START OF 2018 OPEN ENROLLMENT PERIOD

Time: D H M S

2018 Rate Hikes

The 2018 Rate Hike Project: (SCROLL DOWN FOR CHARTS/TABLES)

Back in 2015, I started tracking the individual market premium rate changes (mostly increases, occasionally a decrease) being requested by the various health insurance carriers on a state-by-state basis. At the time, I didn't bother separating out the initial requested rate hikes from the final, approved changes, so my final estimates ended up being a mixture of each. .Even so, I ended up being pretty damned accurate: I estimated that nationally, the overall average, unsubsidized, individual market policy rate increases would be roughly 12-13%, assuming 100% of current enrollees were to re-enroll in the exact same policy. I noted, however, that due to the likelihood of many people switching to different policies (either via the same carrier or a different one), the odds were that the effective average rate increases would turn out to be somewhat lower; likely "under 10% overall".

As it turned out, I called it pretty closely: The overall average approved rate hikes on the indy market (again, for unsubsidized enrollees) ended up being around 11.6-11.7% nationally...slightly below my estimates. Furthermore, the effective average rate hike once the dust settled turned out to be around 8% overall.

For 2016, I started the Rate Hike project earlier in the year, and made sure to add an extra column so I could compare the initial requested rate increases to the final, approved rate hikes...although it really didn't make much difference. While there were a lot of changes over the course of the summer/fall in 2015, in 2016, the approved rate changes ended up being pretty close to those requested in most instances. In the end, I estimated roughly a 25% overall national rate increase for unsubsidized enrollees. I also started tracking the small business market averages as well, although I only did this for a handful of states.

Once again, I nailed it pretty closely: The official ASPE report from the HHS Dept. gave the average as roughly 25%, but that only included the 38 states run via HealthCare.Gov; when you added the other 13 states, it dropped a bit to 22% nationally. However, that only included benchmark plans (the 2nd-lowest-priced Silver plans in each rating area). When you also roll in all the other policies available on the ACA-compliant indy market (Bronze, Gold, Platinum, Catastrophic and other Silver plans), it did indeed end up averaging closer to 25% after all.

This has become something of an annual off-season tradition for me; for good or for bad, I seem to spend 3 months of the year tracking exchange enrollments and the other 9 months of the year tracking how much unsubsidized rates for those same policies are going up. I'm once again tracking every state as comprehensively and accurately as I can as each one releases their initial, revised and final/approved rate changes. I'm also going to attempt to do this for the small business market in every state as well if I can, although those will be posted elsewhere if I'm sure I can lock them in for all (or nearly all) states.

Of course, thanks to the massive Trump/GOP Uncertainty Factor, there's a lot of unknowns at play for next year...and, as I've been predicting for months now, that uncertainty is already clearly leading to significantly higher rate hike requests than would otherwise be asked for. As of this writing I've only documented 4 states (Virginia, Maryland, Connecticut and Vermont), and already at least 4 insurance carriers (CareFirst, Evergreen Health, New Mexico Health Connections and BCBS of Tennessee) have gone on the record as pinning a significant chunk of their requested increases on uncertainty regarding Trump's threat to cut off CSR payments, whether or not HHS Sec. Price will bother enforcing the individual mandate penalty, whether or not the GOP at large will actually repeal the ACA and so on.

UPDATE 5/25/17: Several carrier CEOs have gone on the record to note that the Trump/GOP Uncertainty Factor is a "significant" or "primary" part of their requested rate hikes this year...but today BCBS of North Carolina went well beyond that, to explicitly say, point blank, that the CSR reimbursement issue is directly responsible for over 60% of their 22.9% requested increase.

I've been assuming a ballpark average of 40% being due to general Trump/GOP/CSR uncertainty as a general rule of thumb. I'm sure it ranges widely from carrier to carrier, and I don't expect many other carriers to be quite so candid and specific about this issue, but BCBSNC has over half a million enrollees on the individual market (on + off exchange). That's 2.8% of the entire indy market all by themselves. Food for thought.

