Charles Gaba's blog

Illinois

Unfortuantely, Illinois is another state which doesn't make it easy to analyze annual health insurance premium rate filings. There's no details on their insurance department website, their SERFF listings don't seem to include the actuarial memos or URRT forms, and even the federal Rate Review listings only include the average requested rate changes; the actuarial memos there are mostly heavily redacted.

The unweighted average rate changes requested for 2022 come in at +5.1% for the individual market and +3.5% for small group plans. It's worth noting that neither of the UnitedHealthcare listings from 2021 (on the small group market) show up in the federal database, which either means they're pulling out of the Illinois market entirely or they just haven't been added to the listings yet. Given that it's mid-October, the former seems more likely.

Alaska

Like Wyoming, Alaska is also a sparsely populated state with only two carriers on their individual market and three (possibly four?) on their small group market. Also like Wyoming, Alaska's insurance department website is useless when it comes to getting rate filings or enrollment data; I had to use the federal Rate Review site to even get the requested rate changes.

Fortunately, Premera Blue Cross includes a summary which lists their enrollment numbers, and with Moda being the only other carrier on the market, I was able to estimate a weighted average (assuming Moda only has around 2,000 enrollees, which seems about right given Alaska's total on-exchange enrollment of roughly 18,000 people).

On the small group market, only three carriers are listed in the federal database; Premera Blue Cross isn't, which either means they're pulling out of the state's small biz market or they just haven't been added to the database yet.

Average rate change for unsubsidized enrollees in 2022 will be 10.6% on the individual market...except that almost every enrollee will qualify for financial subsidies this year. On the small group market, the unweighted average increase is 6.4%.

Wyoming

Wyoming is the smallest state and only has two carriers offering individual market policies (and just three offering small group plans). This makes it pretty simple for me.

Unfortunately, neither their insurance department website nor their SERFF filings give any indication of the enrollment numbers for any of the carriers, making it impossible to calculate a weighted average for either market. Then again, assuming a roughly even market share split, the unweighted averages should be pretty close: -4.1% individual market, +1.0% small group.

Tennessee

Tennessee's proposed 2022 rate filings are pretty straightforward...no new entrants or drop-outs among the carriers in either the individual or small group markets, and the SERFF filings actually include the enrollment totals for all of them in both markets (a rarity these days!).

The weighted average premium increase for unsubsidized enrollees is 4.4% for indy market enrollees and 8.9% on the small group market.

UPDATE 10/26/21: Well, it looks like all of the requested rates have been approved by the TN regulators without any changes on either market.

South Dakota

South Dakota's 2022 rate filings are pretty straightforward. There's still just two carriers offering policies on the individual market (Avera and Sanford), while it looks like UnitedHealthcare may be dropping out of the states small group market (they have a rate filing in the SERFF database, but it doesn't show up on the federal Rate Review database, and even the SERFF filing doesn't lis any specific rate increase or decrease).

Assuming all are approved as is, residents are looking at a 1.4% rate drop on the individual market and a 4.0% increase for small group plans.

UPDATE 10/26/21: Sure enough, it looks like all rate requests have been signed off on as is.

COVID-19 Vaccine

Given how much I've been focusing on the red/blue divide when it comes to the COVID pandemic (both in terms of cases & deaths as well as vaccinations), I figured it'd be a good idea to take a look at the case and death rates based purely on vaccination rates instead.

The following graphs are up to date as of yesterday (10/12/21). Both measure the county-level case and death rates since the end of June compared against what percentage of the population is fully vaccinated (i.e., 2 doses of Pfizer/Moderna or 1 dose of Johnson & Johnson).

I've broken the population of the 50 states +DC (~331 million people...this doesn't include the U.S. territories) has been broken out into ten brackets of roughly 33.1 million apiece.

As you can see, case rates since June are 2.3x higher in the least-vaccinated tenth of the country (under 40.2% fully vaccinated) than in the most-vaccinated tenth (66.9% or higher):

COVID-19 Vaccine

Methodology reminders:

  • I go by FULLY vaccinated residents only (defined as 2 doses of the Pfizer or Moderna vaccine or one dose of the Johnson & Johnson vaccine).
  • I base my percentages on the total population, as opposed to adults only or those over 11 years old.
South Carolina

Unfortunately, the South Carolina Insurance Dept. website isn't particularly helpful when it comes to getting the annual rate filing data for these analyses--they post a link to the federal Rate Review website and the SERFF database, but that's it...and most of the filings don't show up in SERFF, while the Rate Review database actuarial memos are all heavily redacted.

As a result, all I have is the unweighted 2022 average rate changes, which are basically flat for the individual market and down around 4.4% for small group plans.

The other noteworthy item is that it looks like UnitedHealthcare is pulling completely out of South Carolina's ACA-compliant small group market, though it's possible that they just haven't been added to the federal Rate Review database yet.

Rhode Island

Via the Rhode Island Insurance Dept:

State of Rhode Island Office of the Health Insurance Commissioner Requested and Approved Summary for 2022 Rates in the Individual, Small Group, and Large Group Markets

The Rhode Island Office of the Health Insurance Commissioner (OHIC) has completed its review of plan year 2022 rates for the individual, small group, and large group markets. This document is a summary of the requested and approved amounts for each insurer by market.

As required by the ACA, OHIC reviews premiums in the individual and small group markets by examining the following components:

COVID-19

A few weeks back, one of my COVID "partisan lean" graphs was cited by David Leonhardt of the New York Times. This paragraph in question gained plenty of attention, and ended up being referenced by Nicole Wallace on Deadline: White House; Morning Joe; Raw Story and Paul Waldman of the Washington Post:

Since Delta began circulating widely in the U.S., Covid has exacted a horrific death toll on red America: In counties where Donald Trump received at least 70 percent of the vote, the virus has killed about 47 out of every 100,000 people since the end of June, according to Charles Gaba, a health care analyst. In counties where Trump won less than 32 percent of the vote, the number is about 10 out of 100,000.

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