Charles Gaba's blog

This Just In via the New Hampshire Insurance Dept...

Governor Sununu and NH Insurance Department Announce Plan to Reduce Premium Rates, Improve Individual Health Insurance Market

CONCORD, NH – Today, Governor Chris Sununu is announcing that the New Hampshire Insurance Department intends to file a Section 1332 State Relief and Empowerment Waiver application with the federal government to promote stability in the state’s individual health insurance market with an expectation that plan year 2021 premiums will be reduced by approximately 15% over what they would have been otherwise.

Someone pointed me towards an official ACA Open Enrollment report for the DC Health Link from a few days ago. There's a bunch of demographic data broken out, but the bottom line is:

  • 18,611 people have selected individual market Qualified Health Plans (QHPs) for 2020
  • Officially, this is down over 5% vs. last year...however...
  • ...the final official total for the 2019 Open Enrollment Period was only 18,035 due to some last-minute clerical error corrections and/or purging of last-minute cancellations.

...which means that at least for the moment, DC is up 3.2% year over year.

Remember, DC residents can still #GetCovered through the end of January for coverage starting in either February or March, so this number should increase a bit more yet.

The FINAL 2020 Open Enrollment Period data for the 38 states hosted by HealthCare.Gov was released yesterday, shaving around 17,000 enrollees off of the semi-final report issued before Christmas. In addition, final 2020 OEP numbers have now been released by Idaho, Maryland, Minnesota, Nevada and Washington State.

Incomplete numbers have been released for California, Colorado, Connecticut, the District of Columbia, Massachusetts and New York, all of which still have ongoing Open Enrollment, and I'm still waiting on any enrollment data for Rhode Island or Vermont.

With all that in mind, here's a state-by-state breakout showing where things stand as of today, Jaunary 9th. The states have been sorted from worst-performing to best, although obviously the 8 states with partial or no data are misleading (vice-versa for the bar graph).

Last year, California passed several important bills related to expanding coverage in their ACA exchange, Covered California. Two of the biggest changes were the expansion of subsidies to middle-class enrollees earning 400-600% FPL (as well as enhancing subsidies for existing enrollees), and the reinstatement of the individual mandate penalty (the revenue from which is actually supposed to be used to help finance the expanded subsidies).

Just before Christmas, I noted that there may be a major awareness problem with the first of these:

Again, there's still another five full weeks of Open Enrollment in California (six, if you include the missing data from last week). As I've noted, they'll have to add at least 134,000 total enrollees to beat last year, or nearly 200,000 to beat their all-time high. From the looks of things, they're on track to hit that 615K figure in the 200-400% range, but the 400-600% range is gonna be a much steeper climb...which is ironic since that's the population which is eligible for the most dramatic price cuts.

Last month the Washington Healthplan Finder, which bumped out their 2020 Open Enrollment Period deadline by a couple of weeks to 12/30, announced that they had enrolled 210,000 people in medical Qualified Health Plans (QHPs) as of 12/19.

Today they issued their final report through the extended 12/30 deadline. While they did tack on a few thousand more people, total enrollments still came up about 3.7% short of the previous year:

Washington Healthplanfinder Sees More Than 212,000 Sign Ups During 2020 Open Enrollment Period

OLYMPIA, Wash.

Washington Health Benefit Exchange (Exchange) today announced more than 212,000 customers selected a 2020 health plan through Washington Healthplanfinder, the state’s online health insurance marketplace. The total number was slightly lower, 3.8 percent, than the nearly 221,000 selections last year.

Even as I'm typing this, Democratic (!) Kansas Governor Laura Kelly and Republican legislative leaders are holding a press conference to announce an agreement to finally expand Medicaid under the ACA:

TOPEKA, Kan. (KWCH) Gov. Laura Kelly and Republican leadership announce an agreement on Medicaid expansion in Kansas.

During a press conference on Thursday, the governor said the program would be funded by the hospital administrative fee. At this time, it's unknown if that fee would be passed on to patients.

Kelly said the hospitals have endorsed the program.

Kansas Senate GOP Majority Leader Jim Denning said the bill would be pre-filed on Thursday with 22 co-sponsors.

If passed in the Kansas Senate and House, the full expansion would go into effect no later than Jan. 1.

(Obviously that's January 1st of 2021 at this point, of course)

Here's some live tweeting of the event by a Kansas-based political reporter:

Earlier today, CMS quietly issued the FINAL 2020 Open Enrollment Period HealthCare.Gov "Snapshot Report":

Final Snapshot: Nov 1-Dec 21

Approximately 8.3 million people selected or were automatically re-enrolled in plans using the HealthCare.gov platform during the 2020 open enrollment period.

These snapshots provide point-in-time estimates of weekly plan selections, call center activity and visits to HealthCare.gov or CuidadoDeSalud.gov. The final snapshot reports new plan selections, active plan renewals and automatic enrollments. It does not report the number of consumers who paid premiums to effectuate their enrollment.

As we do each year, CMS also plans to release a detailed 2020 final enrollment report in March, including final plan selection data from State-based Exchanges that do not use the HealthCare.gov platform.

I just received the following 2020 Open Enrollment report from the Massachusetts Health Connector (via email, no link):

Here are numbers as of yesterday:

  • We have 290,769 members enrolled in January coverage
  • We have 4,444 members enrolled in February or March coverage
  • We have 5,270 plans selected (1st premium not paid yet)
  • That’s a total of 300,483 people
  • We have 41,477 new enrollments.

I wish every ACA exchange would break out their numbers this way. Simple and to the point, but also with relevant details...not only "renewals vs. new" but also how many are enrolled for January vs. February or March coverage and even how many have/haven't paid yet! The last is a bit unfair since Massachusetts is one of only two states, I believe, which actually handle premium payments (Rhode Island does as well...Washington State used to but doesn't anymore).

This Just In via email...

Your Health Idaho enrolls 89,000 Idahoans for 2020 health insurance coverage

  • Idaho exchange sees increase in new customers as overall enrollments decline amid Medicaid expansion

BOISE, Idaho – More than 89,000 Idahoans signed up for 2020 health insurance coverage through the state insurance exchange, Your Health Idaho, during open enrollment which ended Dec. 16, 2019.

Enrollments are down approximately 14,000 from the same time last year. This decline is largely due to Medicaid expansion and was expected by the exchange. Your Health Idaho originally estimated that around 18,000 individuals would move from the exchange to Medicaid under the newly expanded program. 

Maine Governor Janet Mills had already announced her intentions regarding moving Maine to a state-based ACA exchange last fall, but now she and state legislative leaders are making it official with the rollout of a new bill...but they're including several other important improvements as well, and I'm mostly cheering all of these, although the logic is a bit confusing on a couple of points:

Mills, Jackson & Gideon Announce Bill to Improve Health Insurance for Maine People and Small Businesses

Augusta, MAINE – Governor Janet Mills, Senate President Troy Jackson, and Speaker of the House Sara Gideon today announced legislation to improve private health insurance for Maine people and small businesses. LD 2007, The Made for Maine Health Coverage Act, would make some of the most common medical visits free or less costly, simplify shopping for a plan, leverage federal funds to help make premiums more affordable for small businesses, and put Maine in the driver’s seat to ensure that all Maine people have clear choices for their coverage.

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