UPDATE 6/02/17: OK, between North Carolina (60% due specifically to sabotage) and Pennsylvania (75% due specifically to sabotage), I'm bumping my ballpark average assumption up to a flat 50% due to the "Trump Uncertainty Tax" in states which don't otherwise specify the impact. I've also added new columns to the tables below which compare the total rate hike requests vs. what they likely would be without the Trump Tax included.

UPDATE 6/7/17: New York has released their rate requests with the opposite situation: They were instructed to assume CSR payments/etc will continue, which means they're only providing the "NO Trump Tax" scenario. In these cases I'm going to rely on the Kaiser Family Foundation, which estimated that rates would have to be increased an average of 9-27% depending on the state, averaging around 19% overall, 21% for non-Medicaid expansion states and 15% for Medicaid expansion states.

FURTHER UPDATE: Just realized that due to the BHP programs in NY/MN, those states only have 1/3 as many CSR enrollees anyway, so the Trump Tax is likely more like 5 points instead of 15 points in each. Tables revised below.

In any event, as always, it's important to remember several key caveats when reading the tables below:

  • These are for the individual health insurance market ONLY. Thes do not have anything to do with employer-sponsored policies (large or small), Medicare, Medicaid, the VA/TriCare, short term policies or "grandfathered/transitional" policies. These only refer to the roughly 18 million people enrolled in ACA-compiant individual market policies, either on or off the exchanges​.
  • The requested rate changes are oftentimes reduced (and, unfortunately, occasionally increased) by state insurance regulators. Sometimes they're approved exactly as is. Sometimes the carrier submits a revised request later in the summer/fall which is in turn approved or changed again. The green column at the end (APPROVED) likely won't be filled in for any states until sometime in October.
  • These are the full price, unsubsidized rate changes. For roughly 9 million exchange enrollees who are receiving APTC assistance, assuming their income level, etc. doesn't change much and they remain on the same policy, they likely won't see their rates go up much at all, since the tax credits will likely increase to match in most cases. The rate changes below apply mainly to the other 9 million people on the indy market who aren't receiving APTC assistance.
  • These average increases assume 100% of current enrollees renew their existing policy in 2018. This, obviously is not going to be the case for millions of people no matter what happens. Some carriers are dropping out of the market altogether. Some are dropping certain plans. Some are changing their policy offerings. Some are newly entering the individual market. In addition, the individual market has always had a lot of churn anyway, with people jumping in and out from year to year. Since there's no real way of accounting for all of that, I do the best I can with what I have at my disposal.

With all that in mind, here's where things stand as of 5/14/17: With 4 states plugged in (CT, MD, VT & VA) representing less than 6% of the total population, carriers are requesting a pretty unpleasant 32.5% average rate hike.

This will likely change dramatically as each new state is added to the spreadsheets. Once states representing over half of the population have been entered, it will take increasingly dramatic variances for each new state to move the needle up or down. Updates will be added at this link.

And with that, we're off...

UPDATE 5/16/17: OREGON ADDED. There are now 5 states representing around 7.1% of the total population included, with a weighted average requested rate hike of 29.84%.

UPDATE 5/19/17: DISTRICT OF COLUMBIA ADDED. There are now 6 states (DC is treated as a state here) representing 7.3% of the total population included, with a weighted average requested rate hike of 29.75%.

UPDATE 5/25/17: NORTH CAROLINA ADDED. There are now 7 states representing 11.2% of the total population included, with a weighted average requested rate hike of 27.5%.

UPDATE 6/2/17: PENNSYLVANIA ADDED. There are now 8 states representing 14.8% of the total population included, with a weighted average requested rate hike of 29.7% with the Trump Tax or 11.0% without it.

UPDATE 6/7/17: NEW YORK ADDED. There are now 9 states representing 18.3% of the total population included, with a weighted average requested rate hike of 30.4% with the Trump Tax or 11.9% without it.

UPDATE 6/9/17: MAINE ADDED and CONNECTICUT CORRECTED. There are now 10 STATES representing 18.8% of the total population included, with a weighted average requested rate hike of 13.1% WITHOUT the Trump Tax or 34.2% WITH it.

