Hawaii: Preliminary 2019 #ACA rate hikes: 13.8%, but would likely be ~3.8% w/out #ACASabotage

It took me four full months for me to analyse the 2019 ACA rate filings for the first 30 states, but the remaining 20 should come fast & furious starting today, because it looks like they were all finally uploaded to the official RateReview.HealthCare.Gov website earlier this afternoon.

Case in point: Hawaii. There's four carrier listings at RR.HC.gov, but this is misleading; two of them are basically double-listed (Hawaii Medical Service Association separated out their PPOs and HMOs into separate listings, but the filing itself merges both; the same is true of Kaiser Foundation Health Plan, whish has On and Off-Exchange policies listed separately in the database but again merges them into the same filing). In reality, Hawaii only has two carriers on the Individual Market as they have for years.

Both filings mention repeal of the Individual Mandate Penalty as a major factor in their rate hikes, but neither gives a specific breakout. The Urban Institute projected a 17.5% impact from mandate repeal and the expansion of short-term plans combined, but Hawaii has taken action to head STPs off at the pass, so I'm knocking 2 points off of that estimate. In addition, as usual, I'm further knocking 1/3 off of Urban's projections in the interest of caution.

That leaves a 10-point ACA sabotage factor, which suggests that the 13.8% statewide premium increase would likely be closer to 3.8% if not for the mandate being repealed. The average unsubsidized premium in Hawaii is $625/month this year, so that means roughly $63/month or a $750 total sabotage tax for unsubsidized enrollees in 2019.