Charles Gaba's blog

When I was in college at Michigan State in the early 1990's, there was a kid on my dorm floor who signed up for the old Columbia House CD* Club. For those of you too young to remember, here's how it worked:

Any music fan eager to bulk up their collection in the ’90s knew where to go to grab a ton of music on the cheap: Columbia House. Started in 1955 as a way for the record label Columbia to sell vinyl records via mail order, the club had continually adapted to and changed with the times, as new formats such as 8-tracks, cassettes, and CDs emerged and influenced how consumers listened to music. Through it all, the company’s hook remained enticing: Get a sizable stack of albums for just a penny, with no money owed up front, and then just buy a few more at regular price over time to fulfill the membership agreement. Special offers along the way, like snagging discounted bonus albums after buying one at full price, made the premise even sweeter.

The data below comes from the GitHub data repositories of Johns Hopkins University, except 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.

Note that a few weeks ago I finally went through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.

With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, October 10th (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District

Way back in May (a lifetime ago!), the Oregon Insurance Dept. was one of the first states to release their preliminary 2021 ACA premium rate filings for the individual and small group markets.

At the time, the carriers were asking for a weighted average 2.4% increase on the indy market (OR DOI put it at 2.2%) and a 4% increase for small group policies.

They issued some slightly revised rates later on in the summer, and sometime in August I believe they issued the final approved rates...which are just slightly lower on a few carriers.

In the end, 2021 Oregon enrollees are looking at weighted average premium hikes of 2.1% for indy plans and 3.7% for small group policies:

Back in early August, Covered California issued an extensive analysis of their upcoming 2021 individual market offerings, including the preliminary weighted average premium rate changes of just a 0.6% increase. Officially, this was just the average of the preliminary requests; the approved rates were presumably forthcoming at a later date.

Well, the 2021 Open Enrollment Period has technically already started in California...while new enrollees still have to wait until November 1st, current CoveredCA enrollees have apparently been able to re-enroll for 2021 since October 1st! (In previous years, CoveredCA opened up the renewal period starting on Oct. 15th)

A month ago the Oklahoma Insurance Department posted the preliminary 2021 individual & small group market rate filings, including the following press release:

Oklahoma Consumers to Have More Health Options for 2021 ACA Plans

OKLAHOMA CITY – Insurance Commissioner Glen Mulready announced today the 2021 preliminary rate filings for health insurance plans under the Affordable Care Act (ACA). Insurers that currently offer coverage through the Oklahoma Marketplace filed plans requesting average statewide increases of 2.7 percent.

In August, the Nevada Insurance Dept. issued their preliminary 2021 rate filings for the individual and small group markets. Unfortunately, while the filing summaries were easy to find, the actual enrollment numbers weren't. As a result, I only had the department's press release to go on for the weighted overall average on the individual market, and I had to go with an unweighted average for the small group market.

Fortunately, now that the NV Insurance Dept. has issued the approved 2021 rates, they've also added more detailed summaries for both markets, meaning I have effectuated enrollments for every carrier. This allows me to run a proper weighted average rate change across both:

Back in June, Maryland's Insurance Dept. posted the preliminary 2021 rate requests for the individual and small group markets. At the time, carriers were seeking an average 4.8% premium reduction on the individual market and a 5.1% average increase for the small group market.

Recently, state regulators posted the approved rate changes for each, and the final 2021 rates have been reduced from the original requests:

Governor Hogan Announces Third Consecutive Year of Lower Individual Health Insurance Premiums

In early August, the Kentucky Insurance Dept. posted preliminary 2021 rate filings for the individual and small group markets. At the time, the carriers were requesting average increases of 11.6% on the individual market (unusually high this year) and 9.7% for the small group market.

More recently, they posted the approved 2021 rate changes, and the individual market hikes have been cut by more than half, to just a 5.0% increas on average.

Small Group plans have also been shaved down slightly, from a 9.7% average increase to 8.8%.