UPDATE 6/14/17: DELAWARE and MICHIGAN ADDED. There are now 12 STATES representing 21.8% of the total population included, with a weighted average requested rate hike of 13.7% WITHOUT the Trump CSR Tax or 33.1% WITH it.

UPDATE 6/19/17: WASHINGTON STATE ADDED. There are now 13 STATES representing 23.8% of the total population included, with a weighted average requested rate hike of 13.3% WITHOUT the Trump/GOP Sabotage Tax or 32.2% WITH it.

UPDATE 6/20/17: IOWA ADDED. There are now 14 STATES representing 24.6% of the population included, with a weighted average requested rate hike of up to 13.6% WITHOUT the Trump/GOP Sabotage or 32.6% WITH the Trump/GOP Sabotage Tax included.

ALSO NOTE: Going forward, I'm changing the "WITHOUT TrumpTax" label to "w/PARTIAL TrumpTax" because some carriers don't break out their "HHS mandate enforcement uncertainty" factor even if they break out the "assume no CSR reimbursements" factor. This means that the "Without" average is actually somewhat lower than shown overall, but I have no way of estimating how much lower, though my guess is it'd be perhaps 2 points or so overall.

UPDATE 7/2/17: INDIANA and TENNESSEE ADDED. There are now 16 STATES representing 28.3% of the population included, with a weighted average requested rate hike of up to 13.3% with a PARTIAL Trump/GOP sabotage effect or 31.8% WITH the Trump/GOP Sabotage Tax included.

UPATE 7/6/17: GEORGIA ADDED: There are now 17 STATES representing 31.9% of the population included, with a weighted average requested rate hike of up to 15.1% with a PARTIAL Trump/GOP Sabotage Tax or 34.2% with the FULL Trump/GOP Sabotage Tax included.

UPDATE 7/7/17: RHODE ISLAND ADDED: There are now 18 STATES representing 32.2% of the population included, with a weighted average requested rate hike of up to 15.1% with a PARTIAL Trump/GOP Sabotage Tax or 34.1% with the FULL Trump/GOP Sabotage Tax included:

UPDATE 7/12/17: MONTANA and NEW MEXICO ADDED: There are now 20 STATES representing 33% of the population included, with a weighted average requested rate hike of up to 15.1% with a PARTIAL Trump/GOP Sabotage Tax, or 34.2% with the FULL Trump/GOP Sabotage Tax included:

UPDATE 7/14/17: MICHIGAN UPDATED, COLORADO ADDED: There are now 21 STATES representing 34.7% of the population included, with a weighted average requested rate hike of up to 15.0% with a PARTIAL Trump/GOP Sabotage Tax, or 33.7% with the FULL Trump/GOP Sabotage Tax included:

UPDATE 8/1/17: After a long dry spell stretching over the insane Senate "repeal/replace" brouhaha, the rate filings are back with a vengence: I've added IDAHO (complete), ARIZONA (Blue Cross only) MINNESOTA (rough estimates) and the Big One: CALIFORNIA. I've now tracked 25 STATES representing 51% of the population, with weighted average requested rate hikes of up to 13.4% with NO or PARTIAL Trump/GOP sabotage tax included, or 28.2% with the FULL sabotage tax included:

UPDATE 8/1/17: Well, the floodgates have really opened up today (especially with RateReview.HealthCare.Gov being loaded up for 2018). I've also added ALABAMA, ALASKA and WYOMING. Across 28 states representing I've now tracked 28 STATES representing 53% of the population, with weighted average requested rate hikes of up to 13.2% with NO or PARTIAL Trump/GOP sabotage included, or around 28.1% with the FULL sabotage tax:

UPDATE 8/2/17: The flood continues...I've updated 2 states (Minnesota and North Carolina), while also adding two new ones (ARKANSAS and KENTUCKY). I've now tracked the rate requests for 30 STATES representing 55% of the population. The weighted average rate hike request now stands at 12.8% with NO/PARTIAL Trump/GOP sabotage or 27.5% with FULL Trump/GOP sabotage.

