Charles Gaba's blog

SUMMARY OF #COVID-19 SPECIAL ENROLLMENT PERIODS:

ALL OTHER STATES: You may qualify for a 60-day Special Enrollment Period (SEP) if you've recently lost (or will soon lose) your employer-based healthcare coverage, or if you've experienced other Qualifying Life Events (QLE) such as getting marrinew yorked/divorced, moving, giving birth/adopting a child, getting out of prison, turning 26 etc. For these SEPs you may have to provide documentation to verify your QLE. Visit HealthCare.Gov or your state's ACA exchange website for details on the process.

Nolan Finley is the conservative editorial page editor of The Detroit News.

Two weeks ago, he tweeted this out in response to criticism of the COVID-19 policy recommendations by himself and Michigan Republican legislative leadership:

Florida 20 million population, 6100 deaths. Michigan 10 million population, 6400 deaths. https://t.co/O1tNoyWwB0

— Nolan Finley (@NolanFinleyDN) July 29, 2020

Let's take a look at the data, shall we? Here's a graph of official COVID-19 positive test cases and fatalities per capita for both Michigan and Florida. Cases are per 1,000 residents; deaths are per 10,000 in order to make the trendlines more visible:

As I noted last year, the Nevada Insurance Dept. website is both helpful and frustrating when it comes to tracking down the type of data that I need. On the one hand they make it very easy to view the individual & small group market rate filing summaries: Carrier names, markets, sumission dates, status, effective dates and most importantly, the proposed and approved average rate changes are all easily found.

On the other hand, they don't actually link to the filing memos or URRT forms, which means I can't find the actual effectuated enrollment numbers for each carrier, the impact of COVID-19 on each carrier's request or other noteworthy info about the filings. Oddly, they do include the SERFF tracking numbers...except that plugging those into the SERFF database still doesn't bring anything up, which kind of defeats the point.

Fortunately, the NV DOI does provide the weighted average of the entire market and COVID-19 impact elsewhere. I've also been able to piece together the total market enrollment (both on & off-exchange) using some other public data.

via MNsure:

With recent reports illustrating the growing number of uninsured Americans across the country, MNsure is reminding Minnesotans that there are options. For those who have lost their health insurance, seen a change in income, or experienced a qualifying life event, enrollment opportunities may be available.

"The last couple of months has brought tremendous uncertainty to many families across the state," said MNsure CEO Nate Clark. "It's important that Minnesotans know there are enrollment opportunities available if they lose their health insurance. MNsure is here to help."

Since the start of the COVID-19 pandemic, more than 100,000 Minnesotans have come through MNsure to find health insurance coverage.

For new customers, you may be eligible to enroll if:

I've acquired the preliminary 2021 rate filings for Georgia's individual and small group market carriers. There were two filings submitted for many of the carriers because of a (since delayed) ACA Section 1332 waivier submission; the carriers submitted one in case the waiver was approved and a second if it wasn't. Since the process has been delayed, however, the no-waiver filing is the one which is relevant.

As you can see in the tables at the bottom of this entry, the overall weighted rate change requested by individual market carriers in Georgia is a 1.3% reduction, which would have been more like a 2.3% drop if not for the COVID-19 factor, according to the carriers. The small group market carriers are requesting an 11.1% average increase, which is unusually high these days. I haven't reviewed all the memos for the sm. group market to see what they're pinning on COVID-19, however.

Here's what the indy market carriers have to say about the COVID-19 factor in their 2021 filings:

ALLIANT (indy):

The data below comes from the GitHub data repositories of Johns Hopkins University, execpt for Rhode Island, Utah and Wyoming, which come from the GitHub data of the New York Times due to the JHU data being incomplete for these three states. Some data comes directly from state health department websites.

Here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, August 8th (click image for high-res version):

UN. F*CKING. BELIEVABLE.

I don't often swear on this site (and almost never in the lede of the blog post, but this is the most sickening bit of gaslighting I've seen in awhile, which is saying something for the Trump Administration.

About an hour or so ago, Trump held a "press conference" in which he announced that he's supposedly signing an executive order to do exactly what the Patient Protection & Affordable Care Act, which he's currently suing to have struck down, ALREADY DOES.

So how is this being reported by certain "news media" outlets? Let's take a look:

Back on March 10th, the Washington HealthPlanFinder became the first state-based ACA exchange/marketplace to formally create an official COVID-19 Special Enrollment Period, which was originally scheduled to have a deadline of April 8th.

Since that time, nearly every other state-based ACA exchange (all of them except for Idaho) has done likewise. Some of them required some sort of verbal or written attestation of thier eligibility status, while others didn't, but all of them were wide open to any uninsured resident who would normally be eligible to enroll during the official Open Enrollment Period.

