New Hampshire

Regular readers may have noticed that I've been posting fairly lightly of late. Now that open enrollment is over and we're deep in the thick of primary season, I'm trying to catch up with the massive backlog which has built up in my day job.

However, there's still a lot of stuff going on; today, for instance, brought some very positive Medicaid expansion news out of two states:

New Hampshire House passes Medicaid reauthorization

The New Hampshire House on Wednesday approved legislation that would keep 48,000 people on their insurance plans by continuing the state's expanded Medicaid program beyond the end of the year.

The bill, which now goes to the Senate, includes work requirements for recipients and asks insurance companies and hospitals to cover the state's share of the program's costs.

Some of the ACA provisions have been a huge success, such as the Medicaid expansion program, which has added over 14 million people to the program over the past 3 years. Others can be viewed as being successful or so-so depending on your POV, like the 12.7 million people who have enrolled in private policies via the ACA exchanges.

And then there are the portions of the law which have gone, well, not so great, to put it mildly...in particular the non-profit, public/private hybrid Co-Ops, which are the only remaining remnant of the originally much-hoped-for "Public Option". For a variety of reasons, not the least of which was an utterly unnecessary and ultimately pointless stunt pulled by Marco Rubio and other Congressional Republicans (aka the Risk Corridor Massacre), over half of the two dozen Co-Ops nationwide melted down in spectacular fashion last fall, leaving only 11 of them surviving into 2016 after the dust settled.

In light of this, I figured it would be worth posting some positive Co-Op news for a change. First up, Ohio.

(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.

I admit that given the carnage of the past couple of weeks, I'm almost afraid to post this entry...but I had to write something positive about the CO-OP situation.

With the ACA-created CO-OPs seemingly dropping like flies due to the #RiskCorridorMassacre, I thought this would be a good time to flip things around and look at which CO-OPs are doing well (or at least not badly).

This isn't much, but it'll do for now:

Wisconsin's insurance department says it has no intention of shutting down its #ACA co-op, which appears it will remain solvent next year.

— Bob Herman (@MHbherman) October 22, 2015

@charles_gaba and at this point, other than Maine, it's difficult to expect many others will last beyond risk corridors.

— Bob Herman (@MHbherman) October 22, 2015

Louise Norris has again done some of the heavy lifting for me over at healthinsurance.org, this time for New Hampshire:

In 2015, New Hampshire’s exchange had five carriers, up from just one in 2014.  There will still be five carriers in 2016, although there’s one swap:  Assurant/Time is exiting the market (nationwide), but Ambetter (offered by Celtic) is joining the exchange in New Hampshire.

...Two carriers in the exchange – Minuteman Health and Community Health Options – have requested double digit rate increases, although they have not yet been approved.  Both carriers are CO-OPs created under the ACA, and both expanded into New Hampshire at the start of 2015, so their claims data for the state is very limited. 

This article about New Hampshire reveals 3 noteworthy bits of information: First, it looks like at least one of the 37 HC.gov states will be reporting their exchange enrollments monthly during the off-season, even if the HHS Dept. itself refuses to do so:

The New Hampshire Insurance Departmentrecently began requiring insurance companies selling plans through the marketplace to submit monthly enrollment numbers.

Second, here's the first results of those monthly reports:

 According to the latest numbers, a total of 45,504 people had signed up for plans in New Hampshire by April 1

I have a ton of ACA-related stories cluttering up my in-box again; here's some of the more interesting ones, all regarding ACA Medicaid Expansion:

MICHIGAN:

For months now, I've been a bit obsessed with figuring out how my home state's Medicaid expansion enrollment has managed to reach as high as 21% more people than were supposedly even eligible for the program. Estimates last year ranged from 477,000 - 500,000, yet enrollment in Healthy Michigan (Gov. Snyder's name for Obamacare Medicaid Expansion) currently sits at a whopping 579K, less than 1 year into the program.

New Hampshire's ACA Medicaid expansion program got a late start, not kicking off until July 1st of this year. That makes the fact that they've already reached 50% of their total potential enrollment all the more impressive:

State officials had expected 30,000 to 40,000 of the estimated 50,000 eligible adults would sign up in the first year either through the state's managed care program for Medicaid or a program that subsidizes existing employer coverage. As of mid-week, just fewer than 25,300 had signed up.

 

Looks like New Hampshire is switching from "standard" Medicaid expansion to an Arkansas-like "Private Medicaid Option" program next year...and it includes an enrollment update:

"This waiver is an important part of our efforts to improve the health and financial well-being of Granite State families, businesses and communities through our bipartisan health care expansion plan, "Governor Hassan said. " Almost 24,000 Granite Staters have the security that comes with quality, affordable health insurance because of the New Hampshire Health Protection Program, and if approved, this waiver will allow these people to choose private insurance on the health insurance marketplace."

...The purchase of Qualified Health Plans via the marketplace will be paid for with 100 percent federal funds through December 31, 2016.

Through the 19th of November, 23,975 New Hampshire citizens had enrolled in the New Hampshire Health Protection Program.

Last year, New Hampshire had but a single participant in the federal ACA exchange: Anthem BCBS. This year, not one, not two, not three, but four other companies have joined in

Two more insurance companies say they plan to sell policies in New Hampshire’s health exchange in 2015, bringing the total to five carriers. The suddenly crowded field is a sharp contrast to this year, when only Anthem is offering policies through healthcare.gov.

Harvard Pilgrim and Minuteman Health, both based in Massachusetts, announced their intentions to join the exchange earlier this year, and now the New Hampshire Insurance Department says Assurant Health and Maine Community Health Options have also submitted plans for regulatory review.

We don't have a full average-premium percentage breakdown like there are for other states, but this is certainly promising:

Pages

Advertisement