UPDATE 8/3/17: Added WEST VIRGINIA and another Big One: TEXAS. I've now compiled rate request data for 32 STATES representing 65% of the population, As I expected, just as California pulled the national average down several points, Texas has bumped it back up again: The weighted average rate hike request now stands at 13.9% with NO or PARTIAL Trump/GOP sabotage, or around 28.2% with FULL sabotage:

UPDATE 8/3/17: Two updates in one day! I've added HAWAII and ILLINOIS. I've now compiled rate request data for 34 STATES representing 68.5% of the population. The weighted average now stands at 13.8% with NO or PARTIAL sabotage or around 27.9% with FULL sabotage:

UPDATE 8/7/17: MORE states added: LOUISIANA, MASSACHUSETTS, MISSISSIPPI, NEBRASKA, NEW HAMPSHIRE and SOUTH DAKOTA. I've now compiled rate request data for 40 STATES representing nearly 75% of the population. The weighted average still stands at 13.8% with No/Partial sabotage, but the FULL sabotage average has inched up to 28.0%.

UPDATE 8/10/17: Coming into the home stretch. I've added seven more states: FLORIDA, NEW JERSEY, NORTH DAKOTA, OHIO, OKLAHOMA, SOUTH CAROLINA and WISCONSIN. I've now completed rate request data for 46 states (+DC) representing over 95% of the total population. The weighted average now stands at 14.4% assuming No/Partial Sabotage, or 29.0% assuming FULL Sabotage.

I hope to plug in the final 4 states (Kansas, Missouri, Nevada and Utah) ASAP, but they're unlikely to move the needle by much given that they collectively only make up 5% of the total population.

UPDATE 8/14/17: I've started going back and updating/correcting/revising the earlier states, where some carriers have either dropped out, expanded coverage or resubmitted revised filings. So far I've updated Virginia, Maryland, Connecticut, Vermont and Oregon. This has bumped the PARTIAL Sabotage average up by nearly 1 full point, and the FULL Sabotage average up by about 0.5 points:

UPDATE 8/20/17: More updates/corrections, to Maine and the District of Columbia. The averages now stand at 15.4% assuming No/Partial Sabotage or 29.5% assuming FULL Sabotage.

UPDATE 8/23/17: New York has posted their approved average rate hikes, making them the 2nd state to do so after Oregon. I'll start posting revised tables including approved increases as soon as a few more state regulators chime in.

UPDATE 9/01/17: Maryland has posted their approved average rate hikes, making them the 3rd state to do so. In addition, Missouri has finally posted their requested rate increases, so I now have compiled requested increases for 47 states +DC and approved increases for 3 states:

UPDATE 9/06/17: I've finally plugged in the requested rate hikes for the final 4 states (Kansas, Missouri, Nevada and Utah)! Note that Kansas is highly questionable, as I only have data for 1 of the 2 carriers participating, and the missing one has most of the market share. I've also gone back and cleaned up a couple of other states with some minor corrections (I had forgotten that VT, DC and MA all merged their individual and small group market risk pools, meaning the CSR factor is lower in each than I had previously estimated). In addition, with four states having released approved rate changes (Oregon, Maryland, New York and now Vermont), I've overhauled the spreadsheets to start including the columns for APPROVED rate changes.

UPDATE 9/06/17 (busy day!): Two more states have released their APPROVED rate hikes (Maine and Colorado). In both cases, one of my assumptions regarding the requested increases turned out to be wrong, so I have do go back and revise those as well. This has resulted in the "No/Partial Trump Tax" average inching its way over the 16% line for the first time (16.1%, actually), and has the "FULL Trump Tax" average hovering very close to the 30% mark.

With approved rates for 6 states now baked in, the "partial sabotage" average stands at 19.4% while the "full sabotage" average is 24.1%...several points higher and lower respectively, with CSR sabotage "only" accounting for about 20% of the average increase. However, it's very important to remember that these states only represent about 9% of the total population; both numbers will almost certainly jump around quite a bit as more states are added to the mix, just as they did when I started adding requested rate changes in.

