Charles Gaba's blog

via Connect for Health Colorado:

First Two Weeks of Open Enrollment Spell Early Success for Colorado’s Health Insurance Marketplace

  • Sign-ups are 27 percent higher than last year, and more people are qualifying for financial help

DENVER— Open Enrollment for 2024 health insurance coverage started just two weeks ago, and Connect for Health Colorado reports that enrollments are up 27 percent from last year. Currently, more than 36,500 individuals have signed up for a health insurance plan through its marketplace, and 82 percent of those people are qualifying for financial help.

 

The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.

While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)

Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of proposed tweaks to some of the specifics of how the ACA is actually implemented for the following year (actually, it's the year after the following year, since the final rule is generally released in mid-December).

For example, here's what the actual PPACA legislative text itself said about the annual Open Enrollment Period (OEP):

Some guy, November 5th, 2023:

Back in April, the Associated Press reported that the Biden Administration planned on opening up eligibility for ACA exchange, Basic Health Program, Medicaid & CHIP coverage to hundreds of thousands of Americans who have Deferred Action of Childhood Arrivals status:

President Joe Biden is set to announce that his administration is expanding eligibility for Medicaid and the Affordable Care Act’s health insurance exchanges to hundreds of thousands of immigrants brought to the U.S. illegally as children, according to two U.S. officials briefed on the matter.

Oh wow...this is a blast from the past. I'm gonna have to essentially repost much of a blog entry from August 2018 to provide the backstory:

[In 2017], Virginia residents experienced massive amounts of heartburn and ulcers as two major insurance carriers, Optima (Sentara Health) and Anthem (HealthKeepers) played musical chairs with both their 2018 rate filings and which areas of the state they offered plans on.

In May 2017, things didn't look too bad: Both Anthem and Optima were available in fairly large chunks of the state, and while Anthem wanted to raise rates an ugly 38% on average, Optima was only looking to increase rates by around 10-11%.

Ten years ago, during the very first ACA Open Enrollment Period, Oregon was one of 15 states which attempted to operate their own fully state-based marketplace SBM) under the new law, calling it "Cover Oregon."

Cover Oregon was, along with several of the other original SBMs in Nevada, Maryland, Hawaii and (surprisingly) Massachusetts, a complete and utter failure. They flushed a stunning $248 million down the drain on a website portal which, put simply...didn't work. Like, at all. From April 2014:

Cover Oregon poised to switch to federal insurance exchange

Alex Pettit, the state's top information-technology official, recommended Cover Oregon move to the federal exchange at an advisory committee meeting Thursday.

Oregon should pull the plug on the beleaguered Cover Oregon health insurance exchange and switch to the federal exchange, a technological advisory committee recommended Thursday.

The move is considered almost certain to be adopted by the Cover Oregon board, which meets Friday.

New York State of Health

I'm a bit late following up on this, but since New York State of Health isn't launching their 2024 ACA Open Enrollment Period until tomorrow anyway (Nov. 16th...every other state already started theirs on Nov. 1st or earlier), it's still timely.

Two weeks ago a Twitter follower of mine gave me a heads up:

The letter I received had the Essential Plan at 250%. My Navigator told me it was a mistake and pending approval? DM me for specifics

This is definitely cause for concern, since New York's Essential Plan is only available to NY residents who earn between 138 - 200% of the Federal Poverty Level ($29,160/yr for a single adult, $60,000/yr for a family of four).

Sure enough, they sent me the full letter they received from New York State of Health (personal info redacted, of course):

via the Centers for Medicare & Medicaid Services (CMS):

Thanks to the Biden-Harris Administration’s efforts to strengthen maternal health, an estimated 641,000 Americans annually are now eligible for essential care for a full year after pregnancy.

Well, it's not much, but we have our first official 2024 ACA Open Enrollment Period enrollment report, out of Connecticut:

Via Access Health CT's News/Press Releases page:

Stats as of November 10, 2023

Qualified Health Plans (QHP):

  • QHP Enrollment In 2023 Coverage: 11,319
  • 2024 OE Acquisition Summary: 3,081

Medicaid:

  • Completed applications/redeterminations processed through the integrated eligibility system: 7,283

It's my understanding that "Acquisition Summary" refers to CT residents who are brand-new enrollees (never enrolled via the exchange before).

The report was posted this morning so it obviously only includes enrollment data through yesterday (Nov. 9th).

It's worth noting that last year, Access Health CT reported enrolling 10,011 people through Nov. 10th (one extra day since Nov. 1st fell on a Tuesday last year).

OK, there isn't supposed to be a formal Open Enrollment Period report out for another week, but President Biden just tweeted out a pretty impressive topline number for the first week of the 2024 ACA Open Enrollment Period:

In the first week of Open Enrollment, 1.6 million people have signed up for a plan at HealthCare.Gov, including 301,000 new consumers – that’s a 50% increase from last year.

Join them by visiting HealthCare.Gov today.

— President Biden (@POTUS) November 9, 2023

This is excellent news, but it does bear some analysis even without any additional details being included.

Originally posted 9/13/23; updated 11/08/23

via the Washington Insurance Dept.:

Fourteen health insurers have been approved to sell in Washington's 2024 individual health insurance market.  Insurers requested an average increase of 9.11% but 8.94% was approved. How much premium someone pays will depend on the plan they select, the number of people covered, their age, whether or not they smoke and where they live. 

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