Normally by early October I have the preliminary rate filings analyzed & posted for nearly every state and the approved rate changes for at least half of them. This year I'm lagging way behind for several reasons, some personal, some professional.

Having said that, I'm trying to play catch-up this week. Case in point, today I'm posting Iowa's preliminary individual and small group market filings for 2021.

Wellmark is dropping their premiums by a jaw-dropping 42% next year, which would normally be a huge story except that they only have around 3,000 Iowans enrolled to begin with (which may explain the massive rate drop, of course). Oscar Insurance appears to be expanding into the Iowa individual market, while Medica continues to hold nearly 95% of the market and is only raising premiums by around 2.5%. Overall, 2021 rates are essentially flat on averae.

The small group market is much the same...there's a bunch of carriers which only have a few dozen enrollees statewide, and four which hold over 90% of the market share (realistically more like 2-3 carriers depending on how you define UnitedHealthcare and Wellmark subsidiaries).

"If you have a pre-existing condition...heart disease; diabetes; breast cancer...they're coming for you. If you love someone who has a pre-existing condition...they're coming for you. If you're under the age of 26 on your parents' coverage...they're coming for you."

Wednesday night's Vice-Presidential debate between Kamala Harris and Mike Pence wasn't as bad as last week's dumpster fire of a Presidential "debate" between Donald Trump and Joe Biden. The questions were mostly better, and neither Pence nor Harris screamed at each other. On the other hand, the moderator did a terrible job of cutting Pence off when he ran over his time limit or interrupted Harris, and just as importantly, Pence flat-out refused to answer most of the questions at all, often instantly changing the subject to whatever he happened to feel like talking about with zero pushback from moderator Susan Page.

The Delaware Insurance Dept. has posted the approved 2021 individual market rates and it's about as unexciting as you can imagine: There's a single carrier in the state (Highmark BCBS), which asked for a 0.5% average premium reduction and was approved for...a 1.0% average premium reduction. Unsubsidized Delaware enrollees will average around $80 in savings per year.

In early August, the Arkansas Insurance Dept. posted the preliminary 2021 rate filings for the individual & small group market. At the time, the carriers were requesting average increases of 7.0% for ACA indy market plans and a slight drop of 0.3% for the small group market.

The approved rate filings have now been published, and the increases have been cut in half on the individual market to just 3.4%, while the small group market is slightly lower still (-0.4%) due to a revision in the estimated number of current enrollees:

2021 Minnesota health insurance rates continue to show stability for another year; expanded consumer choice across the state

ST. PAUL, Minn.—The Minnesota Department of Commerce announced final 2021 Minnesota health insurance rates today, which will remain stable across the state. For the 2021 plan year, 80 counties have three or more health insurance companies offering plans on the exchange, compared to just 31 counties with three or more in 2020. Ninety-seven percent of Minnesotans buying health insurance through MNsure will have an average of 30 different qualified health plans and three or more carriers to choose from.

Five health insurance companies are partnering with MNsure for the 2021 plan year: BluePlus, HealthPartners, Medica, UCare, and newly added Quartz, a Madison-based insurer offering plans in some southeastern Minnesota counties. Quartz will be offering 14 qualified health plans on the exchange. Additionally, dental plans will be available from Delta Dental and Dentegra.

The data below comes from the GitHub data repositories of Johns Hopkins University, except 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.

Note that a few weeks ago I finally went through and separated out swing districts. I'm defining these as any county which where the difference between Donald Trump and Hillary Clinton was less than 6 percentage points either way in 2016. There's a total of 198 Swing Counties using this criteria (out of over 3,200 total), containing around 38.5 million Americans out of over 330 million nationally, or roughly 11.6% of the U.S. population.

With these updates in mind, here's the top 100 counties ranked by per capita COVID-19 cases as of Saturday, October 3rd (click image for high-res version). Blue = Hillary Clinton won by more than 6 points; Orange = Donald Trump won by more than 6 points; Yellow = Swing District

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