UPDATE 9/7/17: Bad news out of Virginia and Kentucky; Optima Health is pulling out of a bunch of VA counties and the carriers have all submitted revised "NO CSR!" filings which are generally even higher than the Kaiser Family Foundation had estimated for the state. In addition to opening up the "bare county" problem again, this also had the effect of bumping up both the "partial" and "full" sabotage averages a bit, to 16.2% and 29.8% respectively. Meanwhile, in Kentucky, Anthem is similarly pulling out of about half the state, meaning perhaps 35K enrollees will have to switch plans. This ironically reduces the "average increase" in the state slightly.

UPDATE 9/14/17: Added approved rates in Connecticut, Louisiana and Michigan (MI's aren't officially approved but appear unlikely to change much). I now have approved rates for 9 states.

UPDATE 9/27/17: No updates for awhile due to the Graham-Cassidy brouhaha, but with that out of the way and the final 2018 enrollment period contract signing deadling set for tomorrow, several more states have come out with their final, approved rate changes, including Florida, Washington State, Virginia, South Carolina and Mississippi. I now have final rate changes for 14 states representing around 1/3 of the country.

UPDATE 10/01/17: Now that we're past the contract signing deadline (with CSR reimbursements pretty much certain not to be guaranteed next year), the approved rates are popping up pretty quickly: I've added Alaska, Arkansas, Idaho, North Dakota and Tennessee.

UPDATE 10/03/17: I've added two more states today: Minnesota and Arizona. This brings the table up to 22 states representing around 43% of the country.

UPDATE 10/04/17: I've added New Mexico this morning (the numbers are a bit fuzzy but come from the state Insurance Commissioner so should be solid enough to enter).

UPDATE 10/5/17: Thanks to an assist from Protect Our Care, I've managed to plug in the approved rate increases for six more states: Illinois, Indiana, Nevada, Ohio, South Dakota and Utah.

UPDATE 10/5/17: OK, make that seven more today; I've also added Delaware.

UPDATE 10/10/17: I have the approved rates for Kansas, Nebraska and West Virginia, bringing the grand total up to 33 states, but am holding off until I get a few more states added before actually updating the charts/tables below.

UPDATE 10/11/17: BOOM. California has released their statewide weighted average rate increases, both with and without the CSR load. As the largest state in the country, this (along with the small increases from Kansas, Nebraska and West Virginia) brings the total portion of the population represented up to nearly 69% across 34 states.

UPDATE 10/16/17: Pennsylvania has chimed in. That makes 35 sates or 73% of the population accounted for.

With all of these changes/additions/updates, here's what the overall picture now looks like (click images for full-size versions:

Protect Our Care is a healthcare advocacy coalition created last December to help fight back against the GOP's attempts to repeal, sabotage and otherwise undermine the Affordable Care Act. This morning they released a report which compiled the approved 2018 individual market rate increases across over two dozen states.

Needless to say, they found that the vast majority of the state insurance regulators and/or carriers themselves are pinning a large chunk (and in some cases, nearly all) of the rate hikes for next year specifically on Trump administration sabotage efforts...primarily uncertainty over CSR payment reimbursements and, to a lesser extent, uncertainty over enforcement of the individual mandate penalty.

Back in July, I had originally estimated the requested rate increases for New Mexico to average roughly 24.2% with partial Trump Administration sabotage or 37.2% with full sabotage (no CSR payments, full mandate enforcement threat). However, figuring out NM's approved rate hikes is proving to be frustrating.

On the one hand, they have a handy database lookup tool right there on the NM Insurance Dept. website, and they even have the actual premium amount listings for every plan from every carrier in every rating area available. Unfortunately, the premium listings don't give a year over year comparison (or an average percent increase), and the database tool seems not to have been fully updated as of this writing, making it kind of useless. I have some info for a couple of the individual carriers but even that's a bit confusing.

To the best of my knowledge, there are only 2 insurance carriers offering ACA-compliant insurance policies in Arizona next year: Blue Cross Blue Shield of AZ and Centene (branded as HealthNet).

Back in early August, BCBSAZ announced that they were asking for a relatively modest 7.2% rate increase next year in the 13 counties (out of 15 total) where they were offering individual plans. They also explicitly stated that if it weren't for their concerns over whether or not the Trump Administration would guarantee reimbursing their CSR expenses, they'd be keeping the 2018 rates flat year over year. Granted, this is after a massive rate increase for 2017, but it was still welcome news, and once again underscored how much damage the Trump sabotage factor is.