The deadlines for the "open" COVID-19 SEP varied by state...but most of them ended up extending them out as that deadline approached. In some cases, they bumped it out again...and again...and yet again, as it became increasingly clear that the deadly pandemic isn't going away anytime soon.

Yesterday the Pennsylvania Insurance Dept. posted the preliminary 2021 rate filings for the individual and small group markets. On the surface, it appears that Pennsylvania has an absurdly competitive market, with 17 carriers listed on the indy market and 21 small group carriers...but when you look closer, many of these are simply branches of the same main company.

For instance, fully five of the individual market carriers are variants of "Highmark"...which is actually Pennsylvania's rebranding of Blue Cross Blue Shield. Two are branches of Geisinger and another two are both UPMC. The same is true in the small group market.

And don't even get me started about "Capital Advantage Assurance Company" and "Capital Advantage Insurance Company". Sheesh.

In any event, the overall rate filings average out to rougly a 2.6% premium decrease on the individual market and a 2.3% increase for small group plans, when weighted by carrier market share.

The Kentucky Insurance Dept. has posted KY's preliminary 2021 rate filings for the individual and small group markets, and the requested average rate increases for both are unusually high compared to the other states which have submitted their filings so far. In another unusual development, most of the carriers on each market are being pretty specific about the impact (or lack thereof) on their 2021 rate filings from the COVID-19 pandemic (I only have UnitedHealthcare posted once but they account for three of the seven small group carriers listed.

Anthem Health Plans of KY (individual market):

Last week I noted that there's a damned good reason for tracking the spread of COVID-19 across the country on a partisan (red state/blue state) level: Federal (and in some cases, state) policy is being based on it:

...Most troubling of all, perhaps, was a sentiment the expert said a member of Kushner’s team expressed: that because the virus had hit blue states hardest, a national plan was unnecessary and would not make sense politically. “The political folks believed that because it was going to be relegated to Democratic states, that they could blame those governors, and that would be an effective political strategy,” said the expert.

Five states held their primary elections for non-Presidential races yesterday, including Missouri...and Missouri also had another important measure on the statewide ballot:

On Tuesday, August 4, all Missourians will have the chance to vote Yes On 2 to bring more than a billion of our tax dollars home from Washington every year – money that’s now going to places like California and New York instead.

By bringing our tax dollars home, we can protect thousands of frontline healthcare jobs, help keep rural hospitals open, and deliver healthcare to Missourians who earn less than $18,000 a year. That includes thousands of veterans and their families, those nearing retirement, working women who don’t have access to preventive care, and other hardworking Missourians whose jobs don’t provide health insurance.

Just out from Covered California:

California’s Efforts to Build on the Affordable Care Act Lead to a Record-Low Rate Change for the Second Consecutive Year

  • The preliminary rate change for California’s individual market will be 0.6 percent in 2021, which marks a record low for the second consecutive year and follows California’s reforms to build on and strengthen the Affordable Care Act.
  • Covered California’s increased enrollment, driven by state policies and significant investments in marketing and outreach, has resulted in California having one of the healthiest individual market consumer pools and lower costs for consumers.
  • The impact of COVID-19 on health plans’ costs has been less than anticipated as many people deferred or avoided health care services in 2020, and while those costs are rebounding, it now appears the pandemic will have little effect on the total costs of care in California’s individual market for 2020 and 2021.
  • All 11 health insurance companies will return to the market for 2021, and two carriers will expand their coverage areas, giving virtually all Californians a choice of two carriers and 88 percent the ability to choose from three carriers or more.

Paulding County, Georgia has a population of around 169,000 people. According to Johns Hopkins University, as of yesterday, they had 1,452 known COVID-19 cases and 19 COVID-19 deaths.

That's around 8.6 cases per thousand residents, which is lower than 37 states (but still higher than Colorado, Ohio or Washington), but 1.13 deaths per 10,000 residents, which is higher than...well, in the upper half of counties in America (Paulding ranks #1,478 out of over 3,100 counties/county equivalents nationally).

via Twitter:

This is the first day of school in Paulding County, Georgia.

— BlackAzizaNANsi (@Freeyourmindkid) August 4, 2020

via the Arkansas Insurance Dept:

Health Insurance Rate Changes for 2021

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.

Below, you can review information on the proposed rate filings for Plan Year 2020 individual and small group products that comply with the reforms of the Affordable Care Act.  

Users will only be able to view the public details of the filing, as certain portions are deemed confidential by law (Ark. Code Ann. § 23-61-103).

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