remaining Affordable Care Act-created nonprofits could be finding their footing on the state exchanges.

(sigh) OK, this one is not related to the Risk Corridor Massacre, since Community Health Options was actually profitable in 2014 and therefore never qualified for any RC payments anyway. Also, unlike the dozen ACA-created co-ops which are in the process of winding down operations by the end of the year, CHO is not going out of business, and in fact is remaining fully operational for 2016.

Having said that, this development is still a serious bummer given the carnage wreaked across the co-op landscape earlier this fall:

Maine's Community Health Options said Dec. 9 that it will cut short its sales of individual policies for 2016, in a sign that it is the latest Affordable Care Act-funded consumer operated and oriented plan to encounter financial difficulties.

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