In a year when every state's 2018 Open Enrollment situation is messy to say the least, Minnesota's is far more so:

  • Last year they were facing massive rate hikes, especially for unsubsidized enrollees (yeah, I know, I know, don't say it), and came very close to having all of their carriers bail
  • In response, they agreed to let most of them put a maximum enrollment cap on a First Come First Serve, with Blue Plus (BCBSMN) agreeing to take the "overflow".
  • However, the unsubsidized individual market enrollees were royally screwed, so the state legislature and governor slapped together a special, one-time 25% premium rebate specifically for them. The money came directly out of other portions of the state general fund, I believe. MNsure, the state exchange, also added an extra 8-day special enrollment period for these folks to jump in and get in on the rebate.

The Maryland Health Connection is now allowing residents to comparison shop for 2018:

View 2018 health insurance plans and prices now!

MarylandHealthConnection.gov has already been loaded with plans and prices for 2018, one month before open enrollment begins. The upcoming open enrollment period will run November 1 - December 15. Health coverage will start on January 1, 2018.

  • How do I get an estimate for 2018 health insurance plans?

You can compare plans and prices through a desktop computer browser or by downloading our mobile app, Enroll MHC, on your iPhone or Android.

Click on “Get Started”- this will take you to the application portal. Next, click “Get an Estimate” on the application site. Finally, enter basic information like your county, age and income to see what coverage and financial help you may qualify for. If you choose to get an estimate, the site will take you through a scenario of what plans and pricing you could receive for 2018. You won’t actually be applying for coverage.

About a month ago, Colorado was among the first states to release their approved 2018 individual market rate hikes. At the time, the average unsubsidized rate increases assuming CSR payments are guaranteed for all of 2018 averaged around 26.7% statewide.

As for CSR payments not being made, however, the press release accompanying the rate tables was more vague; it stated that they would be "up to" 14 points higher, but didn't clarify whether that would apply to every individual plan or only the Silver policies, which is how most other states appear to be handling it. I assumed the "no-CSR" average would be roughly 32.9% if the load is only dumped on Silver plans, but 40.7% if spread across all metal levels.

More recently, Louise Norris (who lives in Colorado herself) gave me the bad news: That "up to 14 points" is being spread across everything:

The Idaho Insurance Dept. has made things pretty easy for me. While they don't break out the individual market enrollment numbers by insurance carrier, they do provide the statewide, weighted average of those enrollees: 27% approved vs. the 38% average which was requested  requested (assuming no CSR reimbursement payments)

Now that we've passed the 9/27 contract signing deadline for 2018 carrier participation on the ACA exchanges, the state insurance departments are posting their approved final rates pretty quickly. Arkansas has done a fantastic job of clearly laying out not just what the rate changes will be, but is explicitly stating how much of those increases are due to the GOP's refusal to formally appropriate CSR reimbursement payments next year:

Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Arkansas Insurance Department for review and approval before plans can be sold to consumers.  The Department reviews rates to ensure that the plans are priced appropriately.  Under Arkansas Law (Ark. Code Ann. § 23-79-110),  the Commissioner shall disapprove a rate filing if he/she finds that the rate is not actuarially sound, is excessive, is inadequate, or is unfairly discriminatory.  The Department relies on outside actuarial analysis by a member of the American Academy of Actuaries to help determine whether a rate filing is sound.

Louise Norris has been saving me the trouble of digging up/writing up the approved rates in several states...

Insurance Commissioner approves rates insurers filed for 2018; Cost to cover CSRs has been added to silver plan premiums

On September 20, the Tennessee Department of Insurance and Commerce (TDIC) announced that the state had approved the rates that insurers had filed for 2018. However, the announcement indicated that Cigna’s approved average rate increase was 42.1 percent, which was based on the filing Cigna submitted in June 2017. An updated filing, with an average rate increase of 36.5 percent, was submitted in August, and TDIC confirmed by phone on September 21 that the updated filing was approved. The slightly smaller rate increase is due to Cigna’s decision to terminate some existing plans and replace them with new plans).

The following average rate increases were approved for 2018 individual market coverage:

In August I wrote that the situation in North Dakota was pretty straightforward: Three carriers on the individual exchange (BCBS, Medica and Sanford), requesting average rate hikes of around 24%, 19% and 12% respectively for an average increase of 23% assuming CSR payments are made, or a bit higher (28%) if they aren't.

Yesterday, however, with the final contract signing deadline having passed on the 27th, Louise Norris reports that one of the three carriers, Medica, was forced to drop out of the market at the last moment...not because they wanted to, but because the ND insurance dept. insisted on carriers pricing 2018 premiums on the assumption CSRs will be paid for the full year.

Medica understandably refused to take that risk (the odds of CSRs being guaranteed are virtually nil, and the odds of them being paid each and every month, as they're supposed to, is only so-so), so they dropped out instead.

Back in August, I reported that thanks to their just-approved federal reinsurance program, Alaska (which has only a single individual market carrier with the most expensive premiums in the country) is looking at an impressive 22% average decrease in their indy market premiums next year. However, that was based on the assumption that CSR reimbursement payments would not be made (or at least not guaranteed).

Last week the Alaska Journal of Commerce reported that the final, approved 2018 rates have been released, and Premera Blue Cross Blue Shield will instead be lowering rates even further:

Alaskans buying health insurance on the individual market will see a decrease of 26.5 percent in rates next year, the sole insurer in the state announced Tuesday.

Alaskans had been paying some of the highest premiums in the nation.

Some Guy, September 19th:

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

Well, first of all, is it possible that they'll slip CSRs in before the vote? I suppose so, but consider this:

  • The final deadline for the insurance carriers to actually sign their contracts for 2018 is Sept. 27th, just 8 days from now.
  • The end of the 2017 fiscal year (i.e., the deadline for the GOP to try and cram through Graham-Cassidy with only 50 Senate votes) is Sept. 30th.
  • The CBO is "aiming" to provide a "preliminary assessment" of Graham-Cassidy "early next week" which I presume means Monday the 25th or Tuesday the 26th.
  • I assume the other steps (parlimentary ruling, vote-a-rama, etc) would take place on Wednesday the 27th, the same day the contracts have to be signed.
  • Yom Kippur is the evening of the 29th, running through Saturday the 30th. I can't imagine even McConnell would be that much of a dick to schedule the vote then.
  • That leaves Thursday the 28th or Friday the 29th for the actual vote itself.

That's a day or two after the carrier contracts have been signed.

Earlier today, the Georgia Department of Insurance issued this press release:

INSURANCE DEPARTMENT RELEASES PROPOSED RATES FOR 2018 HEALTHCARE EXCHANGE

Atlanta – Insurance Commissioner Ralph Hudgens announced today that his office had submitted proposed 2018 health insurance rates to the Centers for Medicare and Medicaid Services (CMS) for the federally-facilitated Healthcare Exchange for final federal approval.

“Today my office submitted 2018 Obamacare rates to Washington D.C. for approval,” Hudgens said. “In its fifth year, Obamacare has become even more unaffordable for Georgia’s middle class with potential premium increases up to 57.5 percent. I am disappointed by reports that the latest Obamacare repeal has stalled once again and urge Congress to take action to end this failed health insurance experiment.”

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.

I've spent the past two weeks posting about almost nothing besides the Graham-Cassidy debacle, so haven't had a chance to keep on top of the approved 2018 rate changes as I usually do. Fortunately, Louise Norris of healthinsurance.org has stayed on the rate hike job, and reports the final numbers out of Washington State:

2018 rates: 24% approved rate increase, due in large part to federal uncertainty — and higher backup rates will be implemented if CSR funding is cut mid-year

Insurers in Washington had to file rates and plans for 2018 by June 7, 2017. On June 8, Kreidler’s office published a summary of what had been filed (rate filings are available here, and that page will show final rate changes for the individual market once they’re approved), and publicized the filing details on June 19. The average proposed rate increase in Washington, before any subsidies are applied, was 22.3 percent.

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